Rheumatoid arthritis - symptoms and treatment, folk remedies

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Rheumatoid arthritis is a systemic disease of unknown etiology with a common defeat of connective tissue, mainly in the joints, with erosive changes in them, with chronic, often relapsing and progressive course. The trigger mechanism can be an infectious focus, a cold, a trauma.

Pathological process leads to complete destruction of articular tissues, to gross deformities and development of ankylosis, which leads to loss of joint function and disability.

In severe cases, internal organs( heart, kidneys, lungs, blood vessels, muscles, etc.) can be affected, which significantly worsens the prognosis for rheumatoid arthritis. Symptoms, diagnostics and treatment methods of which we will discuss in detail in this article.

Statistics of

The prevalence of rheumatoid arthritis among adults in different climatogeographic zones of averages 0.6 to 1.3% of .The annual incidence rate for the last decade remains at the level of 0.02%.

There is an increase in rheumatoid arthritis with age, more often women are sick than men. Among those under the age of 35, the prevalence of the disease is 0.38%, at the age of 55 and over - 1.4%.A high incidence of the disease was detected in relatives of patients of the first degree of kinship( 3.5%), especially in female patients( 5.1%).

What is this: the causes of

Why does rheumatoid arthritis occur, and what is it? Rheumatoid arthritis refers to autoimmune diseases, that is, diseases that occur when the normal functioning of the immune system is disrupted. As with most autoimmune pathologies, the exact cause of the disease has not been identified.

It is believed that the provoking factors for the onset of the disease are:

1. Genetic predisposition of - in close relatives of patients with rheumatoid arthritis this disease develops much more often.
2. Infections - often arthritis occurs after suffering measles, herpetic infection, hepatitis B, mumps.
3. Adverse factors of external and internal environment - hypothermia, exposure to toxic products, including occupational hazards, stress, as well as pregnancy, breast-feeding, menopause.

Under the influence of these factors, the cells of the immune system begin to attack the cells of the joint membrane, which causes inflammation in them. As a result of this process, the joints swell, become warm and painful when touched. Cells of the immune system also cause damage to the blood vessels, which explains the so-called extraarticular symptoms of rheumatoid arthritis.

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis( Still's disease) is an inflammatory disease of the joints, it is characterized by a progressive course with a fairly rapid involvement in the process of internal organs. For 100 000 children, this disease occurs in 5-15 people.

There is a disease in children under 16 years old and can last for many years. The appearance of the disease can be the result of different effects - viral and bacterial effects, cooling, drugs, increased sensitivity to certain environmental factors and many others.

First signs of

Rheumatoid arthritis can begin acutely and subacute, and the last version of the debut is observed in most cases.

First signs of RA:

• chronic fatigue;
• permanent muscle weakness;
• weight loss;
• the appearance of muscle pain for no apparent reason;
• sudden and causeless temperature jumps to a subfebrile level( 37-38 ° C);
• increased sweating.

As a rule, such manifestations of the disease are left unaddressed, further articular syndrome and extra-articular manifestations of the disease develop.

Symptoms of rheumatoid arthritis: joint damage

In the case of rheumatoid arthritis, when examining a patient's complaints, special attention is paid to such symptoms:

1. Joint pain, their character( aching, gnawing), intensity( strong, moderate, weak), duration( periodic, constant), connection with movement;
2. Morning stiffness in the joints, its duration;
3. Appearance of joints( swelling, redness, deformity);
4. Strong restriction of joint mobility.

The patient with rheumatoid arthritis can also note the presence of other symptoms:

1. Hyperemia of the skin over inflamed joints;
2. Atrophy of adjacent muscles;
3. With subluxations in proximal interphalangeal joints, the wrist has the form of a "swan neck", with subluxations in the metacarpophalangeal joints - "walrus fins".

At palpation it is possible to find out: increase of skin temperature above a surface of joints;soreness of the affected joints;symptom of "lateral compression";muscle atrophy and skin tightening;subcutaneous formations in the region of the joints are more often ulnar, the so-called rheumatoid nodules;a symptom of ballotation of the patella to determine the presence of fluid in the knee joint.

Depending on clinical and laboratory data, there are 3 degrees of exacerbation of RA:

1. Low ( pain in the joints is assessed by the patient no more than 3 points on a 10-point scale, morning stiffness lasts 30-60 minutes, ESR 15-30 mm /CRP - 2 plus);
2. Average ( pain - 4-6 points, joint stiffness up to 12 hours after sleep, ESR - 30-45 mm / h, SRB - 3 plus);
3. High ( pain - 6-10 points, stiffness is observed throughout the day, ESR - more than 45 mm / h, SRB - 4 plus).

In RA, first of all, peripheral joints suffer, but we must not forget that this is a systemic disease, and any organs and tissues with connective tissue can be involved in the pathological process.

Extra-articular symptoms in rheumatoid arthritis

The development of extra-articular( systemic) manifestations is more typical for the seropositive form of rheumatoid arthritis of severe long-term course.

1. The defeat of the musculature is manifested by atrophy, decreased muscle strength and tone, focal myositis.
2. Skin lesions of are manifested by dryness, thinning of the skin, subcutaneous hemorrhage and small focal necrosis.
3. Infringement of blood supply to nail plates leads to their fragility, striation and degeneration.
4. Presence of rheumatoid nodules - subcutaneously located connective tissue nodules 0.5-2 cm in diameter. The round shape, dense consistency, mobility, painlessness, less often immobility due to adhesion to the aponeurosis is characteristic.
   The presence of rheumatoid vasculitis, which occurs in 10-20% of cases.

The most severe course of rheumatoid arthritis is characterized by forms that occur with lymphadenopathy, gastrointestinal tract damage( enetrites, colitis, amyloidosis of rectum mucosa), nervous system( neuropathy, polyneuritis, functional autonomic disorders), respiratory involvement( pleurisy, diffuse fibrosis, pneumonitis, fibrosisalveolitis, bronchiolitis), kidneys( glomerulonephritis, amyloidosis), the eye.

From the side of the main vessels and the heart with rheumatoid arthritis, endocarditis, pericarditis, myocarditis, arteritis of the coronary vessels, granulomatous aortitis can occur.

Complications of

• cardiovascular system pathology;
• dysfunction of the nervous system;
• blood disease;
• of the respiratory system;
• kidney disease;
• affection of joints and musculoskeletal system;
• of skin lesions;
• of eye disease;
• dysfunction of the gastrointestinal tract;
• mental disorders;
• other pathologies.

How to distinguish RA from other diseases?

In contrast to rheumatism, with rheumatoid arthritis inflammation has a persistent character - the pain and swelling of the joints can last for years. From arthrosis this type of arthritis differs in that the pain does not increase from the load, but, on the contrary, decreases after active movements.

Diagnosis

Criteria for diagnosis of rheumatoid arthritis of the American Rheumatology Association( 1987).The presence of at least 4 of the following signs may indicate the presence of the disease:

• morning stiffness for more than 1 hour;
• arthritis of 3 or more joints;
• arthritis of the joints of brushes;
• Symmetric Arthritis;
• rheumatoid nodules;
• is a positive rheumatoid factor;
• radiologic changes.

The blood test shows the presence of inflammation in the body: the appearance of specific inflammation proteins - seromucoid, fibrinogen, C-reactive protein, as well as rheumatoid factor.

The diagnosis of rheumatoid arthritis is possible only when assessing the entire body of symptoms, radiographic signs and laboratory diagnostic results. If the result is positive, treatment is prescribed.

Treatment of rheumatoid arthritis

In case of an accurate diagnosis of rheumatoid arthritis, systemic treatment involves the use of certain groups of drugs:

• non-steroidal anti-inflammatory substances;
• basic preparations;
• hormonal substances( glucocorticoids);
• biological agents.

At the current stage of medical development, the following goals are set for the treatment of rheumatoid arthritis:

• reduction and, if possible, elimination of symptoms of the disease,
• prevention of destruction of joint tissues, disruption of its function, development of deformities and adhesions( ankyloses),
• achieving persistent and prolonged improvementstatus of patients,
• increase in life span,
• improvement in quality of life indicators.

Treatment consists of a set of methods of drug therapy, physiotherapy, therapeutic nutrition, surgical treatment, sanatorium treatment and subsequent rehabilitation.

Non-steroidal anti-inflammatory drugs

This group of drugs is not included in the basic therapy of rheumatoid arthritis, since it does not affect the destructive process in the joints. Nevertheless, drugs from this group are prescribed to reduce pain and eliminate the stiffness of
in the joints. Most often used:

• diclofenac;
• ibuprofen;
• nimesil;
• movalis;
• indomethacin;

Appointed during a period of exacerbation of pain and severe stiffness. Caution is given to patients with gastritis.

Basic preparations

In combination with hormones contribute to a decrease in the activity of rheumatoid arthritis. The most common drugs for treatment currently are:

• gold preparations;
• methotrexate;
• leflunomide;
• penicillamine;
• sulfasalazine.

There are also reserve resources: cyclophosphamide, azathioprine, cyclosporine - they are used when the basic drugs did not give the desired effect.

Biological agents

Monoclonal antibodies to some cytokines provide neutralization of tumor necrosis factor, which in case of rheumatoid arthritis provokes the destruction of own tissues.

There are also studies suggesting the use of regulators of lymphocyte differentiation as a treatment for rheumatoid arthritis. This will avoid damage to the synovial membranes of T-lymphocytes, which are incorrectly "directed" to the joints by immunity.

Glucocorticoids

These are hormonal preparations:

• prednisolone;
• dexamethasone;
• methylprednisolone;
• triamcinolol;

Assign both in the presence of systemic manifestations of the disease, and in their absence. Today, in the treatment of rheumatoid arthritis, both small and large doses of hormones( pulse therapy) are treated. Corticosteroids perfectly stop the pain syndrome.

Methotrexate in rheumatoid arthritis

According to reviews, methotrexate in rheumatoid arthritis is actively prescribed in Russia and European countries. This drug, which inhibits the cells of the immune system, prevents the occurrence of inflammatory processes in the joints and aggravation of the course of the disease. Now it is used very widely.

The drug has several side effects, so it is used under the close supervision of the attending physician, during the course of treatment the patient must regularly take blood tests. Despite this, methotrexate in rheumatoid arthritis is the most appropriate solution, in some cases it is simply irreplaceable.

The price of the drug varies depending on the form of release in the range from 200 to 1000 rubles.

Physiotherapy

Only after the acute form of the disease has been removed, blood tests and temperature are normalized - you can apply massage and other methods of physiotherapy with rheumatoid arthritis. The fact is that physiotherapy has a stimulating effect and can enhance the inflammatory process.

These methods improve the blood supply of joints, increase their mobility, reduce deformation. Phonophoresis, diathermy, UHF, ozocerite and paraffin are applied, infrared irradiation, therapeutic mud, balneotherapy at resorts. We will not elaborate on these methods in detail.

Operation

Surgical surgery can correct a health situation in the relatively early stages of the disease if one large joint( knee or wrist) is constantly inflamed. During such an operation( synovectomy), the synovial membrane of the joint is removed, resulting in long-term relief of symptoms.

Joint surgery is performed for patients with a more severe degree of joint damage. The most successful operations are on the hips and knees.

Surgical intervention has the following objectives:

• relieve pain
• to correct deformities of
• to improve the functional state of the joints.

Rheumatoid arthritis is primarily a medical problem. Therefore, a surgical operation is appointed for those who are under the supervision of an experienced rheumatologist or doctor.

Nutrition

In rheumatoid arthritis, a special diet is recommended, which will reduce inflammation and correct metabolic disturbances.

The rules of the diet are as follows:

• including a sufficient number of fruits and vegetables;
• reduces the burden on the kidneys, liver and stomach;
• exclusion of products that cause allergies;
• replacement of meat with dairy and plant products;
• use of foods with high calcium content;
• rejection of food that causes excess weight.

Rheumatoid arthritis treatment with folk remedies

Treatment with folk remedies involves the use of medicinal plants that have analgesic and anti-inflammatory properties.

1. To alleviate pain in rheumatoid arthritis, should be taken equally with elderberry flowers, parsley root, dense nettle leaf and willow bark. Grind everything, and then 1 tablespoon of the collection to brew with a glass of boiling water, then boil for 5-7 minutes on low heat, after cooling and drain. Take two cups of broth, morning and evening.
2. Collected during flowering chestnut flowers are filled with quality vodka( two parts of flowers should take one part of the vodka).The mixture is infused for two weeks in a dark place, filtered and then the tincture is ready for use. Take tincture you need 5 drops three times a day for an hour before meals.
3. In a hundred grams of alcohol, dissolves 50 grams of camphor oil and adds 50 grams of mustard powder .The protein is whipped separately from the two eggs and added to the mixture. The resulting ointment is rubbed into the affected joint and relieves painful symptoms well.
4. Relieving joint pain will help the burdock .It can be used in the form of tinctures. Grind the leaves of the plant in a meat grinder and fill it with vodka( for 500 grams of leaves 500 ml of vodka).The mixture is shaken and placed in the refrigerator. At night, apply a lot of water wet in this solution gauze to a painful place. The pain after several compresses passes. Treatment of rheumatoid arthritis with folk remedies can also be carried out with wraps for the night with whole leaves of burdock.

At home, you can do compresses, rub your own ointments, prepare broths. It is important to observe the right style of nutrition, which helps to restore metabolism in the body.

Prevention

Prevention of the disease and its exacerbations is primarily aimed at eliminating risk factors( stress, smoking, toxins), normalizing body weight and maintaining a balanced diet.

Compliance with these rules will help to avoid disability and prevent rapid progression of RA.

Forecast

Rheumatoid arthritis reduces life expectancy on average from 3 to 12 years. A 2005 study conducted by the Mayo Clinic showed that the risk of heart disease is twice that of those suffering from rheumatoid arthritis, regardless of other risk factors such as diabetes, alcoholism, high cholesterol and obesity.

The mechanism, which increases the risk of heart disease, is unknown;The presence of chronic inflammation is considered a significant factor. Perhaps the use of new biological drugs can increase life expectancy and reduce risks for the cardiovascular system, as well as slow the development of atherosclerosis.

Limited studies demonstrate a reduction in the risk of cardiovascular disease, with an increase in total cholesterol with an unchanged atherogenic index.