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A complete overview of rheumatoid arthritis: symptoms, diagnosis and treatment. How to get rid of rheumatoid arthritis: principles of therapy

» What joints are affected by rheumatoid arthritis

Rheumatoid arthritis is a dangerous disease with a wide area of damage, including not only joints, but also the main systems of human life, which is why it is called systemic. Therefore, it is extremely important to recognize its earliest symptoms. The first signs of pathology are still reversible, but chronic pathology is much more difficult to treat, and it can lead to destruction of joints and other organs and an unfavorable prognosis. How to treat rheumatoid arthritis - this is what the pages of this article are devoted to.

I="">Causes of rheumatoid arthritis

According to the classics in medicine, the following possible causes of the disease are distinguished:

Autoimmune processes, the mechanism of which is activated under the influence of genetic factors
Infectious factors:

These may be viruses of the following diseases:

measles, mumps, acute viral infection
hepatitis B
herpes, Eppstein-Barr virus
herpes zoster
retroviral infection leading to malignant tumors in the lymphatic and circulatory systems

The fact that rheumatoid arthritis could be caused by some kind of infection is indicated by a reactive reaction of increased erythrocyte sedimentation rate. But the bacterial therapy used too often does not bring results, which gives some reason to doubt the reliability of the infectious theory.

Provoking factors):

hypothermia or sunstroke

intoxication

taking mutagens:

for example, colchicine in the treatment of gout

cytostatics for the treatment of tumor processes

immunosuppressants used in organ transplants

endocrine system diseases

stress

Stages of rheumatoid arthritis

The disease rarely manifests itself in all its multiple symptoms at once.

In the first stage, local swelling and pain occurs near the joint, and the temperature on the surface of the skin may also increase

Within a month and a half, these symptoms are reversible and can be easily treated with anti-inflammatory drugs

In the second stage, the joints become rougher, becoming larger:

This is due to progressive cell division, due to which the synovial membrane becomes inflamed and becomes denser

In the third stage, irreversible destruction of joints and deformation begins under the influence of protein enzymes secreted by the inflamed synovium

The photo shows the stages of rheumatoid arthritis:

I-3="">Disease symptoms

There is something common, regardless of the cause of arthritis - this is the presence of specific antibodies in the blood called rheumatoid factor.

To make a diagnosis, donating blood for a rheumatic test is the first prerequisite.

But rheumatoid factor itself does not mean the presence of arthritis, since it can be detected in some infectious diseases, chronic liver pathologies, and even in healthy people.

Rheumatoid arthritis, in addition to changes in blood tests, has its own clinical symptoms.

They can be divided into three groups:

General symptoms

Fatigue, weakness and weakness
Flu-like symptoms, including fever and joint pain
Dryness of the mucous membranes of the eyes and mouth
Depression and lack of appetite
Cold sweating

Joint symptoms

Pain at night and in the morning
Formation of nodules on joints according to a symmetrical type:

Initially, rheumatoid arthritis affects the small joints on both hands or feet, and then moves to larger ones.
The following types of joints are primarily affected:

second and third metacarpophalangeal
proximal interphalangeal
knee
wrist
elbow
ankle

The occurrence of contracture in the joint (limited range of motion)

Edema of the extremities

Deviation of the limbs from the axis of symmetry: for example, the fingers or toes deviate towards the little finger

In the photo - rheumatoid arthritis of the foot:

I-6="">Extra-articular symptoms

Rheumatoid arthritis gives rise to a simply enormous number of various symptoms and syndromes. The forms of its clinical manifestation are varied. This inflammatory joint disease affects:

On the cardiovascular and respiratory systems, causing:

Pericarditis, atherosclerosis, vasculitis, cardiac and respiratory failure, pleurisy, pneumofibrosis

Urinary system:

Nephritis, amyloidosis, nephropathy

Hematopoiesis:

Thrombocytosis, neutropenia, anemia

Nervous system:

Various types of neuropathy, mononeuritis, myelitis

Organs of vision:

Conjunctivitis, scleritis, ulcerative keratopathy

Skin surfaces:

Rheumatic nodules, hypotrophy, uneven mesh coloration of the skin

The photo shows the surface of the skin with a mesh pattern in rheumatoid arthritis:

I-7="">Types of rheumatoid arthritis

Rheumatoid arthritis in two thirds of cases is polyarthritis, that is, it affects many joints. Much less often, several or one joint is affected by the disease

Symptoms of the disease may be mixed or relate to a specific group of patients:

If both joints and organs are affected, this disease is called articular-visceral.
If the disease occurs before the age of 16 years, then such arthritis is called juvenile
The combination of several signs at once is called a syndrome.

Syndromes in rheumatoid arthritis

Still's syndrome:

Juvenile rheumatoid arthritis of seronegative type with erymatous rash, elevated leukocytes, ESR and enlarged lymph nodes

Pseudoseptic syndrome:

Fever with chills, increased sweating, muscle weakness and anemia predominate

In the background are symptoms of arthritis

Allergoseptic syndrome:

The onset of the disease is rapid:

Temperature up to 40 °C, polymorphic rash, arthralgia, swelling of joints

Possible heart problems and liver enlargement

This syndrome is characteristic of juvenile arthritis

Felty's syndrome:

Polyarthritis is combined with splenomegaly (enlarged spleen)

A variant without splenomegaly is possible, but with a decrease in leukocytes, neutrophils and inflammation of internal organs (visceritis)

The disease is usually combined with skin ulceration and respiratory tract infection

In the photo - Felty's syndrome:

I-9="">Diagnosis of the disease

Making an accurate diagnosis is difficult, since rheumatoid arthritis in its symptoms resembles many diseases:

Rheumatism
Gout
Infectious arthritis (gonococcal, syphilitic, chlamydial)
Reactive (Reiter's syndrome)
Lyme disease (borreliosis)

Of fundamental importance for diagnosis are:

Biochemical and general blood test:

with calculation of erythrocyte sedimentation rate (ESR) and platelets
determining the titer of antibodies to the cyclic peptide ACCP (rheumatoid factor)

Identification of markers of joint syndromes

General clinical signs

Specific signs:

Presence of nodules and typical deformities (eg, rheumatoid hand or foot)

Skin color

X-ray examination of joints

Diagnostics allows you to make a preliminary prognosis of the disease.

Adverse Signs

Unfavorable signs are considered:

Steady involvement of new joints with each new attack
Increase in ESR and antibody titers
Non-responsiveness of the patient to basic medications
Early and rapid destruction of joints, visible on x-ray

The photo shows an x-ray of the affected joint:

I-11="">Treatment of rheumatoid arthritis

If an injection is detected during diagnosis, then antibacterial treatment is prevailing.

I-12="">Selection of NSAIDs and GCS

If symptoms of articular manifestations predominate, select an appropriate non-steroidal anti-inflammatory drug (NSAID) or glucocorticosteroids (GCS)

Of course, you can choose aspirin, diclofenac, and ibuprofen, which are COX-1 inhibitors (cyclooxykenase, which synthesizes prostaglandins, which are responsible for inflammation).
But the duration of treatment for arthritis dictates the need to take drugs from this series that are less harmful to the gastrointestinal tract, which include COX-2 inhibitors:

Movalis (meloxicam), nimesulide, celecoxib

At the same time, injections of glucocorticosteroids are administered into the affected joints

In case of predominance of inflammatory processes, GCS can be used as a means of systemic rather than local treatment

The best long-acting drug for the treatment of rheumatoid arthritis is betameson (diprospan)

Basic drugs

NSAIDs and corticosteroids can help with the early stages of rheumatoid arthritis. They also serve to relieve pain attacks. But for chronic arthritis, other, non-symptomatic remedies are needed.

Today, rheumatologists have somewhat changed the previous treatment regimen - moving from a gradual increase in doses of basic drugs to a sharp aggressive attack on the disease immediately after the diagnosis revealed rheumatoid arthritis. In some ways, this scheme is reminiscent of chemotherapy for oncology.

Such harsh treatment is justified when the consequences of the disease are worse than complications from medications.

The following drugs are used:

Sulfasalazine, penicillamine, leflunomide, aminoquinol, etc.

I-14="">Complex therapy

How to cure rheumatoid arthritis?

The treatment regimen is individual for each patient. After all, there is such a variety of symptoms:

For example, the content of leukocytes or neutrophils in the blood can be either increased or decreased
Both violent extra-articular manifestations in the form of fever, myotrophy, sweating, and their absence against the background of joint pain are possible
Absence or presence of visceral symptoms

However, the main thread of treatment is:

The use of NSAIDs and corticosteroids for exacerbation of pain and inflammation
Taking basic medications:

Methotrexate, sulfasalazine, D-penicillamine

Immunosuppressants - drugs that suppress the immune system, for example:

Cyclophosphomide, cyclosporine, azathioprine

Taking biological genetically engineered drugs:

Drugs that block harmful enzymes of the synovial membrane:

TNF (tumor necrosis factor) inhibitors:

infliximab, etanercept, etc.

B lymphocytes:

Actemra (tocilizumab), Mabthera (rituximab)

Surgical treatment

Surgical treatment of rheumatoid arthritis is used only if it is necessary to remove a completely destroyed joint or for its fusion.

Surgery becomes especially relevant for instability in the cervical spine that threatens the spinal cord.

The main surgical method is arthrodesis, that is, artificial ankylosis of the vertebrae.

Additional measures

In addition, to combat rheumatoid arthritis you need:

Physiotherapy (electro- and phonophoresis)
Therapeutic exercise
Prevention of osteoporosis:

taking calcium supplements to regulate this element in the body: in combination with vitamin D
food containing dairy products (cheese, cottage cheese, sour cream) and nuts

Elimination of risk factors

Sanatorium treatment

The influence of pregnancy on the course of the disease

Of course, for a young woman such a terrible disease looks like a tragedy, because treatment with basic drugs can lead to infertility and is unsafe for the health of the woman herself. Nevertheless, the desire to have a child turns out to be stronger. How do rheumatoid arthritis and pregnancy get along together?

https://www.youtube.com/embed/3kIh75hBLxE?feature="oembed="">

Joints often affected by rheumatoid arthritis are the wrists, hands, legs, and ankles. The disease can affect the elbow, shoulder, hip, knee, neck and jaw joints.

It usually affects joints on both sides of the body at the same time, such as the joints of both hands. The joints most often affected are the joints of the hands and feet.

Extra-articular signs and symptoms also occur in rheumatoid arthritis. Unlike osteoarthritis, which affects only the bones and muscles, rheumatoid arthritis can affect the entire body, including organs such as the heart, blood vessels, lungs and eyes. Rheumatoid arthritis causes changes in many joints at once, whereas osteoarthritis usually causes changes in only one or a few joints, even though several joints may be affected at once.

Small bumps called rheumatoid nodules form under the skin of the elbows, hands, knees, toes and back of the head. These nodules, usually painless, range in size from a pea to a walnut.

“Which joints are affected by rheumatoid arthritis” and other articles from the Arthritis section

Rheumatoid arthritis is a chronic systemic connective tissue disease that primarily affects the joints. This is one of the most serious diseases, affecting approximately 1% of the world's population.

Signs

Rheumatoid arthritis primarily affects small joints. Typically, the disease begins with inflammation of the metacarpophalangeal joints (located at the base of the finger) of the index and middle fingers and inflammation of the wrist joints. Moreover, this inflammation is symmetrical, that is, it develops on both hands at once. Joints swell and hurt. Moreover, the pain intensifies at night, in the morning, and until about noon the person suffers from unbearable pain. Patients themselves often compare this pain to toothache. However, by warming up or simply after any vigorous activity, the pain usually decreases. This is the difference between rheumatoid arthritis and arthrosis, in which pain intensifies due to physical activity. In the middle of the day the pain subsides and by evening it is almost unnoticeable.

Almost simultaneously with the damage to the joints of the hands, the joints of the feet also become inflamed. The joints at the base of the fingers are predominantly affected.

Pain and swelling may last for several months.

After some time, from several weeks to several months, larger joints become inflamed - ankle, knee, elbow, shoulder. However, in older people aged 65-70 years, the disease can begin with damage to large joints and only then inflammation of small ones occurs.

Another characteristic symptom of rheumatoid arthritis is morning stiffness. It can manifest itself as a feeling of a stiff body, and a feeling of tight gloves on your hands. Some patients feel as if their body is in a corset in the morning. In mild forms of the disease, this stiffness lasts about two hours after waking up; in severe forms, the stiffness can last throughout the first half of the day.

Joint deformity, which develops in the later stages of the disease, greatly affects the quality of life. It happens that the hands are fixed in an unnatural position and deviate outward. This is an ulnar deformity and develops 1-5 years after the onset of the disease. And it happens that the mobility of the wrist joints decreases. In this case, patients have to make great efforts to straighten or bend the hand at the wrist. Later, the mobility of other compounds also decreases.

Knee joints can not only become deformed. Quite often, fluid accumulates in the joint cavity. This is called a Baker's cyst. This cyst stretches the joint capsule, and in severe cases even ruptures it. Then the liquid pours into the soft tissues of the lower leg. In this case, swelling of the lower leg develops, and sharp pain appears in the leg.

It happens that not only the joints are affected, but also the spine. Moreover, the cervical spine is predominantly affected. In this case, patients complain of neck pain.

In severe cases, the cricoid-arytenoid joint may be affected. Then the sufferer’s voice becomes rougher, shortness of breath and dysphagia appear. When this joint is damaged, the patient increasingly develops bronchitis.

With rheumatoid arthritis, patients complain of constant weakness, loss of appetite, weight loss up to cachexia (extreme exhaustion), and poor sleep. The temperature rises to low-grade levels, this condition is accompanied by chills. However, in some cases the temperature may rise to 39°C. Rheumatoid nodules often form on the skin - dense, round formations the size of a pea. Most often they are located below the elbows, on the hands, and on the feet. There are usually not many nodules. They may disappear and reappear, or they may remain in place for many years. There is no harm to health from them, however, they spoil the patient’s appearance. However, in some cases, rheumatoid nodules may be localized in the lungs (Kaplan syndrome).

Rheumatoid nodules are an extra-articular manifestation of rheumatism, it can occur not only on the skin. The cardiovascular system may be affected, in which case vasculitis, pericarditis, and early atherosclerosis develop. The kidneys may be affected, in which case amyloidosis and, rarely, nephritis develop. There may be unpleasant complications from the blood - anemia, thrombocytosis, neutropenia. When the eyes are affected, keratoconjunctivitis, episcleritis or scleritis develops. The muscles and nervous system may also be affected.

Description

Rheumatoid arthritis is a rather serious disease, which in a few years turns an able-bodied person into a helpless disabled person. This disease continues for many years. Some suffer from it all their lives.

It is known that rheumatoid arthritis is an autoimmune disease. For some reason, a large number of immune complexes are formed in the body, which circulate in the blood and enter the joints, causing inflammation, which later leads to destruction. In addition, these immune complexes can attack other organs and tissues, leading to extra-articular manifestations of rheumatoid arthritis. Rheumatoid nodules are formed by an accumulation of immune cells and lymphocytes around a small area of dead tissue, but it is not known what attracted these cells there and what came first - tissue necrosis or accumulation of immune cells. And what contributes to the activation of lymphocytes is unknown. There are hypotheses that viruses, bacteria, allergies, injuries, heredity and many other factors are to blame for the development of this disease. The onset of the disease after severe stress is also possible.

There are many forms of rheumatoid arthritis:

acute polyarthritis , in which the joints of the hands and feet are predominantly affected, rheumatoid factor (autoantibodies to class G immunoglobulins) is often detected in the blood;
acute monoarthritis , in which large joints are affected;
symmetrical polyarthritis , which is characterized by a gradual increase in pain and stiffness in the small joints of the arms and legs;
monoarthritis of the knee or shoulder joints , in which the knee or elbow joints are first affected, and then the small joints of the feet or hands are affected quite quickly;
polyarthritis - a disease that mainly affects young people, which, in addition to joint pain, is characterized by fever, enlargement of the liver and spleen;
palindromic rheumatism – multiple recurrent attacks of acute symmetrical polyarthritis of the hands, lasting several hours or days and ending with complete recovery;
generalized myalgia It begins with stiffness, depression, carpal tunnel syndrome, muscle pain, and joint damage comes later.

There are also special clinical forms of rheumatoid arthritis:

Adult Still's disease, which is characterized by recurrent fever, arthritis, and skin rash;
Felty's syndrome, which is characterized by an enlarged liver and spleen, joint damage, hyperpigmentation of the skin of the legs, lung lesions, Sjögren's syndrome and frequent infectious complications.

With rheumatoid arthritis, osteoporosis develops. And depending on the condition of the bones, there are 4 stages of this disease:

Stage I, initial, which is characterized only by periarticular osteoporosis;
Stage II, in which the joint space narrows, but osteoporosis affects the bones only around the joint;
Stage III, which is characterized by all the signs of the second stage and bone erosion;
Stage IV combines signs of the third and ankylosis (complete immobility of the joint, resulting from any changes in it) of the bones.

You can find out what stage of the disease a patient has using an X-ray examination.

Rheumatism usually occurs in waves, with exacerbations and remissions. In less than 10% of cases with this disease there is spontaneous long-term remission . In 15% of cases there is intermittent flow , in which spontaneous or treatment-induced remissions alternate with exacerbations, during which previously unaffected joints are seized. In approximately 60% of cases, the course of the disease progressive . At the same time, new joints are constantly involved in the pathological process, and extra-articular manifestations are also characteristic of this course. In the remaining cases, the course of the disease rapidly progressive . This course is characterized by rapid development of the disease with severe extra-articular manifestations.

Diagnostics

The diagnosis is made by a rheumatologist. However, you may need to consult a neurologist and ophthalmologist. Typically, a physician will refer a patient to a rheumatologist if the characteristic symptoms last more than 6 weeks, more than three joints are inflamed, or morning stiffness lasts more than 30 minutes.

To make a correct diagnosis, it is necessary to do a general and biochemical blood test, and conduct a study of rheumatoid factors in the blood. The following studies are also prescribed:

Treatment

To treat rheumatoid arthritis, drugs that suppress the immune system are used. If the drug does not have an effect within three months, it is changed. This is basic therapy. Hormonal drugs are also used to relieve inflammation in the form of ointments, creams and tablets. Non-steroidal anti-inflammatory drugs can also be used to relieve inflammation.

Prevention of osteoporosis is also of great importance. For this purpose, special medications and a diet high in calcium are used.

The immune system can also be stimulated by physical methods:

plasmaphoresis, in which plasma with a large amount of rheumatoid factors is removed and donor plasma is administered to the patient;
lymphocytophoresis, in which lymphocytes and monocytes are removed from the blood using a centrifuge, which reduces blood reactivity and the degree of inflammation;
irradiation of lymphoid tissue, in which the lymph nodes, spleen, and thymus are sequentially irradiated;
drainage of the thoracic lymphatic duct, in which the lymph is centrifuged, the cellular sediment is separated, and the liquid part of the lymph is returned back to the lymphatic duct.

Physiotherapy is widely used to treat rheumatoid arthritis. At an early stage, laser therapy is indicated; however, a course of more than 15 procedures is not recommended. Ultraviolet irradiation and electrophoresis with dimethyl sulfoxide are also indicated in the early stages. Cryotherapy is often used to reduce pain.

At later stages, phonophoresis with hydrocortisone, pulsed currents and magnetic therapy are used.

Physical therapy is indicated to restore joint function.

Prevention

Prevention of rheumatoid arthritis is divided into primary and secondary. Primary prevention is measures aimed at preventing the disease. It consists of timely treatment of infectious diseases, as well as sanitation of foci of infection, for example, carious teeth. It is important to strengthen the body, toughen up, play sports and lead an active lifestyle, and, if necessary, take vitamins.

Secondary prevention involves preventing exacerbations and complications in those suffering from rheumatoid arthritis. It includes physical therapy and timely administration of necessary medications. It is also important to follow a diet. It is necessary to limit the consumption of fats, sugar, salt, eat more vegetables and fruits, dairy products, and cereals.

I never thought that I would go to doctors so much in search of the cause of my ill health. By my specialty, I am a nurse, and I hoped that by rotating in a medical environment, I would be able to cope with any abnormalities in the body. But making my correct diagnosis proved difficult even for experienced doctors.

It all happened 2 years ago. For a year I was painfully ill. Periodically, the joints on my legs became inflamed to the point of being unable to stand on my feet, my ankles became swollen, and then pain appeared in my spine, and this pain spread throughout my body. My hands became swollen and began to go numb. The pain was concentrated in the left hand, 3 fingers on it went numb. I turned to a massage therapist, who often saved me from exacerbation of osteochondrosis, I thought that was the reason. But there was no effect from the massage.

I went to see a therapist, who prescribed tests for me and referred me to a cardiologist. The cardiologist, in turn, did not find any abnormalities in the cardiological part and sent me to a surgeon. The surgeon goes back to the therapist. In the district consultation, I walked in circles, trying to find the cause of my condition. As a result, I was admitted to the cardiology department because my blood pressure had risen. There were no effects from treatment in the hospital.

Desperate, I even turned to an oncologist. My torment would have continued for a long time if one of the doctors had not advised me to go to a rheumatologist, which I did.

Finally, the rheumatologist made the correct diagnosis - rheumatoid arthritis. At this moment I was very worried about aching muscle pain. The joints of the feet and wrists were inflamed. There was constant pain in the joints, I could not even walk. The doctor prescribed treatment for 4 months, after which I felt better. Then life circumstances developed in such a way that there was no time to continue treatment for rheumatoid arthritis, and I felt so much better that I thought about healing. However, it turned out that this was my mistake, since rheumatoid arthritis is a chronic disease. If it appears once, you must always be on guard. The result of forgetting about my illness was a complication in the elbow and shoulder joints, the spine, with pain in which I now live constantly.

What is rheumatoid arthritis

Modern diagnostics can now easily identify rheumatoid arthritis in the initial stages. However, in district consultations it is often suggested at the very last moment, when there is already deformation of the joints.

Rheumatoid arthritis is a systemic connective tissue disease. The disease is chronic, infectious-inflammatory in origin, which affects both peripheral small joints and large joints such as our spine. In addition, the destructive processes are so strong that the joints can cease to perform their function until they become completely immobile. Among other things, rheumatoid arthritis can be considered an autoimmune disease. That is, the body’s defense system perceives its cells as foreign. It reacts to its own cells as to viruses and bacteria, directing its aggression towards its own body.

For many years, both in our country and abroad, they have been looking for ways to combat rheumatoid arthritis. It can have an acute onset or proceed in a sluggish form. Has no seasonality, i.e. appearance can be expected at any time of the year. Rheumatoid arthritis cannot be infected.

What can cause rheumatoid arthritis?

Injuries.
Various infectious diseases (sore throat, acute respiratory infections, any viral diseases - for example, herpes, rubella, hepatitis).
Decreased immunity, which is facilitated by acute and cumulative stress and depression.

Symptoms of rheumatoid arthritis

The disease begins differently in each case. Rheumatoid arthritis can begin acutely or subacutely (when one or 2 joints suddenly swell).
Appears joint pain, especially when walking. It may occur in the morning and especially in the evening.
Often the joints become inflamed symmetrically. It happens that pain appears in one or another joint, while in the first it has stopped.
Muscle pain in rheumatoid arthritis they are of a long-term aching nature. The patient often tries to rub the muscles with warming ointments, but the effect is insignificant.
In the latent period of rheumatoid arthritis, it manifests itself severe fatigue, weakness, malaise. Stiffness in movements in the morning. A person can hardly clench his hand into a fist.
May appear fever(presence of unmotivated jumps in body temperature).
Sweating.

In later stages of rheumatoid arthritis appear:

Extra-articular lesions in rheumatoid arthritis

Rheumatoid arthritis is not only a joint disease. It affects connective tissue, that is, problems arise in all organs and systems where it is present. These include muscles in any organ and blood vessels. That is, the respiratory, cardiovascular system, and kidneys suffer.

It happens that doctors rarely pay attention to extra-articular lesions. It must be said that it is in vain, since very often these disorders are more serious for the patient than joint lesions.

Thus, with rheumatoid arthritis, one disorder is layered on top of another. It seems that the body is falling apart, which is not far from the truth. The problem is that people believe that these are different diseases. In fact, these are manifestations of the same disease - rheumatoid arthritis.

Why is rheumatoid arthritis so scary? secondary amyloidosis . Amyloid is a pathologically altered protein. When amyloid is deposited in various organs, it destroys them. The most serious complication is renal amyloidosis. Most often this leads to kidney failure.

Treatment of rheumatoid arthritis

Early treatment helps prevent the irreversible consequences of rheumatoid arthritis. Currently, there are many good drugs that are successfully used for arthritis. There is one important rule in the treatment of rheumatoid arthritis: if such a diagnosis is made, treatment and prevention of exacerbations must be constantly addressed, once every six months by contacting a rheumatologist.

Drug treatment is prescribed by a doctor and only by him.

Herbal medicine will help support the body with rheumatoid arthritis. Meeting with a competent herbalist greatly alleviated my condition. I am now sharing this information with you, dear readers.

Herbs for rheumatoid arthritis

Tinctures that are taken in a course of 21 days are very effective:

Elecampane tincture 25%, 30 drops 3 times a day.
Burdock tincture 20%, 30 drops 3 times a day.
Baikal skullcap tincture 25%, 10 drops 3 times a day.
Calamus tincture 20%, 20 drops 3 times a day
Thyme tincture 10% 10 drops 3 times a day

Aqueous extracts (infusions and decoctions) of lingonberry, lemon balm, St. John's wort, bearberry, string, orthosiphon, agrimony, sweet clover, astragalus, and elderberry support the body well. Separately, tansy can be distinguished, with infusions of which they take baths and take a 5% infusion orally. Tansy has immunomodulatory, antibacterial and anti-inflammatory effects. But we must not forget that tansy is poisonous, so it is important not to overdo it in doses.

Cranberry juice, lemon juice and tea with honey are useful.

Medicinal herbs are used to make infusions that are even more effective than the herbs individually. These preparations should have an anti-inflammatory effect and can be taken during hospital treatment.

For rheumatoid arthritis, many herbs are used that can be combined with each other in preparations:

Meadowsweet (meadowsweet)- immunomodulator, reduces blood viscosity, cholesterol levels, improves blood circulation, antiviral and antibacterial agent.
St. John's wort- a good antiseptic and at the same time a sedative, relieves pain.
Knotweed (knotweed) grass- cleanses the kidneys.
Birch leaves(especially May) - puts the kidneys in order, cleanses the body.
Stinging nettle(mayleaf) is a source of vitamins, affects blood circulation, relieves inflammation, but all infusions with nettle should be used on the day of production, because become toxic when stored.
Ledum shoots is a potent remedy, so a minimal amount is added to preparations. Ledum is a strong analgesic component.
White willow bark contains aspirin. Shavings of this bark can even replace cardiomagnyl or aspirin-cardio.
Wormwood, herb- cleanses the body, in particular the liver, restores normal metabolism. This is a very important component, since many drugs used for arthritis have a very aggressive effect on the liver. In this case, wormwood acts as a detoxifying component, i.e. removes poisons.
Also effective for rheumatoid arthritis juniper fruits in the form of a decoction, sage, strawberry herb, silverweed (gurley).
Has a good anti-inflammatory effect creeping wheatgrass (cat grass roots).
Licorice naked acts as a hormone-like agent. Burdock is useful for rheumatoid arthritis both in the form of infusion and tincture. Forest geranium (joint, cinquefoil - not to be confused with cinquefoil!) is used in tinctures. But cinquefoil is a powerful anti-inflammatory agent and is widely used to make dietary supplements and ointments for arthritis.
Among other things, plants containing vitamins are very useful (rose hips, mountain ash, buckwheat, wild strawberries, creeping clover). These plants are good to add to preparations for rheumatoid arthritis.
Can be used pine needles and heather. A little about heather: it calms the nervous system, relieves inflammation, heals the kidneys, and relieves pain.
Usage horse chestnut in the form of a tincture for rubbing has long been used for rheumatoid arthritis.

It must be said that Chinese medicine, unlike European medicine, considers rheumatoid arthritis to be a treatable disease. For this, an extract of mountain ants is used, which is designed to regulate the immune system in case of autoimmune disorders, and a mushroom called cordyceps.

In conclusion from the author

If you have a suspicion of rheumatoid arthritis, if you feel that you are not suffering from the flu, but you have a fever, pain in the joints, your heart is acting up, your blood pressure is rising, you should definitely consult a specialist. From my own experience, I was convinced that the rheumatologist should be one of the first doctors to visit, and not the last, as in my case. Delay leads to the fact that we waste the time we need to stop rheumatoid arthritis in the initial stage, and not lead to its more complex manifestations and complications.

Nature has given us a large number of remedies that can support the body with rheumatoid arthritis and protect against the negative effects of drug therapy, which cannot be avoided. We must not forget about the disease “rheumatoid arthritis,” as happened to me; we must try to use all means for rehabilitation in order to prevent further destruction of joints and other organs. And, of course, you shouldn’t give up and be lazy about brewing all this and accepting it in a disciplined manner.

I wish everyone who is faced with the same illness as me to relentlessly act in preventing complications and exacerbations of rheumatoid arthritis.

Good health!

Honey. sister Lyudmila Karpova, Vladimir

Some diseases are caused by a hereditary predisposition, but certain predisposing factors are required to activate the pathological process. One such disease is rheumatoid arthritis.

Rheumatoid arthritis – what is it?

Rheumatoid arthritis is a connective tissue disease that develops in individuals with a genetic predisposition after exposure to certain provoking factors. The disease most often occurs in women over 40 years of age and is characterized by the development of irreversible degenerative and inflammatory processes in small joints, as a result of which their normal functioning is disrupted.

Rheumatoid arthritis can be seropositive (occurs in most cases) or seronegative. In the first case, rheumatoid factor is present in the patient’s blood, and the disease develops gradually.

When seronegative RA is detected, rheumatoid factor is absent, the clinical picture of the disease develops quickly, beginning with inflammation of the joints of the wrist or knee joint.

According to ICD 10, rheumatoid arthritis is designated M05 (seropositive), M06 (seronegative) and M08 (juvenile) - a detailed table of codes is at the end of the article.

Rheumatoid arthritis is often confused with arthrosis or regular arthritis. These are completely different diseases, although in both cases there is damage to the joints, the difference between rheumatoid arthritis and arthritis can be seen in the table:

How does the pathological process proceed?

The pathological process develops as a result of exposure to any factors on the body, against the background of which the immune system begins to produce antibodies that destroy joint tissue

Degenerative processes in the joint occur as a result of long-term disruption of its blood supply.

Age at which the disease most often occurs

Occurs at any age

In most cases, it occurs in older people, especially those who have subjected their joints to intense stress.

Develops on its own

Past infectious diseases.

Hypothermia of the extremities against the background of which an inflammatory process develops;

Poor circulation in the joints.

Pain syndrome that increases with joint loads;

Local hyperthermia, swelling over the joint.

Pain in the joint during exercise, which subsides at rest and intensifies when weather conditions change. When the joint moves, a crunching and clicking sound is heard.

Laboratory diagnostic indicators

Rheumatic tests reveal the presence of an inflammatory process in the joints

There are no deviations from the norm

Anti-inflammatory drugs do not cure the disease completely, but somewhat reduce the clinical manifestations

Anti-inflammatory drugs relieve pain.

If the integrity of the cartilage in the joint is not compromised, chondroprotectors are prescribed.

Causes of the disease

The development of rheumatoid arthritis can be caused by numerous factors, the most common of which are:

Heredity - in patients who have had cases of this disease in their family, genes are present in the body, and the immune system begins to produce antibodies against them;
Infectious diseases - rubella, herpes simplex, Epstein-Barr virus, hepatitis and others. These diseases most often provoke the further development of rheumatoid arthritis.

The first signs of rheumatoid arthritis

Most often, rheumatoid arthritis develops in the cold season; the provoking factor can be hypothermia, viral or infectious diseases, surgery, or food allergies.

At the initial stage of development, the disease may not manifest itself in a pronounced clinical manner; a patient with rheumatoid arthritis is concerned about general symptoms:

Increased sweating;
Muscle weakness even at rest;
Minor changes in body temperature not caused by a viral infection;
Fatigue;
Losing weight.

As the pathological process progresses, pain in the joint area is added, which is aching, periodic, and constant.

After the slightest physical exertion or during treatment with anti-inflammatory drugs, the pain syndrome intensifies, and symmetrical damage to small joints appears.

The inflammatory process in rheumatoid arthritis of the joints is accompanied by fever, lethargy of the patient, general weakness, and muscle pain.

A characteristic sign of rheumatoid arthritis in the hands is the appearance of stiffness in the morning, mainly after sleep. The patient cannot perform the usual actions with his fingers; they seem to not obey.

Attempts to move the fingers are accompanied by increased pain, which goes away after about 40 minutes. Morning stiffness is due to the fact that during the night pathological fluid accumulates in the area of joints affected by degenerative and inflammatory processes, which prevents full movements.

As the pathological process progresses, the patient develops visible deformations of the limbs - “walrus flippers”, spindle-shaped fingers and a swan neck. The first signs of rheumatoid arthritis include other joint lesions:

Impairment and sharp limitation of mobility of the elbow and radioulnar joints;
Damage to the shoulder joint - increased local body temperature, hyperemia of the skin over the inflamed joint, pain, limited mobility, gradual muscle atrophy;
Damage to the joints of the foot, namely deformation of the toes, sharp pain during exercise (walking, running), inability to choose shoes, impaired gait and stability;
Inflammation and gradual deformation of the ankle joint;
Damage to the knee joint, limitation of its mobility;
Deformation of the joints of the spinal column (usually in the last stages of the disease);
Damage to the joint of the first cervical vertebra of the atlas, as a result of which the mobility of the neck is sharply impaired, severe pain in the back of the head appears, and a crunching sound occurs when trying to turn the head to the side.

In addition to joint lesions, other manifestations of rheumatoid arthritis include:

The appearance under the skin of so-called rheumatoid nodules;
Excessive dryness and flaking of the skin;
Small hemorrhages under the skin (ecchymoses and petechiae);
Increased brittleness of nails;
Necrosis of tissues of the periungual bed;
Impaired function of the muscles that are attached to the joints affected by the inflammatory and degenerative process, a decrease in their tone, gradual atrophy;
Minor disturbances in the functioning of the gastrointestinal tract - bloating, flatulence, loss of appetite;
The development of diseases of the respiratory system - dry pleurisy, damage to lung tissue;
Diseases of the cardiovascular system – endocarditis, pericarditis, myocarditis;
Severe damage to the glomeruli of the kidneys, development of glomerulonephritis.

Symptoms of rheumatoid arthritis

The first symptoms of rheumatoid arthritis of the fingers, photos

In most cases, rheumatoid arthritis develops gradually, the first symptoms of the disease are:

Signs of general intoxication of the body (fever, weakness, lethargy, pale skin, drowsiness, chills, swollen lymph nodes, increased body temperature);
Signs of joint lesions;
Signs of extra-articular lesions.

A little later, to the general signs of intoxication of the body, symptoms of joint damage are added:

Swelling and redness of the skin over the affected joint;
Pain when moving, increasing load, temperature changes;
Decreased mobility in the joint;
Morning stiffness;
Sharp limitation of movements and gradual deformation of the joint.

The first symptoms of rheumatoid arthritis of the fingers are similar to the general symptoms, but may be more pronounced:

pain when moving;
redness of the skin over the knuckles and swelling;
increase in temperature;
limited ability to move;
morning stiffness of fingers;
possible enlargement of lymph nodes and the appearance of rheumatoid nodules

It is important not to ignore the first symptoms of finger arthritis, but to immediately consult a rheumatologist for diagnosis and prescription of medications. Advanced cases of the disease are much more difficult to treat and restore all joint functions.

Extra-articular lesions of the body develop against the background of rapid progression of rheumatoid arthritis, as a result of which blood circulation and nutrition of the tissues adjacent to the affected joint are disrupted.

Diagnosis of arthritis

If the above-described clinical manifestations of rheumatoid arthritis appear, the patient should contact a local physician as soon as possible, who will prescribe a detailed examination to confirm the diagnosis.

Diagnosis of RA includes:

Collecting an anamnesis of the patient’s life - hereditary predisposition, previous joint injuries, operations, recent infectious and viral infections;
Biochemical blood test - special attention is paid to ESR, level of C-reactive protein, creatinine;
Complete blood count - examines hemoglobin levels;
Urinalysis - characteristic protein content, increased urea levels;
X-ray examination - the image clearly shows areas of deformation and inflammation in the joints;
Detection of rheumatoid factor;
Study of intra-articular fluid.

Timely diagnosis and treatment of rheumatoid arthritis can prevent numerous complications and significantly improve the patient’s quality of life.

Treatment of rheumatoid arthritis

Since the exact causes of the development of rheumatoid arthritis have not been identified, treatment of the disease comes down to symptomatic therapy and preventing further progression of joint deformity.

Drugs for rheumatoid arthritis are selected by the attending physician, depending on the clinical picture of the disease:

Non-steroidal anti-inflammatory drugs - Nimesil, Nurofen, Ibuprofen, Meloxicam and others - can quickly eliminate pain, relieve swelling, reduce signs of inflammation and restore joint mobility;
Glucocorticosteroids - prescribed in the form of ointments or injections into the affected joint - can quickly relieve pain, swelling, inflammation, acute process, and restore mobility;
Calcium and vitamin D supplements strengthen bones and prevent tissue destruction;
Chondroprotectors are drugs that help restore cartilage tissue of the affected and deformed joint;
Vitamin complexes.

Outside the period of exacerbations of the disease, treatment of rheumatoid arthritis consists of exercise therapy, physiotherapeutic procedures, and surgery to correct joint deformities and restore its mobility.

Complications of rheumatoid arthritis

In the absence of timely diagnosis and treatment of rheumatoid arthritis, the patient gradually develops complications:

Severe depression - occurs as a result of a significant deterioration in quality of life, inability to self-care and visible degenerative changes in the limbs;
Heart diseases;
Diseases of the respiratory system;
Muscle weakness, decreased tone, gradual atrophy;
Decreased general immunity, tendency to develop infections;
Violation of the external condition and functioning of the skin and nails - deformation of the nail bed, hemorrhages under the skin, scratching.

Prevention of rheumatoid arthritis

In order to prevent the development of rheumatoid arthritis, patients at risk should follow simple recommendations from doctors:

Perform gymnastic exercises daily;
Treat viral and infectious diseases in a timely manner;
Lead a healthy lifestyle - toughen up, eat a properly balanced diet;
Do not overcool;
Take medications only as prescribed by a doctor.

Rheumatoid arthritis icd 10

According to ICD 10, rheumatoid arthritis is classified under the headings: M05 - seropositive, M06 - seronegative and M08 - juvenile.

M05.0 - Felty syndrome (with splenomegaly and leukopenia);
M05.1 - Rheumatoid lung disease;
M05.2 - Rheumatoid vasculitis;
M05.3 - RA with damage to other organs or systems;
M05.8 - other rheumatoid arthritis seropositive;
M05.9 - unspecified seropositive RA.

M06.1 - Still's disease in adults;
M06.2 - rheumatoid bursitis;
M06.3 - rheumatoid nodule;
M06.4 - polyarthropathy;
M06.8 - other specified rheumatoid arthritis;
M06.9 - unspecified rheumatoid arthritis.

M08.1 - juvenile ankylosing spondylitis;
M08.2 - juvenile arthritis with systemic onset;
M08.3 - seronegative juvenile polyarthritis.

Rheumatoid arthritis of joints 1, 2, 3 and 4 degrees

Every year, joint diseases are becoming more common. This is due to the increase in the pace of life of a city dweller, violation of the rules of healthy eating, a sedentary lifestyle and refusal to play sports. Already at a young age, many people are diagnosed with first-degree arthritis, which subsequently progresses.

What is this disease? What causes degenerative changes in joints, and what treatment can restore health to the musculoskeletal system?

What is arthritis and its types?

Literally translated, the term “arthritis” sounds like “inflammation of the joint.” The process usually begins in the area of the synovial membrane, after which it actively spreads. Late stages of the disease are characterized by diffuse inflammation of bones, cartilage, joint capsule, and surrounding soft tissues.

Depending on the type of disease, joint damage may be accompanied by pathology of the cardiovascular system, systemic septic reactions, and destruction of articular cartilage.

The following types of arthritis are distinguished:

Rheumatoid- an autoimmune disease, mainly in younger people. Large joints, heart, eyes, and bronchopulmonary system are affected.
Osteogenic– occurs as a consequence of natural wear and tear of the articular surfaces, is diagnosed in people 45-60 years old, more often in women. Affects knee, elbow, and finger joints.
Reactive- develops in individuals with a weakened immune system after illness. Often occurs after influenza, acute respiratory infections, acute respiratory viral infections.
Septic- the result of pathogenic microflora entering the joint cavity. Infection usually occurs hematogenously in the presence of foci of chronic infection or trauma in the recent past.
Arthritis-like diseases- a set of diseases that have a pathogenesis and clinical picture similar to arthritis. These include cervical spondylosis, pseudogout and gout, ankylosing spondylitis, etc.

Arthritis can lead to complications at any stage of the pathological process. Their list includes periarticular osteoporosis (softening of bone tissue), muscle atrophy, and joint contractures.

Degrees of the disease

The stages of a disease such as rheumatoid arthritis are not fundamentally different from other types of disease. Arthritis of different origins proceed in a similar manner to each other, which makes it possible to combine them into a single group of pathological processes. There are 4 degrees of arthritis, which follow each other:

1st degree The disease is characterized by minimal structural changes in the joint. Despite the fact that the pathological process has already begun, only slight thinning is noted in the bones in the area of diarthrosis. Symptoms of the disease are completely or almost completely absent.
2nd degree characterized by more pronounced destructive changes. X-ray images show bone ulcerations, areas of osteoporosis become more voluminous and noticeable. The second degree of severity leads to a slight decrease in the patient’s quality of life.
3rd degree Arthritis can be diagnosed when the disease has already led to deformation of bone structures. At the same time, ulcerations intensified, diarthrosis became deformed, and joint function was impaired. At this point, a noticeable clinical picture of the disease is developing.
4th degree speaks of irreversible damage to the joint. The function of the limb is completely lost, its cavity is filled with connective tissue. The patient becomes completely disabled.

Most patients seek help at stage 3 of the disease, when the pathology leads to a noticeable decrease in quality of life. At the same time, it is no longer possible to stop the process or significantly slow it down.

Symptoms of rheumatoid arthritis and its stages

The course of rheumatoid arthritis is characterized by periods of exacerbation and remission. In this case, the clinical picture of an exacerbation of the second stage of the disease may resemble the 3rd or 4th stage. In general, each stage of development of the destructive process has its own characteristic features.

Stages of rheumatoid arthritis:

Rheumatoid arthritis at the first stage development is not actively manifested. At the time of exacerbation, patients complain of some stiffness in the joints in the morning or after a long stay in a stationary state. Mild pain may occur when walking for a long time. During the period of remission, there are no clinical signs of the disease.
For the second stage rheumatoid arthritis is characterized by the appearance of the same symptoms as in the first, but in a more pronounced form. In the morning, patients cannot begin to move until their knees, elbows, and shoulder joints develop. Swelling appears in the affected areas, and local hyperthermia is noted. The pain is severe enough that pain medication may be required.
Third stage the disease leads to the appearance of pronounced symptoms. In this case, swelling of the joint, local hyperthermia, and redness of the skin over the affected area are noted. Stiffness develops. In the morning, the patient experiences severe pain when trying to move the affected limb. The function of the joint is not fully restored even after long attempts to develop it.
Fourth stage is terminal. At this stage, the joint completely loses its function and collapses. Tissues that have undergone destruction are replaced with connective fibers. The patient loses the ability to control the affected limb. Other manifestations of the disease also reach a maximum, which can result in loss of vision or disruption of vital systems (cardiovascular, urinary).

Treatment and prevention of joint arthritis

Treatment of rheumatoid arthritis at any stage of its course is a complex task that requires the collaboration of several specialists. Therapy can be carried out using medicinal and non-medicinal methods. Traditional medicine techniques can also be used as an auxiliary aid.

Medication

Drug therapy for rheumatoid arthritis is carried out in two main areas: relieving the inflammatory process and suppressing excessive activity of the immune system.

To relieve inflammation, non-steroidal anti-inflammatory drugs (analgin, ibuprofen, diclofenac) can be prescribed. However, the use of these funds does not allow achieving the expected effect and maintaining it for a long time. The tablet helps relieve pain in the joints for several hours, after which the medication must be taken again.

Intra-articular administration of synthetic analogs of cortisone (hydrocortisone, prednisolone) is more productive. The medicine is injected directly into the joint cavity using a long puncture needle. This group of drugs relieves inflammation within 24 hours. The achieved effect can last up to six months.

Suppression of the activity of the immune system is carried out using immunosuppressants (penicillamine) - drugs that weaken the severity of the body's defense reactions. The side effect of drugs in this group is the activation of existing foci of infection and a high risk of infection by pathogenic species of bacteria. Therefore, treatment with immunosuppressive drugs requires certain precautions.

Non-drug

Non-drug treatment of arthritis of rheumatoid origin includes physical therapy and physiotherapeutic methods. A set of exercise therapy exercises is selected by the instructor in tandem with the attending physician. Here it is important to take into account the stage of the disease and the severity of its course. As a rule, patients are recommended swimming, walking at a calm pace, and gymnastic warm-up in the morning (squats, arm swings, using a finger expander). Serious sports activities should be avoided if you have a disease such as rheumatoid arthritis.

Physiotherapeutic treatments include:

electrophoresis;
phonophoresis;
magnetic therapy;
laser therapy.

Treatment is prescribed in 10-15 procedures every six months. Under the influence of physical factors in the pathological zone, microcirculation improves and regenerative processes are activated. When anesthetics are administered using electrophoresis, an analgesic effect can be achieved. Physiotherapy is prescribed only during remission. The acute stage of the disease is a contraindication for physical impact on the joints.

Traditional methods

Traditional recipes cannot be the main method of treating a disease such as rheumatoid arthritis, even at the 1st stage of the process. However, they successfully complement drug therapy, reducing the duration of the course of medication. The following are used as traditional methods of treating arthritis:

bay leaf decoction;
compresses from ranunculus flowers;
apple cider vinegar;
lingonberries.

Traditional medicine preparations help to activate regenerative mechanisms and saturate the patient’s body with vitamins and essential minerals.

Disease prevention

Secondary prevention for arthritis is aimed at preventing exacerbations and includes a nutritious diet with plenty of omega-3 fatty acids, taking medications prescribed by a doctor, and performing permitted physical exercises.

Primary prevention measures include:

timely sanitation of infectious foci;
maintaining a healthy lifestyle;
exercise and high-quality nutrition high in minerals, carbohydrates, fats and protein components.

In general, rheumatoid arthritis allows you to lead an almost full life if treatment was started on time. The first stage of the disease is easily stopped and put into remission. In the future, the patient is required to follow the rules of secondary prevention and regularly undergo courses of maintenance therapy.

The third and fourth degrees of the disease cannot be cured and cannot be put into remission. Therefore, at the first signs of rheumatoid joint damage, you should consult a general practitioner or rheumatologist.

In modern medicine, despite all the progressive achievements, there remains a large number of diseases that have insufficiently studied causes and complex multi-stage development mechanisms that form a diverse clinical picture with damage to tissues and organs, which causes difficulties in treatment. For example, systemic connective tissue diseases. This group of diseases includes rheumatoid arthritis, the distinctive feature of which is erosive and destructive damage to joints, mainly small ones. Its cause has not yet been established; the main role in the development mechanism belongs to the attack of the immune system on the body’s own tissues.

Research continues into the causes and mechanisms of development of this pathology, and the search for new, more effective and safe treatment methods, especially complex ones.

Rheumatoid arthritis of the joints: symptoms and treatment

Rheumatoid arthritis is characterized by progressive destruction of the joints, which become irreversible in the later stages of the disease. Typical signs of pathology:

the presence of erosive and destructive elements in the area of articular surfaces;
destruction of small joints;
symmetrical lesion;
development of inflammation in the feet and hands;
deformations that interfere with the normal functioning of the joints.

In addition to typical articular lesions, disorders of other tissues and systems are also characteristic, including the presence of serositis (inflammatory process in the area of the membranes of the heart, peritoneum, pleural membrane), the formation of inflammatory nodules under the skin, vascular damage in the form of vasculitis, enlarged lymph nodes (lymphadenopathy) and peripheral lesions of nerve endings (neuropathy).

Treatment methods for rheumatoid arthritis are determined by a rheumatologist specializing in autoimmune and inflammatory diseases. He carries out a full diagnosis: an external examination with an analysis of all complaints and their detailed recording in the chart, a number of laboratory tests and instrumental studies (including ultrasound data, radiography and other additional procedures).

Medical correction is based on long courses of medications in combination with physiotherapy and non-drug methods, dietary correction and, in some cases, surgery. Courses of anti-relapse therapy and rehabilitation are carried out, and the sooner drugs are prescribed and methods of medicinal influence are recommended, the more favorable the prognosis will be. In advanced cases, the disease threatens permanent disability.

More often, a similar problem occurs in adults; for children, a peculiar form of deviation in the form of JRA (juvenile) is typical, with peculiarities of clinical symptoms, diagnosis and therapeutic approaches.

Causes and diagnosis of pathology

The exact causes of the disease have not been established to date, although there are theories about the nature of its development. According to most researchers, there is a hereditary predisposition, past infections and the action of provoking factors. It has been noted that some microorganisms (retroviruses, herpes viruses, cytomegalovirus, Epstein-Barr, rubella, and mycoplasma) contribute to the development of inflammatory processes in the joints. As a result of an infection and improper functioning of the immune system, autoimmune reactions are triggered - aggression of one’s own immunity against the connective tissue of joints and other parts of the body, which leads to the growth of connective tissue and the destruction of cartilaginous structures and their irreversible deformation. The process leads to contractures - restrictions in movement and irreversible deformations of the joints, subluxations and disruption of their functional activity.

When you contact a specialist with complaints “I have rheumatoid arthritis, how and what to treat,” the following symptoms are revealed:

stiffness in the joints in the morning, which goes away after a while;
deformation of the small joints of the fingers and toes (a specific symptom is deformation of the fingers like a “button loop” or “walrus flipper”;
symmetrical changes in the joints of the limbs;
swelling of the joint area.

The results of laboratory tests reveal an increase in ESR, alkaline phosphatase and specific indicators of systemic diseases - rheumatoid factor, sialic acids and seromucoid. On X-ray examination, specific symptoms of joint damage appear.

Rheumatoid arthritis: treatment at home or inpatient?

Placing a patient in a hospital when there is a suspicion of the development of the disease or when the diagnosis has already been established is indicated in the following cases:

if necessary, to confirm or refute the diagnosis, to clarify the characteristics of the course, assess the prognosis for future life and ability to work, and resolve the issue of disability;
selection of basic anti-inflammatory therapy (BPVT) with drugs at the initial stage and then throughout the disease;
with a sharp exacerbation and development of complications;
when there are severe and systemic manifestations involving the nervous system and serous membranes;
in the formation of concomitant complications, signs of septic arthritis or others, including those associated with taking medications.

In all other cases, treatment at home is allowed under the strict condition of constant medical supervision with regular examinations.

How to get rid of rheumatoid arthritis: principles of therapy

The basis is an integrated approach and a combination of medication with non-drug methods, diet, physical exercise and rehabilitation measures. If necessary, an orthopedist, neurologist, cardiologist, or psychotherapist is involved in consulting and developing a treatment regimen. With minor deformation of the joints, patients can continue their usual activities with limited physical activity and stress, subject to the prevention of infectious diseases and abandonment of bad habits.

An equally important condition for reducing symptoms, especially in the lower extremities, is body weight control, which reduces the load on the affected joint surfaces and bones, reducing the risk of osteoporosis, fractures and deformities. A properly selected diet high in polyunsaturated fatty acids, high-quality animal and plant proteins helps reduce the intensity of inflammation and stimulates the restoration of cartilage tissue.

The doctor tells the patient in detail how to reduce the manifestation of the disease through changes in physical activity, through exercise therapy and the use of physiotherapeutic techniques. In the stage of minimal manifestations or during the period of remission, sanatorium-resort treatment is indicated.

Standard treatment for rheumatoid arthritis

In recent years, there has been significant progress in understanding the basic mechanisms of formation; the pathology is considered as a chronic inflammatory disease of an immune nature, for which therapy is most effective in the initial period. Today, a new standard has been developed, including the use of a number of drugs with different effects:

non-steroidal anti-inflammatory drugs (NSAIDs);
hormonal (glucocorticosteroids, or GCS);
biological;
synthetic agents for stopping immune and inflammatory reactions.

The basis for improving well-being is basic anti-inflammatory therapy (BPVT), which is important to start in the first months of development, and taking medications should be regular (oral, injection), with constant changes in the regimen if there is little effectiveness. The disappearance or reduction of clinical symptoms and signs of inflammation according to laboratory data indicates the effectiveness of the measures taken. The use of BPVT should be carried out taking into account possible side effects.

How to cure rheumatoid arthritis

In the acute stage or during exacerbation of chronic pathology, drug correction is necessary, but how the treatment proceeds is determined solely by the attending physician. Steroids, tumor necrosis factor (TNF) drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used.

At the first stage suppression of acute processes is carried out, followed by a transition to maintenance therapy during the period of attenuation of symptoms and remission. Non-steroidal drugs are used most actively, usually this is a group of non-selective COX inhibitors (cyclooxygenase is an enzyme responsible for the synthesis of substances that contribute to the development of inflammation). The effect of taking them develops quickly, after 3-5 days of use, but the drugs themselves have a number of side effects that limit their long-term use and choice for some categories of patients. Selective COX inhibitors are actively used, which have a smaller list of side effects; they belong to a new generation of drugs, are better tolerated and are more effective.

Treatment of rheumatoid arthritis also involves glucocorticoid drugs. They quickly and strongly suppress immune and inflammatory reactions, affect metabolic processes and are applicable when non-steroidal anti-inflammatory drugs are ineffective. GCS reduce inflammation in the joints and reduce the likelihood of damage to internal organs, but they also have an impressive list of side effects and contraindications, and therefore their use is strictly controlled and selected very carefully and individually. With pulse therapy, in combination with cytostatic agents, they are used only on a hospital basis. Unsupervised use of these drugs at home is prohibited; they can be dangerous in terms of serious complications.

New generation drugs for the treatment of rheumatoid arthritis

Today, a new series of drugs – biological therapy – are widely used to combat this pathology. Specific compounds belonging to the group of TNF inhibitors (tumor necrosis factors) do not allow the clinical picture of immune inflammation to develop. The drugs have been used relatively recently and have shown good results, but they significantly affect the immune system, suppressing it during long-term use. They are prescribed in difficult cases when the disease is resistant to conventional remedies. Biological products have one significant drawback - high cost, which limits their widespread use.

Local therapy

The external method of using medications is also practiced; for these purposes, medications are prescribed for local application - gels, ointments, creams, patches with anti-inflammatory components. The main effect is a local effect on the joint tissue and periarticular surfaces; drugs are used to reduce pain and swelling. However, they have low effectiveness compared to medications that are taken orally (tablets) and are recommended only in complex therapy.

Often external agents have a multicomponent composition and may contain NSAIDs, heparin (to improve microcirculation and vascular permeability), local anesthetics (to reduce joint pain).

How to Treat Rheumatoid Arthritis with Physical Therapy

As the acute process subsides, the question always arises of what to do next, at the stage of attenuation of inflammation and when it goes into remission. At the stage of additional correction, including at home, physical exercise is indicated. The procedures help reduce pain, eliminate morning stiffness, and increase the patient’s physical activity.

Methods of influencing the area of affected surfaces with galvanic currents and magnetic fields, applications of paraffin or ozokerite are used. Methods of dosed irradiation with infrared rays or ultrasound of a certain frequency are no less effective.
Magnetic therapy for joint diseases has the most pronounced positive effect:

reduces pain and swelling in the joint area;
increases range of motion;
eliminates morning stiffness;
allows you to reduce the drug load on the body, as it reduces the need to take drugs with an analgesic effect.

Although these methods have sufficient activity, they cannot be used as the only remedy when deciding how to cure rheumatoid arthritis without a doctor’s prescription. Physiotherapy is indicated as an additional technique against the background of basic treatment.

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Joint structure

Today, rheumatoid arthritis is considered an autoimmune disease that primarily affects the small joints of the hands. Over time, this pathology leads to deformation of bone tissue and dysfunction of the hand.
According to statistics, the pathology occurs in 0.8% of the population, and it is diagnosed much more often in women. There is also an increase in the number of cases in the age category after 50 years.

What are the causes of this disease?

highest chances of getting sick

The exact causes of rheumatoid arthritis have not yet been established. A role in the development of the pathology of certain infections is assumed: mycoplasma, Epstein-Barr virus, cytomegalovirus, rubella virus. The infection causes chronic damage to the synovium of the joint. Subsequently, this leads to the formation of new antigens on its inner surface, and so-called autoimmune inflammation develops.

The next stage in the development of the disease is direct damage to the joints themselves with characteristic signs

What is the clinical picture of rheumatoid arthritis?

The onset of the disease, as a rule, does not have specific symptoms. The patient may experience general weakness, increased fatigue, low-grade fever, and pain in small and large joints for several months. Very rarely, in 10% of cases, there is a rapid onset of the disease with high fever and enlarged lymph nodes.

The next stage in the development of the disease is direct damage to the joints themselves with characteristic signs:
1. Pain that gets worse with movement
2. Swelling and tenderness of the tissues around the joint
3. Stiffness in the joints, especially in the morning, for at least an hour
4. Local increase in temperature, especially for large joints

What joints are affected by rheumatoid arthritis?

Mainly, localization is noted on the hands. Moreover, the lesion is always selective; the proximal interphalangeal and metacarpophalangeal joints are much more often involved. But the inflammatory process in the distal interphalangeal joints is observed much less frequently.
In addition, other joints of the upper extremities can be affected in parallel: wrist, elbow. On the lower extremities these are most often the knee, ankle, and metatarsal joints.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic systemic connective tissue disease that primarily affects the joints. This is one of the most serious diseases, affecting approximately 1% of the world's population.

Almost simultaneously with the damage to the joints of the hands, the joints of the feet also become inflamed. The joints at the base of the fingers are predominantly affected.

Pain and swelling may last for several months.

It happens that not only the joints are affected, but also the spine. Moreover, the cervical spine is predominantly affected. In this case, patients complain of neck pain.

At later stages, phonophoresis with hydrocortisone, pulsed currents and magnetic therapy are used.

Physical therapy is indicated to restore joint function.

Prevention

Classification of rheumatoid arthritis - joint damage

Classification of rheumatoid arthritis.

Currently, the International Statistical Classification of Diseases, 10th revision (ICD-10), as well as the working classification of rheumatoid arthritis proposed by the Association of Rheumatologists of Russia in 2003, are used in practical work.

Clinical picture of rheumatoid arthritis.

At its onset, rheumatoid arthritis manifests itself as articular syndrome. Patients complain of pain in the small joints of the hands and feet, most intense in the morning and decreasing in the evening. The formation of arthritis is sometimes preceded by muscle pain, moderate arthralgia, bursitis and tendovaginitis. It should be noted that the symptoms of the initial period of the disease (“early” RA) are not always pathognomonic, which creates certain difficulties in making a diagnosis.

Joint damage in the initial stage of rheumatoid arthritis may be unstable. Sometimes patients develop spontaneous remission with the disappearance of the articular syndrome. However, after some time, the pathological process resumes again with damage to a large number of joints, the pain becomes more severe, requiring the use of NSAIDs or glucocorticoids.

Typical for rheumatoid arthritis is symmetrical damage to the metacarpophalangeal, proximal interphalangeal and II-V metatarsophalangeal joints. Subsequently, the pathological process involves the wrist, knee, shoulder, hip, elbow, ankle joints, tarsal joints, cervical spine, as well as the temporomandibular joints. In the initial stage of the disease, pain occurs only during movements, but as it progresses, they also bother patients at rest. Swelling and redness of the skin develops over the affected joints, stiffness of movements and, as a result, dysfunction of the joints. As a rule, tendons, joint capsules, muscles and bones are involved in the process. Muscle atrophy develops on the dorsal surface of the hands.

Morning stiffness is one of the most important symptoms of rheumatoid arthritis and is diagnostically significant if it lasts more than one hour. One of the reasons for the development of morning stiffness is a disruption of the normal rhythm of production of adrenal hormones with a shift in the peak of their production to a later period of the day, as well as the accumulation of cytokines in the edematous fluid of inflamed joints during sleep.

The most complete answers to questions on the topic: “which joints are most often affected by rheumatoid arthritis?”

What are the causes of this disease?
What is the clinical picture of rheumatoid arthritis?
What joints are affected by rheumatoid arthritis?
Methods for diagnosing the disease
Treatment of rheumatoid arthritis

joint structure

What are the causes of this disease?

highest chances of getting sick

The next stage in the development of the disease is direct damage to the joints themselves with characteristic signs

What is the clinical picture of rheumatoid arthritis?

What joints are affected by rheumatoid arthritis?

The next stage in the development of rheumatoid arthritis is the appearance of deformities in the affected areas of the limbs. On the hands, they deviate to the radial side, and the fingers to the ulnar side, the so-called Z-shaped deformity. Characterized by limited mobility of the thumb, which prevents the patient from grasping small objects.

Many patients also experience extra-articular manifestations of the disease. These include: damage to the heart, lungs, pleura, development of muscle atrophy, rheumatoid nodules. Rheumatoid nodules are small, painless lumps located around the affected joint and do not cause concern to the main patient.

Methods for diagnosing the disease

X-ray diagnosis of the disease is not always simple
Today, the diagnostic method is an initial examination of the patient and identification of characteristic clinical signs of the disease. The following additional studies have found application:
1. X-ray of joints
2. MRI of the hands
3. Detection of increased titers of rheumatoid factor during biochemical studies
4. Antibodies to cyclic citrullinated peptide, it is the most specific indicator of rheumatoid arthritis.

Treatment of rheumatoid arthritis

The first group of drugs used to treat rheumatoid arthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). They quickly eliminate inflammation in the joints, relieve pain, but, unfortunately, do not stop progressive diseases.

The second group is glucocorticoid hormones. They are used in small doses, fractionally. A positive aspect of their use is that they slow down the progression of the disease, in particular the formation of bone destruction. There are also methods for their intra-articular administration.

Drugs that affect the immune stages of inflammation in the joints are also used. These include immunosuppressants, cytostatics, gold preparations, sulfasalazine and others. They need to be taken for a long time, many of them have a number of serious side effects.

Treatment of rheumatoid arthritis is aimed at minimizing symptoms: reducing inflammation and pain, restoring joint function, preventing destruction and deformation. When choosing how to treat a disease, a rheumatologist focuses on the degree of activity of the process, the location of the affected areas, the general state of health and the age of the patient. Treatment of rheumatic disease should prevent complications from the heart, eyes, blood vessels, and skin, so it is important to consult a doctor in time.

Of the recently proposed treatment methods, extracorporeal hemocorrection techniques are used. These are technologies for cryomodification of autoplasma and incubation of cell mass with immunomodulators. Their essence is to take blood from the patient and extract autoimmune complexes from it. The treated blood plasma is then returned to the patient.

In each specific case of rheumatoid arthritis, a whole range of therapeutic measures is carried out. It depends on the severity of the disease, stage of development, and the presence of concomitant lesions of internal organs. Only a specialist rheumatologist will be able to correctly prescribe a treatment regimen that will reduce the manifestations of the disease and its progression.

Rheumatoid arthritis refers to systemic connective tissue diseases. This is a chronic disease of infectious-inflammatory origin, which mainly affects peripheral small joints. It is characterized by destructive processes in the joint tissue, a progressive course with the development of ankylosis (complete immobility in the joint). Among other things, rheumatoid arthritis is considered an autoimmune disease, that is, the defense system ceases to distinguish between foreign microorganisms (

virusesbacteria

) from their own cells, and thus directs their aggression towards their own body.

For many decades, attempts have been made to find the pathogenic infectious agent that causes rheumatoid arthritis.

Symptoms of the disease such as:

Acute onset
Increased body temperature and sweating
Enlarged lymph nodes

On the other hand, there are no clear criteria for rheumatoid arthritis to be an infectious disease:

The disease has no seasonality
Not transmitted through blood transfusion or organ transplantation
No effectiveness in antibiotic treatment

If a family member has rheumatoid arthritis, the risk of other members becoming ill is very low.

Causes and predisposing factors in the development of rheumatoid arthritis

Genetic predisposition This theory is supported by the fact that patients suffering from rheumatoid arthritis have special genes that modify receptors on the surface of the body's cell membranes. As a result, the immune system does not recognize its cells and produces special antibodies against them to destroy and remove them from the body. These genes include DRB1.

Infectious diseases There are various viruses, the presence of which in the body increases the risk of developing rheumatoid arthritis. These include:

Rubella virus
Herpes virus
Epstein-Barr virus
Hepatitis B virus, etc.

Symptoms of rheumatoid arthritis

When considering clinical symptoms, it should be borne in mind that rheumatoid arthritis is primarily a systemic disease, which can affect both joints and various organs and systems.

Clinical manifestations depend on a number of factors:

The severity of the current
Localization of the pathological focus
Reversibility of the process
Pathological changes
Presence of complications

In 70% of cases, the disease begins in the cold season. Provoking factors are: viral, bacterial infections, injuries, surgical interventions, food allergies, etc. It is characterized by a slow course with a gradual increase in clinical symptoms. In rheumatoid arthritis, small peripheral joints of the hands and feet are predominantly affected. Subsequently, other organs and systems are involved in the pathological process - the so-called extra-articular manifestations of rheumatoid arthritis.

In the latent (hidden) period of the disease, even before the appearance of pronounced clinical symptoms of joint damage, the following are noted:

Fatigue
Weakness
Weight loss
Unreasonable increase in body temperature
Muscle pain
Sweating

There are several options for the onset of the disease: acute, subacute

In most cases, rheumatoid arthritis is characterized by a subacute onset. In this case, the patient complains of:

Joint pain

Joint pain is characterized by a number of symptoms:

The pain is inflammatory in nature
Constant
Aching
Wavy in nature - pain may intensify in the evening
Eliminated by taking anti-inflammatory drugs
Characteristic symmetrical joint damage

More often, the process involves small joints of the hands, feet, wrists, knees, and elbows. Less commonly, the hip, shoulder and spinal joints become inflamed. The number of affected joints varies depending on the activity of the disease. Most often it manifests itself as polyarthritis (affecting 3 or more joints). Less common are injuries to 2 (oligoarthritis) or one (monoarthritis) joints.

Muscle pain

A symptom that accompanies acute inflammation. Has an aching, long-lasting character.

Fever

Fever reflects the presence of an inflammatory process. The more actively the disease develops, the higher the body temperature rises.

Morning stiffness

Morning stiffness, which lasts from 30 minutes to an hour or more, appears in the morning after sleep. It is characterized by limited mobility and increased pain in the affected joints when trying to make any movement. This is explained by the fact that during the night it accumulates in the cavity of the joints.

inflammatory exudate(liquid), as well as a disrupted daily rhythm of glucocorticoid hormone release.

Glucocorticoids reduce inflammatory reactions and the amount of exudate in the joints. Normally, the peak release of these hormones is observed in the morning.

Gradually, symptoms progress, joint function is impaired, and deformities appear.

Pathological changes in individual joints

Damage to the joints of the hand In 90% of cases with rheumatoid arthritis, the joints of the hand are damaged. Typically changes are noted in:

Proximal (closer to the metacarpus) interphalangeal joints
second and third metacarpophalangeal joints
wrist joints

In the initial stage develops

around the joints involved in the process. Along with damage to the joints, inflammation and swelling of the muscle tendons attached to these joints are observed. Mobility is impaired due to pain. The patient complains of the inability to clench his hand into a fist. With frequent exacerbations or treatment failure, other signs and symptoms of the disease appear.

Second stage of the process characterized by the progression of the rheumatoid process. In addition to the primary manifestations of the disease in the initial stage, there are symptoms associated with various deformities of the hand and fingers. These include types such as:

"walrus fin"– deformation of the metacarpophalangeal joints and deviation of 1-4 fingers to the medial side (towards the ulna)
"Neck of the Swan"– deformation in the form of flexion of the metacarpophalangeal joints, hyperextension of the proximal interphalangeal joints and flexion of the distal (extreme) finger joints.
Spindle fingers– thickening in the area of the finger joints.

Other symptoms include:

Tenosynovitis of the hand– inflammation of the tendon sheaths (the sheaths within which the tendons pass). They attach to joints and provide motor function. Main symptoms:

pain on palpation
swelling in the tendon area
thickening of inflamed tendons
impaired motor function of the fingers and hand

Carpal tunnel syndrome

This sign occurs due to compression of the median nerve. The tendons of the finger flexor muscles pass through a special canal, which is located between the forearm and hand and is called the carpal tunnel. The median nerve, which innervates the palm and part of the fingers, passes through the same canal. With synovitis, the digital flexor tendons thicken and put pressure on the median nerve. In this case, the sensitivity and motor function of the first three fingers of the hand are impaired.

The syndrome includes:

Pain that extends to the forearm area
Paresthesia (numbness), sensitivity of the first 3 fingers is impaired

Damage to the elbow and radioulnar joints manifested by pain and limited mobility. As the process progresses, it may develop

contracture(limitation of mobility when the joint is in a certain position for a long time), more often the elbow joint is in a semi-flexed position.

Damage to the shoulder joint involves inflammation of the muscles of the shoulder girdle, collarbone, and neck. It manifests itself as an increase in local temperature, swelling, and limited mobility in the joint. Immobility caused by pain entails atrophy (loss of mass, lack of function) of the muscles, weakness of the joint capsule and the appearance of subluxation of the head of the humerus.

Damage to the joints of the feet accompanied by pain when walking and running. Deformities of the toes (usually 2, 3, 4) complicate the selection of comfortable shoes for walking. With rheumatoid arthritis of the feet, as well as with lesions of the hands, there is a displacement of the fingers to the outside, pathological flexion of the fingers, which, in combination with pain, further reduces stability, maintaining balance and a uniform gait.

Ankle joint damage is rare and manifests itself with the same basic symptoms as with inflammation of other joints

Gonarthrosis – inflammation of the knee joint is of a special nature. Deformations that occur in the joint significantly impair the patient’s motor activity. With prolonged immobility, flexion contracture of the joint and atrophy of the quadriceps muscle (performs extension in the knee joint) develop.

Inflammatory exudate accumulates in the interarticular cavity. When bending the knee joint, the pressure of the inflammatory fluid increases, which protrudes into the popliteal fossa. This symptom was first described by Baker, in whose honor it was named

(Baker's cyst).

Coxarthrosis is arthritis of the hip joint. It develops in rare cases and is of a severe, protracted nature. Important symptoms are pain radiating (spreading) to the groin area, a feeling of shortening of the affected limb and associated lameness when walking. In recent years, ischemic

necrosis(death from insufficient blood supply) of the femoral head. Involvement of the hip joint in the process has serious consequences and leads to disability of the patient.

Damage to the spinal column. A rather rare manifestation of the disease, it occurs in advanced stages of the process. In rheumatoid arthritis, the cervical region is affected, mainly the joint is affected

atlanta(first cervical vertebra). The disease is expressed in the appearance of pain in the neck area, radiating to the back of the head, shoulder and arm. As deformities develop, crepitus (crunching) and subluxation of the cervical segments occur, which leads to limited mobility of the neck.

Damage to other joints. Among the rarest manifestations of the disease, damage to the following joints is noted:

Sternoclavicular
Acromioclavicular
cricoarytenoid

The listed joints have a poorly developed articular apparatus. The rarity of damage to the corresponding joints is explained by the fact that in rheumatoid arthritis, the process mainly involves joints in which there is an articular capsule, fluid and a significant layer of intra-articular cartilage.

Extra-articular manifestations of rheumatoid arthritis Rheumatoid arthritis primarily affects the joints. But we must not forget that this is an autoimmune disease that affects all organs and systems where connective tissue is present. These can be: blood vessels, skin, muscles, respiratory, cardiovascular systems and other organs. As a rule, extra-articular lesions begin to appear after some time, with complications of the rheumatoid process.

Skin lesions The condition for skin manifestations is inflammation of the peripheral small arteries and veins. This disrupts nutrition and metabolism in the skin and subcutaneous fat. The main symptoms are:

Thinning and dry skin
Ecchymoses (small subcutaneous hemorrhages)
Brittle nails
Tissue necrosis in the periungual area

Rheumatoid nodules– these are subcutaneous dense formations of small diameter (up to 2 cm). According to one of the most common theories, rheumatoid nodules are nothing more than tissue necrosis around inflamed small blood vessels, with the accumulation of immune complexes and rheumatoid factor in them. The appearance of nodules is associated with an exacerbation of the chronic process. When inflammation subsides, they disappear or significantly decrease in size.

Characteristics of nodules:

density
painlessness
mobility
the nodes are not fused with the surrounding tissue

Appear on the outer surfaces of the limbs or in places of constant pressure (elbows, back of the head, sacrum). The number of nodules varies from one to ten. The formation of rheumatoid nodules in internal organs: heart, lungs, nervous system is possible.