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Treatment of Rheumatoid Arthritis

Treatment of rheumatoid arthritis focuses on managing the effects of the disease. The goals of rheumatoid arthritis treatment programs are 3:

- control joint damage
- prevent loss of function
- decrease pain

The first stage of treatment starts with education. It is important for the patient to learn about the disease and the possibilities of joint damage and loss of function, and to learn about the benefits and risks of various treatments 3. Patients with rheumatoid arthritis might work with several types of allied health professionals, including, physical therapists, occupational therapists, social workers, and patient educators.

Herbal Medicines
Herbal medicines may help improve some of the symptoms of rheumatoid arthritis. In a randomized, controlled study, evening primrose and olive oil reduced pain and morning stiffness 51. Feverfew and cabbage leaf significantly improve grip strength in subjects with rheumatoid arthritis 51.   In addition, capsaicin cream, made from cayenne peppers, can reduce pain 51.

Pool Exercise

Exercise in a temperate pool can reduce feelings of stiffness and load on the joints while providing the benefit of significantly improved muscle endurance in upper and lower extremities 4.

Drug Therapy
Most patients with newly diagnosed rheumatoid arthritis will begin taking a disease-modifying antirheumatic drug (DMARD) within 3 months of their diagnosis 3.  DMARDS help to prevent the joint damage which often occurs early in rheumatoid arthritis.
Some examples of DMARDs include:

In addition to DMARDS, nonsteroidal antiinflammatory drugs (NSAIDS), glucocortoid joint injections, and prednisone may be used to control symptoms 3.   Treatment of rheumatoid arthritis may involve combinations of several types of medications, in order to reduce side effects and provide the greatest degree of symptom relief 3.

Joint Replacement
The removal of an arthritic or damaged joint and replacement with a prosthesis is called total joint replacement 2. During this procedure, a surgeon removes the damaged bone and cartilage and replaces them with metal and plastic pieces that fit into the joint to restore movement and function 2. The new joint pieces may or may not be cemented to the bone 38. Younger, more active individuals are usually treated with non-cemented joints allowing their bones to grow into the new prosthesis 38.

Joint replacement has a 90 percent success rate 38. Complications may occur following surgery, however, most are treatable 38. Continuous passive motion treatment is used as a means of enhancing collagen tissue healing following total knee arthroplasty. However, study results suggest that continuous passive motion treatment does not favor better range of motion at the knee following total knee arthroplasty 12.

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