Best Rheumatoid Arthritis Treatment In Delhi NCR.

Rheumatoid Arthritis treatment and cure
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What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease and inflammatory disease. RA commonly affects joints in the hand, wrist and knees. In a joint with RA the linings of the joint becomes inflamed, causing damage to the joint tissue. This tissue damage leads to severe joint pain and deformities. RA can affect other tissues throughout the body and can cause problems in organs such as lungs,heart and eyes.

Symptoms of Rheumatoid Arthritis
  • Pain in more than one joint
  • Stiffness in more than one joint
  • Tenderness and swelling in one or more than one joint
  • Deformities
  • The same symptoms on both sides of the body
  • Weight loss
  • Fever, fatigue, weakness
Causes of Rheumatoid Arthritis

There are many causes of lumbar spondylosis, some of them include:

  • Old-Age,
  • Heredity,
  • Back trauma,
  • Repetitive spine loading,
  • Repetitive bending, lifting, twisting, and
  • Sustained postures.
Risk Factors of Rheumatoid Arthritis
  • Age- RA can begin at any stage , but the likelihood increases with advanced age. Most common in the sixties.
  • Sex- Women are more prone to this than men
  • Genetics- People born with certain genes are more likely to develop RA . These genes are HLA ( human leukocyte antigens) class 2 genotypes, can also make your arthritis worse.
  • Smoking- Smoking increases a person’s risk of developing RA and can make the disease worse.
  • History of giving birth- Women who have never given birth may be at a greater risk of developing RA.
  • Obesity- Being obese can increase the risk of developing RA.
Diagnosis of Rheumatoid Arthritis

Rheumatologists will look for signs and symptoms and medical history.

  1. Looking for swelling and redness.
  2. Examining joint function, ROM
  3. To check warmth and tenderness
  4. Examining skin nodules.
  5. Testing for reflexes and muscle strength.
    Since no single test can detect RA. They may also request certain imaging tests such as x-ray, MRI, Ultrasound. Blood test for RA:
    1. Rheumatoid factor test- This check for a protein called rheumatoid factor. High levels of rheumatoid factors are associated with autoimmune disease .
    2. Anti Citrullinated peptide antibody test- This test looks for an antibody that’s associated with RA . People who have this antibody usually have this disease . The anti ccp test is more specific for RA then RF blood test and is often positive before the RF test.
    3. Erythrocyte sedimentation rate: The ESR helps to determine the degree of inflammation anywhere in your body. However it does not indicate the cause or site of inflammation.
    4. C reactive protein test: A severe infection or significant inflammation anywhere in your body can trigger your liver to make C reactive protein. Higher levels are associated with RA.
Treatment

Note- There is no cure for RA. Treatment aims to reduce the inflammation and symptoms.

  • NSAIDS: It can relieve pain and lessen inflammation. It includes ibuprofen and naproxen sodium. Side effects could be heart problems, kidney damage, stomach irritations.
  • Steroids: Prednisone reduces inflammation and slows joint damage. Side effects may include thinning of bones, weight gain, diabetes.
  • Conventional DMARDs: These drugs can slow the process of joint damage. Common DMARDs are methotrexate, leflunomide, hydroxychloroquine. Side effects may include liver damage and lung infections.
  • Surgery includes synovectomy, tendon repair, joint fusion, total joint replacement.
  • Exercises can improve joint range of motion, apply heat or cold to ease pain.

Rheumatoid Hand

It includes the joint deformities of the hand in RA.

  • Boutonniere deformity- It occurs when the middle or proximal interphalangeal joint of a finger is flexed and the distal joint is extended.
  • Swan neck deformity- The most common in RA. It occurs when there is weakness or tearing of ligament due to inflammation. This laxes the joint of the finger and flexion of the distal joint.
  • Hitchhiker’s thumb: It occurs when the thumb flexes at the metacarpophalangeal joint and hyperextends at the interphalangeal joint. It is also called z shaped deformity.
  • Rheumatoid nodules: These are hard lumps that form under the skin near the joints. They can occur in multiple areas, most commonly near your elbows. Usually these are not painful.
Physiotherapy Management

Assessment and evaluation

  1. Assessment of posture
  2. Testing muscle strength and power
  3. Measuring joint movement
  4. Gait analysis

Treatment

  1. Cold therapy in acute phase for 10 to 20 mins twice a day.
  2. Heat therapy in chronic phase for 20 to 30 mins twice a day
  3. TENS will give short term pain relief.

Exercises for acute phases

  1. Assisted movement through normal range.
  2. Static muscle contraction helps to maintain muscle tone without increasing inflammation.
  3. For chronic cases we can progress the above exercises to include light resistance.
  4. Postural, core stability exercises.
  5. Swimming, walking, cycling to maintain cardiovascular fitness.
  6. Gentle stretching of tight muscles.
  7. Maintaining muscle strength is important for joint stability & preventing injury.
  8. Muscles can become weak following reduced activity.
  9. Muscle length can be affected by prolonged positions and immobilization and tightness can limit daily activities.
  10. Splints will be provided for every deformity to keep the joint in the correct position.
  11. Advanced physiotherapy techniques like dry needling, manual muscle release will be unbeatable in correcting muscle stiffness and relieving joint pains.
  12. Iontophoresis is believed to work through the transcutaneous delivery of charged medications like lidocaine, corticosteroids, salicylate, antibiotics. It is used for delivery of substances that need local penetration in order to avoid systemic effects.
  13. Orthotic devices can make activities of daily living much easier, leading to a greater degree of independence.

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