Rheumatoid arthritis arises when the immune system mistakenly attacks the lining of the joints, leading to chronic inflammation, pain and stiffness. Over time, the disease can deform the joints and lead to disability. Strength training and light aerobic exercise, like walking, benefits people with rheumatoid arthritis.
Rheumatoid arthritis is an autoimmune disease in which joints, usually including those of the hands and feet, are symmetrically inflamed, resulting in swelling, pain, and often the eventual destruction of the joint's interior. Rheumatoid arthritis is the most common inflammatory joint disease and a major cause of disability, morbidity, and mortality. It occurs worldwide, affecting approximately one per cent of adults. Rheumatoid arthritis may be accompanied by fatigue, anxiety, weight loss, and depression. Rheumatoid arthritis is the most common of the inflammatory arthritides, affecting millions of adults around the world. It represents a significant cause of increased disability, morbidity, and mortality.
Diet for Rheumatoid
A regular, healthy diet can reduce symptoms of rheumatoid arthritis. Some people have flare-ups after eating certain foods. A diet rich in fish and vegetables has beneficial effects on reducing inflammation.
The traditional diets of people in the Mediterranean region tend to be high in fruits, vegetables, fish and olive oil, and comparatively low in red meat. Components of the Mediterranean diet have anti-inflammatory effects. UK researchers split 130 women with rheumatoid arthritis into two groups. One group attended classes on Mediterranean-style eating, which included hands-on cooking instruction. The other group was given written dietary information only. Women who attended the classes bumped up their intake of fruits, vegetables, and beans and monounsaturated fat and over the next few months reported improvements in pain, morning stiffness and overall health. Annals of the Rheumatic Diseases, September 2007.
A gluten-free vegan diet full of nuts, sunflower seeds, fruit and vegetables reduces the risk of heart attacks and strokes for people with rheumatoid arthritis and also affect the immune system, easing some symptoms associated with the painful joint condition.
Omega 3 fish
oil fatty acids for joint pain in rheumatoid arthritis
Omega-3 fatty acids can reduce joint pain associated with rheumatoid arthritis. See Fish oil s for more information.
Glucomannan supplement may be helpful in rheumatoid arthritis.
Vitamin B6 and
Compared with healthy women, those with rheumatoid arthritis are deficient in vitamin B6 and have elevated levels of homocysteine, a type of amino acid that has been linked to heart attacks and strokes. The vitamin B6 deficit appears to be the result of altered metabolism, not reduced dietary intake. As vitamin B6 levels drop and homocysteine levels rise, disability status worsens. It is not clear whether vitamin B supplement use would benefit those with rheumatoid arthritis, and if it does what the appropriate dosage would be. Journal of the American Dietetic Association, March 2008.
Glucomannan in prevention of oxidative stress and inflammation occurring in adjuvant arthritis.
Neuro Endocrinol Lett. 2008 October. Bauerova K, Ponist S, Navarova J, Dubnickova M, Paulovicova E, Pajtinka M, Kogan G, Mihalova D. Bauerova K, Ponist S, Navarova J, Dubnickova M, Paulovicova E, Pajtinka M, Kogan G, Mihalova D. Institute of Experimental Pharmacology, Slovak Academy of Sciences, Bratislava, Slovakia.
The aim of this study was to evaluate the effects of a biological response modifier, glucomannan, isolated from Candida utilis, on the progress of adjuvant arthritis in Lewis rats. Adjuvant arthrithis was induced in Lewis rats by a single intradermal injection of Mycobacterium butyricum. Glucomannan was administered in two different doses of 5 and 7.5 mg/kg b.w. The important characteristics of glucomannan isolated from Candida utilis, such as good water solubility and relatively small molecular weight, along with the observed in vivo anti-inflammatory and antioxidant effects, appear to be promising features for its prospective use as a natural agent in prevention and supplementary therapy of rheumatoid arthritis.
Rheumatoid arthritis can also produce a variety of symptoms throughout the body. The exact cause of rheumatoid arthritis isn't known, but many different factors, including genetic predisposition, may influence the autoimmune reaction. This disease develops in about 1 percent of the population, affecting women two to three times more often than men. Usually, rheumatoid arthritis first appears between 25 and 50 years of age, but it may occur at any age. In some people, the disease resolves spontaneously, and treatment relieves symptoms in three out of four people; however, at least 1 out of 10 people eventually becomes disabled.
In rheumatoid arthritis, the immune system attacks the tissue that lines and cushions joints (certain immune cells, perhaps mast cells, attack the carbohydrate molecules, known as glycosaminoglycans, in the joints). Eventually, the cartilage, bone, and ligaments of the joint erode, causing scars to form within the joint. The joints deteriorate at a highly variable rate.
Treatment of rheumatoid arthritis
Treatment of rheumatoid arthritis ranges from simple, conservative measures such as rest and adequate nutrition to drugs and surgery. Treatment starts with the least aggressive measures, moving to more aggressive ones if needed. A basic principle of treatment is to rest the affected joints, because using them aggravates the inflammation. Regular rest periods often help relieve pain, and sometimes a short period of total bed rest helps relieve a severe flare-up in its most active, painful stage. Splints can be used to immobilize and rest one or several joints, but some systematic movement of the joints is needed to prevent stiffening. The main categories of drugs used to treat rheumatoid arthritis are non-steroidal anti-inflammatory drugs (NSAIDs), slow-acting drugs, corticosteroids, and immunosuppressive drugs. Generally, the stronger the drug, the more severe its potential side effects, so that closer monitoring is needed.
When it comes to initial drug treatment for rheumatoid arthritis, many sufferers would prefer not to have to take the steroid prednisone. Dislike for prednisone is strong and widespread.
treatment of rheumatoid arthritis
Non-pharmacological treatment modalities are often used as an addition to drug therapy in patients with rheumatoid arthritis. The few available randomized controlled trials that have specifically investigated patients with early RA support the effectiveness of dynamic exercise and cognitive behavioral interventions, and to a lesser extent of joint protection programs and foot orthoses.
used in rheumatoid arthritis treatment
Anti-inflammatories are commonly prescribed to reduce inflammation and pain.
Disease modifying anti-rheumatic drugs include medications like methotrexate, gold, hydroxychloroquine, cyclosporine, D-penicillamine, sulfasalazine, leflunomide are used to preserve joints and may protect against heart disease associated with rheumatoid arthritis.
Biologic response modifiers include Adalimumab (Humira), infliximab (Remicade), etanercept (Enbrel), abatacept (Orencia), anakinra (Kineret) and rituximab (Rituxan) slow progression of the disease and joint damage.
Corticosteroids are fast acting anti-inflammatories good for short term use.
Immunosuppressants: third line medications used for severe RA - azathioprine (Imuran), chlorambucil (Leukeran) and cyclophosphamide (Cytoxan).
Hyaluronic acid intra-articular injections: Sodium hyaluronate (Hyalgan and Supartz) and hylan G-F20 (Synvisc) are substances similar to synovial fluid found in joints and can be injected into the joint.
medication for RA
Biologic treatment options for rheumatoid arthritis, including abatacept and rituximab, have been approved for use in the management of rheumatoid arthritis since 2005. The newer biologic treatment options, abatacept and rituximab have novel mechanisms of action which have helped to make abatacept and rituximab effective options in many patients for whom traditional therapy has failed.
Rheumatoid arthritis Research Update
Randomized double blind trial of an extract from the pentacyclic alkaloid-chemotype of uncaria tomentosa (Cat's Claw) for the treatment of rheumatoid arthritis.
Mur E. Innsbruck University Hospital, Austria.
J Rheumatol. 2002 Apr;29(4):678-81.
To evaluate safety and clinical efficacy of a plant extract from the pentacyclic chemotype of Uncaria tomentosa (cat's claw) in patients with active rheumatoid arthritis. Forty patients undergoing sulfasalazine or hydroxychloroquine treatment were enrolled in a randomized 52 week, 2 phase study. During the first phase (24 weeks, double blind, placebo controlled), patients were treated with UT extract or placebo. In the second phase (28 weeks) all patients received the plant extract. Twenty-four weeks of treatment with the cat's claw extract resulted in a reduction of the number of painful joints compared to placebo (by 53% vs 24%). Patients receiving the cat's claw extract only during the second phase experienced a reduction in the number of painful and swollen joints compared to after 24 weeks of placebo. Only minor side effects were observed. This small preliminary study demonstrates relative safety and modest benefit to the tender joint count of a highly purified extract from the pentacyclic chemotype of UT in patients with active rheumatoid arthritis taking sulfasalazine or hydroxychloroquine.
Some patients who take the anti-rheumatic drug Arava (leflunomide) develop peripheral neuropathy, a nerve problem that involves numbness, tingling or pain in the hands or feet.
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