Primary preventive care for Rheumatoid arthritis

Among the most effective for RA is aspirin, because in addition to its effect on pain it has a valuable anti-inflammatory effect. Frequently, large doses of aspirin are needed around the clock. In an occasional patient, aspirin will cause bleeding in the stomach or intestine or may even help produce a peptic ulcer. 

Such patients may obtain relief of pain from a medicine such as Tylenol. Indocin and Butazolidin are other anti inflammatory pain relievers that may be used along with, or in place of, aspirin. These agents may some- times produce peptic ulcers so, as a precaution against this, the physician will advise that they be taken with meals or with liquid antacids.

Narcotics should be avoided because of the risk of addiction. Gold salts and certain compounds for malaria are occasionally of value in RA. Their side effects, however, may be drawbacks to their use. Steroid compounds provide the most dramatic relief because their potent anti-inflammatory properties lead to rapid suppression of joint pain and swelling. They may be used for acute disabling attacks or when all other medicines fail to produce adequate results. Steroids, however, do not cure RA. They have such side effects as bone brittleness, weight gain, ulcer formation, diabetes, and others.   Arthritis associated with "wear and tear" in the joints.

 It does not usually develop before middle age except when a joint has been injured or when joints have been subjected to much stress and overuse, as in the finger joints of some pianists.

Degenerative joint disease (DJD) is an uncomfortable but not very severe disease. Unlike RA, it produces no constitutional symptoms such as fever and weight loss. In some cases, how- ever, it may cause joint disability. The joints usually affected are the weight-bearing ones such as hips, spine, knees, and ankles. Frequently swellings of small finger joints are seen. 

Affected joints may "creak" and grate on movement. Typically, and in contrast to RA, pain is increased by exercise and relieved by rest. An essential element of primary prevention is the avoidance of excessive weight gain, which adds to the burden and wear and tear of weight- bearing joints.