Rheumatoid Arthritis - preventive care and treatment

The joints may be stiffer and sorer in the morning than after exercise. In some cases, small hard nodules may appear under the skin, especially in pressure areas. In many instances, the hand affected by RA begins to deviate outward (toward the little finger). To confirm the diagnosis, x-ray studies may reveal characteristic changes of bones and joints. Blood tests may be used, including one for an unusual protein that appears in the blood of patients with RA, although it may sometimes be related to other diseases. 

Once RA is diagnosed, the physician can envision two possible scenarios for the disease. In one form of RA, there is severe joint inflammation, with pain, swelling, fairly rapidly developing deformities. Fever and prostration often accompany this type of RA; and if the disease is untreated, not only may there be rapid development of deformities, but the deformities may become crippling. In the second and more common type, the arthritic pains and swelling are not as severe and disabling, and there may be intervals during which few, if any, symptoms are experienced.

However, gradually over many years and often after several attacks of more severe joint pain, the joints may become deformed and impaired. Although medical science is learning more and more about rheumatoid arthritis, much remains to be revealed about the cause. The latest findings seem to indicate that an unusual type of bacterium or virus may cause the disease.

Meanwhile, lacking means of primary prevention, the physician must rely on methods of secondary and tertiary prevention to counter the ill effects of RA-joint deformity and disability. For secondary prevention, a many-pronged approach is used. Bed rest is important for acutely inflamed joints. In severe cases, this may mean hospitalization. In less severe cases, adequate sleep and avoidance not only of excessive fatigue but also of coldness and dampness may serve. It's important; too, that inflamed joints be maintained in non-deforming positions.

Swollen, inflamed joints are most comfortable when slightly bent, but if they freeze in this position they become of limited usefulness. Therefore every effort must be made to keep the joints extended or straight. This may require that splints and braces be worn at night and, in some cases, during the day as well. It may also call for use of a non-sagging mattress with a small pillow under the head to help keep the back straight; chairs with firm seats and straight backs; avoidance of tightly drawn sheets; use of cane or crutch to avoid excess weight on sensitive joints; and proper shoes with straight last. 

Exercise is important as part of the program to keep joints from stiffening. Special exercises may be needed to increase or maintain muscle power or to relieve any deformities that may have begun to develop. Local heat-from heating pad, lamp, etc.-helps relieve muscle spasm and pain. Pain-relieving medications also are essential for the arthritic.