Rheumatoid arthritis is an inflammatory disorder of joints that may result in destruction and deformities of the joints resulting in limitations in the motion. When the symptoms of rheumatoid arthritis including pain, swelling, tenderness and stiffness of the joints appear, immediately contact your doctor and opt for the treatment as early as possible to avoid future complications. The treatment for rheumatoid arthritis includes various options such as medications, exercise, self-care, physiotherapy and surgical options.
The first step in the treatment for rheumatoid arthritis is use of medications to relieve the symptoms of this disease. The analgesics or non-steroidal anti-inflammatory drugs are effective to reduce the pain and inflammation in the joints. Other medications used for the treatment of this disease are glucocorticoids or prednisone, disease modifying antirheumatic drugs, biologic response modifiers and protein-A immunoadsorption therapy. Physiotherapy includes some exercises to improve the flexibility and motion of the joints.
In some cases of rheumatoid arthritis, the above mentioned treatment options may not be useful and they may require some surgical options to remove the inflamed synovial tissues and to heal the affected joint. Some of the surgical procedures included in the treatment for rheumatoid arthritis are synovectomy, tendon repair, arthroscopic surgery, osteotomy, arthrodesis and total joint replacement surgery or arthroplasty.
Synovectomy or removal of the joint lining is performed if the joint lining or synovium is inflamed which results in the painful joint. This procedure decreases the pain and swelling of the joints and prevents further damage of the joints.
In arthroscopic surgery, the surgeon inserts a tiny tube having a light at its end through a small incision into the joint and examines the joint damage on the closed-circuit television connected to the instrument. Then the doctor takes the tissue samples from the damaged joint, repairs the tears in the joints, removes the loose cartilage, smoothes a rough surface and removes affected synovial tissue. This surgical procedure is generally performed on the joints of shoulder and knee.
Due to inflammation and damage of the joints, the tendons around the joints may get tightened or loosened. These tendons are repaired through the tendon repair surgery. Osteotomy is another surgical option that helps to increase the stability of joints due to redistribution of the weight on the joints. However, it is not often applied in the treatment of rheumatoid arthritis. In addition to this surgery, Arthrodesis is another option which involves the fusion of two bones. It causes the limitations of movements, increases the stability and reduces the pain in the joints of wrists, toes, ankles, spine and fingers.
Arthroplasty or joint replacement surgery is the replacement or surgical reconstruction of the joints. It is helpful for the people who may be in a wheelchair. This surgical procedure involves the relining and resurfacing of the ends of bones, removal of the joint and replacement of the joint with an artificial component. Generally, this procedure is recommended for the people over 50 years and having severe progression of the disease.
Reiter’s syndrome is also known as reactive arthritis as it occurs as a reaction that originates in the genital or intestinal tract. There are two forms of this disorder such as one that occurs due to sexually transmitted infections including Chlamydial infection and other resulting from the intestinal infection such Salmonellosis or Shigellosis. The Reiter’s syndrome may affect various body parts and cause the inflammation of joints, eyes, skin, genitals, bladder and mucus membranes. The diagnosis of this disorder is based on the symptoms, physical examination, medical history of the patient and some laboratory tests performed to detect the infections.
There are various options of the treatment for Reiter’s syndrome including medications, rest and exercise. As this disorder affects various body parts, it is recommended to consult with different specialists such as a rheumatologist for the treatment of arthritis, ophthalmologist to treat conjunctivitis, urologists to treat the urogenital symptoms in men, dermatologist to treat the skin problems and gynecologist for the treatment of urogenital symptoms in women.
Although there is no cure for this disorder, the treatment for Reiter’s syndrome is meant for relieving the symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin are effective to reduce the joint inflammation due to Reiter’s syndrome. If NSAIDs are not effective for the people having severe joint inflammation, then the corticosteroid injections are found to be advantageous. They can be directly injected in the affected joint to decrease the inflammation. These injections are most frequently applied to cure severe ankle or knee inflammation.
Use of topical corticosteroid is another effective medicine that can be directly applied on the skin lesions resulted from the Reiter’s syndrome which helps to decrease an inflammation and enhance healing. As the bacterial infections act as the triggering factors for the Reiter’s syndrome, antibiotics are prescribed by the doctor to eliminate the infections. The antibiotic to be used for the treatment is decided on the basis of a type of infection. In few cases, the patients with Reiter’s syndrome may have severe symptoms that cannot be cured by above mentioned medications. In such cases, the medicines which suppress the immune system including methotrexate or sulfasalazine are found to be effective.
In addition to medications, exercise is another beneficial option of the treatment for Reiter’s syndrome. Some gentle range-of-motion and strengthening exercises are helpful to maintain or improve the functioning of joint, build up the muscles, decrease the stiffness and improve the flexibility of joints. Besides this treatment option, short-term bed rest is advantageous to reduce the inflammation and pain of arthritis.
In most cases, above mentioned treatment options are sufficient for cure. However, in some cases of severe joint damage, the surgical reconstruction of the joints like total knee replacement or total hip replacement performed by the orthopedic surgeon is necessary to restore pain-free function.
There are various treatment options for the chronic, inflammatory type of arthritis. It is important to opt for early treatment for psoriatic arthritis as this disease can damage the joints and cause deformities of joints. This disease causes inflammation of joints which results in pain, redness and stiffness of joints. The diagnosis psoriatic arthritis is done on the basis of physical examination, symptoms and x-ray findings. After the proper diagnosis, suitable treatment option is decided.
The treatment for psoriatic arthritis is aimed to manage the pain and reduce the symptoms. The analgesics like paracetamol are useful to reduce the pain. Anti-inflammatory medications called as non-steroidal anti-inflammatory drugs like ibuprofen can help to reduce stiffness and pain in the joints. If proper response is not found, then disease modifying anti-rheumatic drugs (DMARDS) such as methotrexate, sulfasalazine, cyclosporine can be used.
Antimalarial medications like hydroxychloroquine (Plaquenil) can be useful for persistent psoriatic arthritis. Leflunomide (Arava) is an effective treatment for both psoriasis and psoriatic arthritis. Corticosteroids are effective anti-inflammatory agents which can be given orally or can be directly injected into the joints to decrease the inflammation.
There are 3 various options of treatment for psoriatic arthritis such as topical therapy, phototherapy and systemic therapy. The topical agents include the medications that are directly applied to the skin. They include vitamin D-3 derivatives, corticosteroids, anthralin, coal tar and retinoids. The phototherapy involves application of ultra-violet light from the sun which reduces the production of skin cells and decreases inflammation. Sunlight is found to be beneficial to reduce the psoriasis symptoms in some cases. Ultra-violet B light is used for the treatment of psoriasis. PUVA treatment involves use of a medicine known as psoralen and UV A light. When topical treatment and phototherapy are not found to be beneficial, systemic agents such as Psoralens, Etanercept, cyclosporine and Methotrexate are used for the treatment of this disorder.
Recently, three new medications are proved to be advantageous for the treatment of severe psoriatic arthritis. If DMARDs does not work, you may apply the TNF-blockers such as infliximab (Remicade), etanercept (Enbrel) and adalimumab (Humira) is found to be useful for severe psoriatic arthritis which significantly improve psoriasis as well as arthritis and prevent the progressive joint damage.
Exercise which can be done at home or with the help of physiotherapist is very helpful to manage the symptoms of psoriatic arthritis. Application of heat and cold is beneficial to ease the joint stiffness and reduce joint swelling. Have a balance diet with plenty of vegetables and fruits.
Reiter’s syndrome can be called as a group of symptoms including arthritis, conjunctivitis, urethritis and lesions of mucus membrane and skin and it is characterized by the inflammation of the joints, eyes, skin, genitals, bladder and mucus membranes. It may occur after the infections such as campylobacter, Chlamydia, yersinia or salmonella. A person with positive genetic factor HLA-B27 is more susceptible to this disorder.
The symptoms of Reiter’s syndrome are dependant on the body part which is affected by this disorder. Generally, the Reiter’s syndrome occurs after the inflammation of urinary tract or gastrointestinal tract. The arthritis related to the Reiter’s syndrome usually affects the ankles, knees and feet which causes swelling and pain in the joints. Fingers, wrists and other joints are less commonly affected. In addition to these symptoms, the patients with Reiter’s syndrome may develop the enthesopathy (inflammation of tendons) which may result in pain in heel and thickening and shortening of toes and fingers. Besides that, there may be possibility of development of heel spurs, a bony growth in the heel which may cause chronic pain in foot.
Arthritis in the Reiter’s syndrome may cause the damage to the joints in back and result in spondylitisn or sacroiliitis. The people with HLA-B27 gene are at greater risk of developing spondylitis or sacroiliitis. However, in most people, the joint inflammation caused due to Reiter’s syndrome does not result in the permanent damage or disability of the joints.
As Reiter’s syndrome is followed by the infection of genitourinary tract, the symptoms of Reiter’s syndrome are associated with the urogenital tract. It may affect penis, urethra and prostate in men and vagina, uterus and fallopian tubes in women. Men may experience increased frequency of urination with a burning sensation as well as discharge from the penis. Besides this, there is a possibility of developing prostatitis, inflammation of prostate gland in some cases. Women having the Reiter’s syndrome may develop the symptoms like an inflammation of the urethra (urethritis), which may result in burning sensation during micturition or an inflammation of the cervix (cervicitis).
As the Reiter’s syndrome can affect the eyes, conjunctivitis is one of the common symptoms of Reiter’s syndrome. It can cause the inflammation of conjunctiva and may result in eye pain and irritation, redness of the eyes and blurred vision.
In addition to these symptoms of Reiter’s syndrome, one can experience small, painless lesions or sores known as balanitis circinata may be seen on the roof of the tongue or mouth or on the head of penis.
