The Non-Pharmacologic Treatment of Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic, progressive, destructive and deforming arthropathy, characterized by symmetrical erosive synovitis and multisystemic injury. Despite the progresses of pharmacological therapy for RA, many patients continue to have active disease with the risk of developing disability. A number of non-pharmacological therapies are used in addition to the regular treatment of RA. On October 7th, 2008, American Physical Activity guidelines were released, based on the latest physical activity techniques, with impact on the health of people with arthritis, grouped under the acronym SMART. A comprehensive management program for RA includes patient education, psycho-social interventions, adequate rest, exercise, physical and occupational therapy, nutritional and dietetics counseling, interventions to reduce the risk of cardiovascular diseases, osteoporosis and immunizations to reduce the risk of complications from immunosuppressive treatment. The objectives of this program are: disease stabilization, preventing deviations, deformities and ankylosis, combating retractions and stiffness, partial or complete restoration of motor functional capacity of patients. For achieving these goals, the treatment must adhere to the following general conditions: to be initiated early, to be continuous and complex. In conclusion, education and counseling of the patient are important for the management of RA. The physicians should explain to the patient all the treatment options and develop with him a longitudinal treatment plan, which includes the association of the pharmacological therapy with the non-pharmacological one.

Navigating Pain in Rheumatology: A Physiotherapy-Centric Review on Non-pharmacological Pain Management Strategies

“…A significant amount of physiotherapy time is spent managing rheumatic disorders, and hospitals that concentrate on rheumatic disease have physiotherapy departments dedicated solely to this area of physiotherapy. Traditionally, physical and occupational therapists have treated patients using non-pharmacologic techniques [ 12 ]. The following include walking aids, braces, splints, orthoses for the feet, electrotherapy, patient education, therapeutic physical activity, and assistive devices for activities of daily living (ADL).…”

Diagnosing and managing patients with rheumatoid arthritis

“…A significant aspect of treatment is proper patient education about the disease, treatment, and health maintenance so patients can be better involved in the management of their disease. Consultations with physiatry and occupational and physical therapies are invaluable because they provide assistance with splints and orthotic devices, exercise programs, education on joint protection, adaptive equipment use and training, and methods to conserve energy 21. Consultation with a nutritionist also can be beneficial, especially for patients with severe RA, who frequently suffer from malnutrition or anorexia.…”

“…Consultations with physiatry and occupational and physical therapies are invaluable because they provide assistance with splints and orthotic devices, exercise programs, education on joint protection, adaptive equipment use and training, and methods to conserve energy. 21 Consultation with a nutritionist also can be benefi cial, especially for patients with severe RA, who frequently suffer from malnutrition or anorexia. Patients with obesity would also benefi t from consultation with a nutritionist to help modify their eating habits; excess weight puts stress on joints.…”