Top Questions on Living with Rheumatoid Arthritis

Dr. Sirish PhysiotherapistBPTh/BPTPhysiotherapist

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It sounds like you're experiencing limited mobility in your thumbs and are unsure about the underlying cause, whether it's related to carpal tunnel syndrome or basal thumb arthritis. Here's what you can consider in terms of diagnosis and testing: medical evaluation: schedule an appointment with a healthcare professional, preferably a hand specialist or orthopedic surgeon, who can assess your symptoms and perform a thorough physical examination of your thumbs and hands. They will ask about your medical history, including any previous injuries or conditions that may be contributing to your symptoms. Diagnostic tests: based on your symptoms and physical examination, your healthcare provider may recommend one or more diagnostic tests to further evaluate your condition. These tests may include: x-rays: x-rays can help identify any abnormalities or degenerative changes in the bones of the thumb joint, which can indicate basal thumb arthritis. Blood tests: blood tests may be ordered to rule out underlying conditions such as rheumatoid arthritis or other inflammatory disorders that can affect the joints. Nerve conduction studies: nerve conduction studies can help assess nerve function and determine if there is any evidence of nerve compression or damage, which is characteristic of carpal tunnel syndrome. Electromyography (emg): emg testing may be recommended to evaluate the electrical activity of muscles and detect any abnormalities associated with nerve compression or damage. Imaging studies: in addition to x-rays, other imaging studies such as ultrasound or mri may be ordered to provide detailed images of the soft tissues, including the ligaments, tendons, and cartilage, to help assess the extent of joint damage or inflammation. Physical examination: your healthcare provider will also perform a physical examination of your thumbs and hands, assessing for signs of inflammation, swelling, tenderness, and range of motion. They may also perform specific tests to assess thumb function and mobility. Comprehensive assessment: based on the results of these tests and examinations, your healthcare provider can provide a comprehensive assessment and diagnosis of your condition. They will discuss treatment options tailored to your specific needs, which may include conservative measures such as splinting, physical therapy, or medications for pain and inflammation, as well as surgical options if necessary. 

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Dr. Rajesh Chander ChoddaBachelor of Ayurveda, Medicine and Surgery (BAMS)Ayurvedic Doctor

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Neem juice benefits include blood purification, toxins removal, ulcers, and insect bites treatment. With anti-bacterial traits, it cures burns, infections, and skin problems fast. It destroys those bacteria that pose infections. 

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Dr. G.R. AgrawalDHMS (Hons.)Homeopathy Doctor

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Hi, lybrate user, Lump in breast includs three different stages Underlying : 1: -Cyst'. 2:- Fibrodenoma 'and ' 3: - Fibrodenometosis, at three diferent sites in breast, • Its dimension is to be assessed , first ,most of the lumps can't be declared as cancerous unless , examined through memeography and FNAC to assess its axact condition . Tumor might be associated with white or bloody discharge from nipples . Reduce ,your weight , if you are obeased . Take, Haldi(curcumine), fish,tomatoes,flex seeds,spinach,Pomegranate,broccoli and blueberries. Proper homoeopathic remedies can assist, you , successfully, reviewing your reportés , privetly in this regard,please. Till then,take homoeopathic medicine, underlying: @ Acitic acid 30ch-5 drops, thrice/ Avoid , junk food, spicy and fried food. TK, Care. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Rheumatoid arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education assistive devices and adaptive equipment occupational therapy improves functional ability in patients with ra. Occupational therapy interventions such as assistive devices and adaptive equipments have beneficial effects on joint protection and energy conservation in arthritic patients. Assistive devices are used in order to reduce functional deficits, to diminish pain, and to keep patients' independence and self-efficiency. Loading over the hip joint may be reduced by 50% by holding a cane. In fact, most of these instruments are originally designed for patients with neurologic deficits; therefore, certain adaptations may be needed for them to be used in patients with arthritis. Elevated toilet seats, widened gripping handles, arrangements related with bathrooms, etc. Might all facilitate the daily life. The procedures needed to increase compliance of the patient with the environment and to increase functional independence are +mainly determined by the occupational therapist. Massage therapy that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Massage is found to be effective on depression, anxiety, mood, and pain. Therapeutic exercise every joint should be moved in the rom at least once per day in order to prevent contracture. In the case of acutely inflamed joints, isometric exercises provide adequate muscle tone without exacerbation of clinical disease activity. Moderate contractures should be held for 6 seconds and repeated 5–10 times each day. Dynamic exercise therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (ra). Finally, in chronic stage with inactive arthritis, conditioning exercises such as swimming, walking, and cycling with adequate resting periods are recommended. They increase muscle endurance and aerobic capacity and improve functions of the patient in general, and they also make the patient feel better. It might be due to lack of blood circulation which is the reason for you to have scrotum pain / back pain. You have to do basic aerobic exercises for you to become fit and also to maintain the blood circulation and tone. Patient education in patients with ra, sociopsychological factors affecting the disease process such as poor social relations, disturbance of communication with the environment, and unhappiness and depression at work are commonly encountered. The treatment of rheumatic diseases should provide education and information to their patients about their condition and the various physical therapy and rehabilitative options that are available to improve their quality of life. Passive treatments for rheumatoid arthritis •cold therapy reduces circulation, which ultimately decreases swelling. For example, a cold compress may be placed on the painful area. •cold therapy in acute phase •dosage 10-20mints/1-2 times a day. •heat therapy eases muscle tension and gets blood to flow more quickly to the painful area. For example, a moist, warm cloth may be used to promote circulation. •heat therapy in chronic phase •dosage 20-30mints/1-2 times a day. •hydrotherapy involves reducing your ra-related pain and other symptoms with water. With hydrotherapy, you will be submerged in warm water to relieve your symptoms. •massage can help reduce muscle tension and promote good circulation. It's also a fantastic way to help you manage stress (especially important for people with rheumatoid arthritis). •transcutaneous electrical nerve stimulation (tens) works by blocking pain signals from getting to your spinal cord. It also helps decrease muscle spasms. •tens short term pain relief (6 to 18 hrs) •ultrasound creates warmth using sound waves, whichenchanes circulation and decreases joint pain, inflammation, and stiffness. Exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. 

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Dr. Rahul RaiMSPT (Master of Physical Therapy), Bachelor of physiotherapyPhysiotherapist

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Yes you can take for joint pain and swelling but you hv any infection in your body thn dnt take like liver, skin,kidney or tb or taking blood thinner thanks. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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1.resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. 2•standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone •stretching exercises. Regular, steady stretching exercises can reduce muscle spasm and help lengthen the muscle-tendon unit. Don't bounce during your stretch. 3•strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press.•this is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened. 

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Dr. Yogitaa MandhyaanBPTh/BPT, Weight Management Specialist, Diploma in Nutrition and Health Education (DNHE)Physiotherapist

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If there are acute symptoms of RA like pain,swelling in the joints then limit carbohydrates(wheat,bread etc) and eat more of fruits and vegetables.Also take physiotherapy treatment to keep the joints mobile by exercising to maintain the range of motion.Can take heat/cold treatment as advised by the therapists.Also take omega 3 either in the form of supplements or fatty fish. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy this should be due to the sciatic nerve compression in the right side probably close to your l5 vertebrae. It can also be due to the strain on the left leg, try wearing mcr chappals which would help you to get relieved from pain. To protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Rheumatoi d arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy this should be due to the sciatic nerve compression in the right side probably close to your l5 vertebrae. It can also be due to the strain on the left leg, try wearing mcr chappals which would help you to get relieved from pain. Rheumatoid arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education assistive devices and adaptive equipment occupational therapy improves functional ability in patients with ra. Occupational therapy interventions such as assistive devices and adaptive equipments have beneficial effects on joint protection and energy conservation in arthritic patients. Assistive devices are used in order to reduce functional deficits, to diminish pain, and to keep patients' independence and self-efficiency. Loading over the hip joint may be reduced by 50% by holding a cane. In fact, most of these instruments are originally designed for patients with neurologic deficits; therefore, certain adaptations may be needed for them to be used in patients with arthritis. Elevated toilet seats, widened gripping handles, arrangements related with bathrooms, etc. Might all facilitate the daily life. The procedures needed to increase compliance of the patient with the environment and to increase functional independence are +mainly determined by the occupational therapist. Massage therapy that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Massage is found to be effective on depression, anxiety, mood, and pain. Therapeutic exercise every joint should be moved in the rom at least once per day in order to prevent contracture. In the case of acutely inflamed joints, isometric exercises provide adequate muscle tone without exacerbation of clinical disease activity. Moderate contractures should be held for 6 seconds and repeated 5–10 times each day. Dynamic exercise therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (ra). Finally, in chronic stage with inactive arthritis, conditioning exercises such as swimming, walking, and cycling with adequate resting periods are recommended. They increase muscle endurance and aerobic capacity and improve functions of the patient in general, and they also make the patient feel better. It might be due to lack of blood circulation which is the reason for you to have scrotum pain / back pain. You have to do basic aerobic exercises for you to become fit and also to maintain the blood circulation and tone. Patient education in patients with ra, sociopsychological factors affecting the disease process such as poor social relations, disturbance of communication with the environment, and unhappiness and depression at work are commonly encountered. The treatment of rheumatic diseases should provide education and information to their patients about their condition and the various physical therapy and rehabilitative options that are available to improve their quality of life. Passive treatments for rheumatoid arthritis •cold therapy reduces circulation, which ultimately decreases swelling. For example, a cold compress may be placed on the painful area. •cold therapy in acute phase •dosage 10-20mints/1-2 times a day. •heat therapy eases muscle tension and gets blood to flow more quickly to the painful area. For example, a moist, warm cloth may be used to promote circulation. •heat therapy in chronic phase •dosage 20-30mints/1-2 times a day. •hydrotherapy involves reducing your ra-related pain and other symptoms with water. With hydrotherapy, you will be submerged in warm water to relieve your symptoms. •massage can help reduce muscle tension and promote good circulation. It's also a fantastic way to help you manage stress (especially important for people with rheumatoid arthritis). •transcutaneous electrical nerve stimulation (tens) works by blocking pain signals from getting to your spinal cord. It also helps decrease muscle spasms. •tens short term pain relief (6 to 18 hrs) •ultrasound creates warmth using sound waves, whichenchanes circulation and decreases joint pain, inflammation, and stiffness. Exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Polyarthritis do’s do the prescribed exercise regularly to maintain strength, flexibility and range of motion. Do keep the affected arm supported. Use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. Don’ts don't sleep on the affected side. Don't lift heavyweight with the affected arm. Don't jerk your shoulder to avoid stress. Don't use the arm to push yourself up in bed or from a chair. Don't participate in contact sports or do any repetitive heavy lifting. We suggest you to wear shoulder support brace which is available in two different sizes which makes the patient to feel comfortable as it maintains the shoulder in anatomical position and the short lever is maintained. The reason to maintain the short lever in the shoulder joint is it helps the shoulder to prevent the movements which itself is the key to have better progression of healing in the shoulder region. This is suggested for the following conditions. This shoulder support brace what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Knee arthritis can be painful and debilitating. For osteoarthritis (oa) of the knee, self-care early on can often help significantly. It is important to stretch and strengthen the surrounding leg muscles to provide more support and reduce stresses around the joint. The following best bet exercises will help you get started on your path to feeling stronger, more flexible and more active. Remember: exercise should not be painful – if you experience pain, discontinue and consult with your physician. Advice: 1.must take adequate rest 2.apply hot water with mild heat with cotton towel 3.avoid cross leg sitting and long time standing 4. Put the small size chair under the ankle during sitting in the chair for leg elevation 5.do the exercise given below 2 times per day 1.quadriceps setting exercise helps to strengthen the quadriceps muscle (the big muscle on the front of the thigh), an important stabilizer of the knee. Lie on your back with the leg you want to exercise straight. Place a small rolled towel underneath the knee. Slowly tighten the muscle on top of the thigh (quadriceps) and push the back of the knee down into the rolled towel. Hold contraction for 5 seconds and then slowly release, resting 5 seconds between each contraction. Perform 3 sets of 10 repetitions, 1 time daily. 2.straight leg raise also helps to strengthen the quadriceps muscle. Lie on your back with the leg you want to exercise straight. The other knee should be bent to support your lower back. Tighten the muscle on the top of your thigh and lift to the level of your other knee. Slowly lower. Perform 3 sets of 10 repetitions, 1 time daily. 

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