Rheumatoid Arthritis Treatment

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

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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. Stiffness might have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. You need to consume good protein and iron diet in your body which will help you to break the fatigue and general body pain. However non veg foods definitely makes you to get increased with the toxin levels in the body and it makes your knee to have less fluid content in the system. In general we suggest patients who has knee pain to eat more water content vegetables which will definitely help you to feel better. 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. •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. ••muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees ••d cartilageacl •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. ••knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain 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, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain.•legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. •knee pain, when leg folding time get pain. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which 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. 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. 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 1. Heel and calf stretch 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. You need to consume good protein and iron diet in your body which will help you to break the fatigue and body pain. You have to reduce the weight by walking minimum 1 km per day. Slowly reduce the weight and slowly avoid adding salt in the diet which will help you to prevent water retention in the body. Excess salt in general leads to water in the body which might be the reason for you to have leg pain. Hotwater fermentation that would help you to get relieved from joint pains. But food precautions, it is better to avoid tamarind in the food rather to add lime or mango. You can generally do basic aerobic exercises which will definitely help to improve the body weakness. Consume good protein and vitamin diet which will help you to improve your weakness of the whole body. You can give good vitamin d and calcium which will help to have quick healing. If you are a non veg person consume seer fish or if you are a veg person eat mushrooms which has vitamin d3. You need to consume water content vegetables which will make you feel hydrated. A good brace will protect your knee and take the pressure off your meniscus, allowing it to rest. Your doctor may recommend the rice regimen—rest, ice, compression, and elevation—to treat a eroded cartilage which is the main reason for the synovial fluid to get drained. Resting your knee can help relieve your symptoms. Steps to heal a worn out cartilage naturally: rest: it's crucial to rest your knee after it starts to ache. You should not participate in activities where you could cause additional strain. Ice: apply ice to your knee for 15 minutes at four-hour intervals. 

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

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It 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. Sirish PhysiotherapistBPTh/BPTPhysiotherapist

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Fyzen is a brand name for a medication called piroxicam, which belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs (nsaids). Piroxicam is commonly used to reduce pain, inflammation, and swelling associated with various conditions, including musculoskeletal injuries, osteoarthritis, rheumatoid arthritis, and other inflammatory conditions. Given that you consulted an orthopedic doctor for knee pain that occurred after a minor accident, the prescription of piroxicam (fyzen) is likely aimed at reducing inflammation and providing pain relief associated with the knee injury. Piroxicam works by inhibiting the production of certain chemicals in the body that are involved in the inflammatory response, thereby helping to alleviate symptoms such as pain and swelling. It's important to follow your doctor's instructions regarding the use of fyzen or any other prescribed medication. Be sure to take the medication as directed, at the prescribed dosage and frequency. It's also important to be aware of any potential side effects or contraindications associated with piroxicam, and to discuss any concerns or questions you may have with your doctor. If you experience any adverse reactions or if your symptoms persist or worsen despite treatment, it's important to follow up with your doctor for further evaluation and management. Additionally, your doctor may recommend other treatments or interventions to help address your knee pain and promote healing, such as physical therapy, rest, ice, compression, and elevation (rice), or other modalities as appropriate for your specific condition. 

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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. 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. 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. Prakhar SinghMBBS, Basic Life Support (B.L.S), Advanced Cardiac Life Support, Fellow of Academy of General Education (FAGE)General Physician

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I am sorry to hear about your concern but will be happy to assist you. The causes of limited mouth opening include trauma, infection, temporomandibular joint disorders (tmds), neurological disorders, rheumatoid arthritis, drugs, tumors, hyperplasia of the coronoid process, etc. Let's connect over a call so that we can discuss your concern in details and make a treatment plan for you. 

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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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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. 

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