Question

My wife us having ra factor 18.6,esr - 59 and crp 23.6 what should be the treatment.

Dr.Julie Mercy J David · Accepted Answer

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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