Rheumatoid Arthritis (cont.)
Other treatments
There is no special diet for
rheumatoid arthritis. One hundred years ago, it was touted that "night-shade" foods, such as tomatoes, would aggravate rheumatoid arthritis. This is no longer accepted as true. Fish oil
may have
anti-inflammatory beneficial effects, but so far this has only been shown in
laboratory experiments studying inflammatory cells. Likewise, the benefits
of cartilage preparations remain unproven. Symptomatic pain relief can
often be achieved with oral acetaminophen (Tylenol) or over-the-counter topical preparations, which are rubbed into the skin.
Antibiotics, in particular the tetracycline drug minocycline (Minocin), have been tried for rheumatoid arthritis recently in
clinical trials. Early results have demonstrated mild to moderate improvement in
the symptoms of arthritis. Minocycline has been shown to impede important
mediator enzymes of tissue destruction, called metalloproteinases, in the
laboratory as well as in humans.
The areas of the body other than the joints that are
affected by rheumatoid inflammation are treated individually. Sjogren's syndrome
(described above, see symptoms) can be helped by artificial tears and
humidifying rooms of the home or office. Medicated eyedrops, cortisporine ophthalmic drops (Restasis), are also available to help the dry eyes in those affected. Regular eye checkups and early
antibiotic treatment for infection of the eyes are important. Inflammation of
the tendons (tendinitis), bursae (bursitis), and rheumatoid
nodules can be injected with cortisone. Inflammation of the lining of the
heart and/or lungs may require high doses of oral cortisone.
Proper, regular exercise is important in maintaining
joint mobility and in strengthening the muscles around the joints. Swimming is
particularly helpful because it allows exercise with minimal stress on the
joints. Physical and occupational therapists are trained to provide specific
exercise instructions and can offer splinting supports. For example, wrist and
finger splints can be helpful in reducing inflammation and maintaining joint
alignment. Devices such as canes, toilet seat raisers, and jar grippers can
assist in the activities of daily living. Heat and cold applications are
modalities that can ease symptoms before and after exercise.
Surgery may be recommended to restore joint mobility or
repair damaged joints. Doctors who specialize in joint surgery are orthopedic
surgeons. The types of joint surgery range from arthroscopy to partial
and complete
replacement of the joint. Arthroscopy is a surgical technique whereby a
doctor inserts a tube-like instrument into the joint to see and repair
abnormal tissues.
Total joint replacement is a surgical procedure whereby a
destroyed joint is replaced with artificial materials. For example, the
small joints of the hand can be replaced with plastic material. Large
joints, such as the hips or knees, are replaced with metals.
Finally, minimizing emotional stress
can help improve the overall health in people with rheumatoid arthritis. Support and extracurricular groups provide those with rheumatoid arthritis time to discuss their problems with others and learn more about their illness.
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