Rehabilitation for rheumatoid arthritis

Rheumatoid arthritis is a systemic connective tissue disease that typically affects the ankle, knee, ankle, and hand joints. Women are affected 3 times more often than men. The root cause of this disease is not fully understood, it is believed that this may be a malfunction in the body's immune system. However, such provoking factors as trauma, hypothermia, past infections and stress can serve as an impetus for the development of rheumatoid arthritis.

Since the disease is asymptomatic at the initial stage, patients who turn to the doctor, as a rule, already have a sufficient development of the disease. To determine the degree of damage to the joints, the doctor will prescribe blood tests - immunological and biochemical, X-ray or magnetic resonance imaging of the joints.

Modern methods of treatment of rheumatoid arthritis involve the use of immunomodulatory and anti-inflammatory drugs. These drugs reduce pain and inflammation, inhibit the manifestation of immune reactions. Unfortunately, taking medications can last quite a long time, sometimes a lifetime. Their appointment and control is carried out only by a specialist.

In addition to therapeutic treatment, patients with rheumatoid arthritis are prescribed physiotherapy, massage and exercise therapy for speedy rehabilitation and return to a normal lifestyle.

Fundamentals of rehabilitation of patients with rheumatoid arthritis

Recovery of patients with rheumatoid arthritis is the most difficult problem of modern rheumatology. The progressive course of the disease, the high frequency of lesions in young people, the loss of functional and social skills, the severity and localization of joint damage, the incidence of the disease in adults is about 2% - all these factors make the rehabilitation process long and difficult.

Rehabilitation measures should be started as early as possible to obtain a positive dynamics of the patient's condition.

The main tasks of the rehabilitation process are:

• Eliminate pain syndrome
• Increased range of motion of the affected joints,
• Prevention of the formation of deformities and elimination of existing deformities,
• Increasing the endurance of the patient's muscle tone,
• Improving the level and quality of life of the patient.

Successful means of rehabilitation of patients with rheumatoid arthritis are:

• Physiotherapy,
• Massage,
• Orthotics,
• exercise therapy,
• kinesitherapy,
• Reflexology,
• traction treatment,
• Preformed (hardware) methods,
• Spa treatment.

Physiotherapy as a method of arthritis rehabilitation

This method is an integral part of the rehabilitation process of patients with arthritis. Some types can be prescribed with an active acute process, others - in remission.

Treatment with ultraviolet light and electrophoresis with the use of glucocorticoids on the affected joints is prescribed for the acute course of the process. The session lasts about 15-20 minutes, a total of 10-12 sessions are prescribed.

The subacute stage involves receiving UHF therapy sessions, helium-neon irradiation, magnetotherapy and light therapy.

During the proliferative period, patients can receive sessions of ultraphonophoresis, high-intensity magnetic therapy, general cryotherapy, naftalan therapy.

Massage for rheumatoid arthritis

Massage is a complex of manipulations with the soft tissues of the body, aimed at stimulating and restoring the muscles, circulatory and nervous systems. In combination with exercise therapy, a balanced diet, massage can achieve significant results in patients with rheumatoid arthritis.

Before starting a massage session, a rheumatologist must accurately determine the following factors:

• Determine the stage of limitation of the motor function of the affected joint;
• The degree of relaxation or muscle tension at the site of inflammation;
• Energy points to be affected;

It must be remembered that massage is not prescribed in the acute phase of the disease.

Several massage techniques are used for rheumatoid arthritis: segmental, acupressure, self-massage, etc.

After discharge from the hospital and with strict adherence to the instructions of a rehabilitation doctor, patients with rheumatoid arthritis can perform self-massage at home.

Massage can be carried out in any position, the main thing is to listen to your body, to pain and not overdo it.

Like any procedure of physical impact on the body, massage has its own contraindications:

1. Acute infectious diseases;
2. Skin diseases (rash, ulcers, abscesses, eczema);
3. Pain in the area of ​​the joint affected by rheumatoid arthritis;
4. Heat;
5. Increased blood pressure.
6. Cardiovascular diseases in acute form;
7. thrombosis, varicose veins,
8. Tuberculosis in an open form,
9. Allergic reactions (Quincke's edema, urticaria).

Orthotics

A conservative method of treatment and prevention of diseases of the musculoskeletal system, which consists in maintaining or restoring the functions and shape of the affected parts with the help of special devices - orthoses - is called orthotics.

The main tasks of orthotics are:

• creating controlled rest to reduce pain or inflammation in the joint;
• unloading and protection of joints;
• prevention and slowdown in the development of contractures and deformities.

Orthoses are external orthopedic devices designed for unloading, correcting and stabilizing axes, protecting joints and segments of the musculoskeletal system.

Most often, orthoses are used for arthritis of the joints of the hands and wrist dysfunction.

Methods of exercise therapy

The main general tasks of exercise therapy are:

• Improving blood circulation in the affected joint and water-salt metabolism,
• Relaxation of the muscles that support the joint
• swelling reduction,
• Relief of pain syndrome
• Further strengthening of muscle strength and expansion of the range of motion.

The doctor is obliged to advise the patient about the benefits, goals and objectives of exercise therapy. When prescribing a set of exercises to a patient with arthritis, it is necessary to take into account the clinical picture (age group, degree of damage, the state of other body systems).

The main course of rehabilitation gymnastics is performed for about 30-40 minutes for two weeks under the supervision of a kinesiologist and consists of the following steps:

• The introductory relaxing part - the doctor will teach the patient, lying down, to relax the limbs and adjust breathing - takes about 10-15 minutes,
• The main training part - exercises for patients with lesions of the upper and lower extremities - 30-35 minutes,
• The final part - the specialist will teach patients simple exercises that they can do on their own at home after discharge.

The main criteria for compiling a training program are:

1. The choice of a set of exercises,
2. The number of repetitions
3. The number of approaches
4. Load during the lesson,
5. The duration of the procedure.

Water gymnastics, as one of the successful methods of exercise therapy

Water procedures are shown to absolutely all patients with a similar pathology. Swimming and active movements in the water help to reduce the burden of the patient's own weight on the joints. The appropriate temperature of the water in the pool reduces pain. Patients are instructed to do the following:

• Holding on to the handrails, swing your legs in the water,
• Spread your arms to the sides, walk on bent legs,
• Having plunged to the appropriate depth, spread your arms in the water and drive with straight arms along the water surface, overcoming the force of resistance,
• Smooth turns of the body to the sides,
• Swimming with a rubber ball.

Performing health exercises in the pool is not allowed in the presence of bleeding wounds, skin diseases, allergic rashes and sexually transmitted diseases.

Spa treatment

Every year, patients with rheumatoid arthritis should undergo spa treatment. A specialist can send a patient to a sanatorium only if he is able to serve himself. In the case when the patient experiences serious pain and cannot move independently and perform basic procedures, treatment in a sanatorium is contraindicated.

The course of treatment in the sanatorium includes the following methods: exercise therapy, physiotherapy, balneotherapy, climatotherapy, acupuncture.

The success of rehabilitation techniques in rheumatology

Rehabilitation of patients with rheumatoid arthritis should be started as early as possible, since the reversibility of inflammatory processes is high, in the absence of pronounced disorders in the functionality of the joints and early diagnosis. In combination with drug therapy, the rehabilitation of patients gives a rather positive trend.

In patients with a chronic course of the disease, the rehabilitation process will help stop the involvement of new joints and prolong periods of remission.