Various treatment and choice of rheumatoid arthritis (rheumatoid arthritis)

Rheumatoid arthritis or rheumatoid arthritis is an autoimmune disease that occurs when the body's immune system attacks healthy joints back. As a result, the joints become painful, stiff, swollen, and other rheumatic symptoms arise. There are various ways to treat rheumatism that doctors usually recommend to treat this disease. What are the medications and treatments for rheumatism or rheumatoid arthritis?

Drugs and treatment for rheumatoid arthritis or rheumatoid arthritis

Rheumatoid arthritis (RA) or rheumatism is a type of arthritis that cannot be completely cured. The treatment given is generally to reduce inflammation, relieve symptoms, slow the progression of disease and joint damage, and improve joint motion function, which will have an impact on improving the quality of life.

The likelihood of achieving these goals will be even higher if the disease is treated early. Therefore, you should immediately see a doctor if you feel certain symptoms in the joints associated with this disease.

However, the treatment given to each rheumatoid patient can vary. This will depend on the severity of the disease, your age, and your overall health condition. But in general, here are various ways to treat rheumatism or rheumatoid arthritis that doctors recommend:

1. Rheumatic drugs

Medicines are the main way to treat rheumatism. The type of medication recommended by your doctor depends on the severity of your symptoms and how long you have had the disease. The types of drugs include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAID drugs work to reduce inflammation and relieve pain in joints due to rheumatoid arthritis. For example, generic rheumatic NSAIDs or those that can be purchased at pharmacies, namely ibuprofen and naproxen.

Meanwhile, stronger NSAID rheumatism drugs generally require a prescription from a doctor, such as COX-2 inhibitors (celecoxib or etoricoxib). However, NSAIDs have a risk of side effects, such as stomach irritation, heart problems, and liver and kidney damage.

Corticosteroids

Corticosteroid drugs, such as prednisone, can reduce inflammation, relieve pain and stiffness, and slow joint damage. Doctors generally prescribe this drug to relieve symptoms of acute rheumatism in the short term or when relapses (flares).

Long-term use of steroid drugs can have serious side effects, such as thinning bones (osteoporosis), weight gain, diabetes, easy bruising, muscle weakness, and skin thinning.

Disease-modifying antirheumatic drugs (DMARD)

DMARD drugs can slow the progression of rheumatic disease and help save joints and other tissues from permanent damage. This type of drug works by blocking the effects of chemicals released when the immune system attacks your joints.

For example, the DMARD drugs, namely methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine. The side effects that may be caused include liver damage, bone marrow disorders, and lung infections.

Biologic agents

This rheumatic drug is also known as a biological response modifier drug and is a new type of DMARD (biological DMARD). This type of drug is usually given at the same time as methotrexate or other DMARD drugs, and is generally only used if DMARD alone has not been effective in treating rheumatoid arthritis.

Biological DMARDs work by targeting the parts of the immune system that trigger inflammation in joints and other tissues. Some examples of biological DMARD drugs, namely abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, and tofacitinib.

However, this type of drug can also provide side effects, in the form of infection, fever, or headaches. Giving the drug tofacitinib in high doses can also increase the risk of blood clots in the lungs.

2. Therapy

In addition to medication, your doctor may also recommend that you undergo therapy to help treat rheumatic symptoms. There are several therapies that can be done, such as physical and occupational therapy.

In physical therapy, a therapist will help you improve your fitness and muscle strength and train your joints to be more flexible. While in occupational therapy, the therapist will train you to carry out daily activities.

3. Operations

If medications and physical therapy fail to prevent or slow down joint damage, your doctor will likely recommend surgery as another way to treat rheumatism. Surgery is performed to reduce symptoms and repair damaged joints.

Arthritis surgery in rheumatism usually involves one or more procedures. The surgical procedures that are usually performed are:

• Synovectomy: Surgery to remove the inflamed synovium (joint lining). This procedure can be performed on the knees, elbows, wrists, fingers, and hips.
• Tendon repair: Inflammation and joint damage can cause the tendons around the joint to break or loosen. Through this procedure, the doctor will repair the damaged tendons around your joints.
• Total joint replacement: This procedure is performed to remove the damaged joint and replace it with a prosthesis made of metal and plastic.
• Joining joints: This procedure is performed to relieve pain and re-stabilize the damaged joint. This method is done if a total joint replacement is not possible.

Things that must be considered in the treatment of rheumatism in the elderly

Although it can happen to anyone, rheumatoid arthritis is often found in the elderly or elderly. However, treating rheumatism in the elderly is more difficult than in younger people.

The reason is, the elderly are more sensitive to the side effects of drugs. In addition, diseases begin to emerge as a person gets older, so that the elderly often need more drugs to treat their various ailments. Consumption of various drugs can also cause chemical interactions with each other that can harm your body.

Therefore, giving rheumatic drugs to the elderly is usually more careful. Although the drugs given can be the same, in general the elderly get drugs with lower doses. The elderly may also receive additional drugs to reduce the risk of side effects.

For example, the administration of corticosteroid drugs can be with drugs bone-protective agents to reduce the risk of osteoporosis. In addition, administering drugs to the elderly also needs to consider their medical conditions.

Special handling in the treatment of rheumatism for pregnant women

Treating rheumatism in pregnant women is just as difficult as the elderly. The reason is, the National Rheumatoid Arthritis Society said, rheumatic diseases and certain drugs commonly used to control them can affect the development of the fetus and the baby's immune system when it is born.

But keep in mind, pregnancy itself can also affect rheumatic disease. Some pregnant women actually feel that their rheumatic symptoms improve during pregnancy, although some are persistent or even worse.

In this condition, doctors generally provide rheumatic drugs that are safe for pregnant women. Some of the drugs that may be given such as:

• Low-dose NSAIDs, especially in the first and second trimesters.
• Low to moderate doses of corticosteroids.
• Some DMARD drugs, such as hydroxychloroquine and sulfasalazine. The methotrexate drug is not safe for pregnant women because it has the potential to cause birth defects.

Some other safe drugs may still be given to pregnant women for the treatment of rheumatism. Talk to your doctor about the right type of medication.

Healthy lifestyle that can support the treatment of rheumatism

Apart from medical treatment, you need to take other measures that can help treat and relieve the symptoms of rheumatism, including sore and stiff joints in the morning. These ways, namely:

• Exercise regularly to strengthen the muscles around your joints and fight any fatigue you feel, such as walking or swimming for 150 minutes per week.
• Cold or hot compresses to help relax muscles, relieve pain and reduce swelling.
• Avoid foods that are prohibited from rheumatism and eat healthy and nutritionally balanced foods.
• Maintain your weight to prevent the severity of rheumatism, by exercising regularly and eating foods low in calories and fat.
• Do other therapies, such as acupuncture, massage, meditation, or using herbal remedies for rheumatism, with a doctor's consultation.