Physiotherapy and Occupational therapy



Physiotherapy and Occupational therapy

Q: What is rheumatoid arthritis?

Rheumatoid arthritis is inflammation of the joints caused by the growth in the synovium of the joint granulation tissue. This expansion destroys parts of the bones, which are located under the joint cartilage (subchondral departments), and of course, the destruction of the cartilage is exposed himself. Form of erosion, develop sclerotic changes, and then fibrous and bony ankylosis. The disease begins as a rule, small joints (phalanges). The course of rheumatoid arthritis may be a slowly progressive and rapid. Moreover, some patients may be one option to pass the flow to another.

Q: What is background of rheumatoid arthritis ?

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease primarily affecting the articular structures and synovial membranes of the joints. RA is characterized by joint pain, swelling, tenderness, and deformity. Although some RA patients have a short and limited disease course, RA is usually a progressive disease.

Although the cause of RA is unknown, evidence increasingly suggests that inflammation and joint and cartilage destruction result from activation of proinflammatory cells by an unknown mechanism. Once activated, the proinflammatory cells infiltrate the synovium and attack joint tissue. The synovia of the joints become inflamed, and this inflammation spreads to the joint space, ultimately invading cartilage, bone, and ligaments, resulting in joint damage and deformity. RA initially affects asymmetrical joints; disease progression results in symmetrical involvement. Deformity from RA progression leads to unnaturally shaped joints and impaired range of movement. RA often affects extra-articular tissue, including the skin, eyes, muscles, blood vessels, heart, and lungs. Potential complications include pericarditis, pleuritis, pleural effusion, cervical spine instability, and anemia (Vriezekolk, et.all,2011).

Q: How can rheumatoid arthritis be classified ?

According to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria, diagnosis of “definite RA” is based on the presence of synovitis in at least one joint that is not better explained by another disease, and a total score of = 6 of a possible 10 points from the individual scores in 4 categories: the number and site of involved joints (range 0-5), serologic abnormality (e.g., positive serum rheumatoid factor) (range 0-3), elevated acute-phase response (range 0-1), and symptom duration (range 0-1).

RA patients often seek emergency medical attention due to increased pain and discomfort (e.g., for rheumatoid “flares” [i.e., symptom exacerbation], secondary organ involvement, systemic complications), and usually require lifetime treatment by a multispecialty team of clinicians, including specialists in rheumatology, orthopedics, infectious disease, cardiology, pulmonary, nephrology, and ophthalmology. In addition to treatment with pharmacotherapy, RA patients are commonly advised to minimize symptoms through good nutrition, stress management, weight loss, exercise (e.g., low-impact, stretching, yoga, tai chi), and hydrotherapy/physiotherapy (i.e., the use of heated water). Using specialized devices to improve hand function is encouraged; treatment may include joint or intramuscular injections (e.g., gold, steroids) or joint replacement surgery. Patient education on lifestyle changes that reduce risk for RA exacerbation is essential to manage pain, optimize functional status, and improve quality of ...