Rheumatism is an umbrella term for many different diseases. More than 400 diseases can be categorized as one form of rheumatism. The therapy for rheumatic diseases looks correspondingly diverse. The measures serve to a large extent to stop inflammation and damage processes to joints, tissues or organs. Permanent restrictions are to be avoided as far as possible.
Commonly used treatment methods for rheumatism are:
- Medication
- Physiotherapy (exercises to improve pain and maintain motor function)
- physical therapy (e.g. cold treatment or heat)
- Occupational therapy (training of behaviors for everyday life)
- healthy nutrition
- Surgery
The treatment of rheumatism consists of different building blocks.
However, which means and procedures are used depends crucially on the individual disease and how severe it is. A degenerative disease caused by wear and tear and degradation such as osteoarthritis requires a different treatment strategy than an inflammatory rheumatic disease such as rheumatoid arthritis.
The manifestations give clues to the exact cause of rheumatism in the individual sufferers. Nevertheless, thorough medical examinations and differentiation of various diseases are required. The therapy can then be adapted to the diagnosis. Medication for rheumatism
An essential part of the treatment of rheumatic diseases is to take or administer medication. Although the remedies do not heal the rheumatism, they can significantly improve the symptoms. Pain can be relieved and mobility promoted. Various means can also stop or delay the progression of the disease.
Important drugs belong to the following groups:
- NSAIDs (nonsteroidal anti-inflammatory drugs)
- Cortisone (corticosteroids)
- Non-opioid analgesics
- Opioids (opioid analgesics)
- Disease modifying antirheumatic drugs (DMARDs)
- Biologicals (biologics, special agents that are also among the basic drugs)
NSAIDs are pain-inhibiting, anti-inflammatory agents such as diclofenac, ibuprofen or celecoxib, which is one of the stomach-sparing variants. The NSAIDs improve the symptoms, but do not reduce the damage in the joint. Nevertheless, they are useful to relieve pain and promote mobility.
Cortisone preparations such as prednisolone are also anti-inflammatory. They can also be injected into a rheumatism-affected joint to work better in the treatment right place and cause fewer side effects than when ingested.
For pain, non-opioid analgesics (including paracetamol) or opioid analgesics can also be used. The latter have a stronger effectiveness against the pain.
Basic drugs (basic therapeutics) are able to favorably influence the course of rheumatic disease. They are given as early as possible in inflammatory rheumatic diseases in order to avoid damage to the joints or other tissues. These agents include methotrexate (MTX). A newer group of basic drugs are biologics.
However, the use of medication can have side effects. NSAIDs, for example, often cause problems with the gastric mucosa, which is why a stomach-friendly agent (such as omeprazole) is often given when taken for a long time. Cortisone can have a detrimental effect on the immune system and lead to weight gain. It must not be given over too long a period of time. Basic drugs also have a number of side effects that must be taken into account during treatment. Physiotherapy
Flexibility, strength and coordination can be promoted through physiotherapy exercises. Physiotherapy, with regular exercise, helps to preserve the function of the joint. A so-called occupational therapy serves to support training and learning how everyday processes can best be exercised. For this purpose, aids can be useful. Physiotherapy
Treatment with cold is often useful for inflammatory rheumatic diseases. Applying the cold can relieve the pain and reduce the inflammation. A whole-body cold treatment (cold chamber) has proven to be an effective method to improve pain in rheumatism. In the case of osteoarthritis (joint wear), heat is considered, but it should not be used in the case of active inflammation. Other options from physical therapy are treatment with electric current or ultrasound therapy.
In rheumatic diseases, diet has a complementary influence on delaying progression. It is particularly important to eat meat and animal fats only in small quantities. They contain a lot of arachidonic acid, which promotes rheumatic inflammation. In addition to eating plenty of vegetables and fruits, the diet should include foods that contain omega-3 fatty acids. These can weaken inflammatory processes. Omega-3 fatty acids are abundant in various types of fish, but also nuts or certain vegetable oils.
In addition, patients should use diet and exercise to reduce obesity or maintain a normal weight. Operations
Surgical measures are usually the last resort when other treatment measures for rheumatism no longer show success. A joint endoscopy (arthroscopy) can be used to remove the inflamed synovial membrane (synovectomy). It is also possible to obliterate the synovial membrane in the knee joint due to the so-called radiosynoviorthesis.
With a correction of malpositions, it can be achieved that joints are less stressed.
Changes to tendons, bursae, skin or other soft tissues can sometimes also be treated surgically.
In the case of extensive damage to a joint, an artificial joint replacement (endoprosthesis) or joint fusion (arthrodesis) may be considered. Naturopathy and alternative medicine
Some patients experience relief of rheumatic complaints through herbal active ingredients (phytotherapy). Medicinal plants used for rheumatism include willow bark (contains substances similar to chemical painkillers), arnica, nettle, devil’s claw or cayenne pepper. In alternative medicine methods such as acupuncture or homeopathy, some patients also report support to improve the symptoms.