The effects of Rheumatoid Arthritis on joints.

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THE EFFECTS OF RHEUMATOID ARTHRITIS ON JOINTS.

This subject has been chosen because the writer feels the need to clarify the cause and effects of the disease Rheumatoid arthritis and dispel a few myths about it being an old peoples disease of the bones, personal experience has taught that this is not the case at all.

Most people hear the word Arthritis and think immediately of old people with bad joints. In the case of Rheumatoid Arthritis this would be far from the truth. Rheumatoid arthritis starts with a factor in the blood, believed to be passed genetically, which you are either born with or not. If you have the factor you can be totally unaware until you reach old age, equally you can become rapidly debilitated in your youth. Many researchers in the medical profession believe that an allergic reaction to something can be the key that activates this disease and personal experience seems to substantiate this.

Rheumatoid arthritis affects more than 350,000 people in Britain alone, arthritis research campaign online (2003). To give a brief description of how Rheumatoid arthritis works, a joint is where two bones meet and are covered with cartilage to allow them to move easily and without causing any friction, the cartilage also acts as a shock absorber. The joint is surrounded by the synovium (a membrane), which produces a thick fluid (synovial fluid), which acts as a lubricant to keep the cartilage slippery and mobile. The synovium also has an outer layer of ligaments that hold the joint in place and prevents too much movement, this is called the capsule. (see fig 1.)

In fig 2. you can see how the Rheumatoid arthritis has affected the joint. The synovium is inflamed and red from the increase in blood flow, which results in the joint becoming warm. Extra synovial fluid is produced and the joint becomes painful for two reasons. Firstly the capsule is stretched by the swelling of the joint and secondly the chemicals produced are irritating the nerve endings.

In about 20% of Rheumatoid arthritis sufferers the disease develops very rapidly and in most cases this occurs in the twenties or thirties. Most of you will have experienced the feeling that you have to exercise your wrist and wait for the ‘click’ that puts it back to normal. In Rheumatoid arthritis cases the ‘click’ never comes and within a short space of time other joints join in the game. Steroids and anti-inflammatory drugs and a regime of treatments can be offered. However, in another 5%, the disease gets progressively worst and can lead to severe disability. The majority of patients find that their flare-ups become less frequent over time but this does not mean there are no problems in the interim as some damage is done to joints in each episode, but apart from a few changes in life style, they should be able to live relatively normal lives.

There are four types of physical treatment to supplement any medication prescribed:

Vichy Massage is a massage given with the patient lying on a stone bed with a long bar positioned overhead that holds several showerheads. The pressure is turned up as much as the patient can endure and the heat as high as can be tolerated and the treatment begins. The therapist massages every inch of the body starting from the tips of the toes and ending with the fingers. This process helps to stimulate the circulation and mobilise each and every joint in the body.

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Hydrotherapy is exercise undertaken in a hot swimming pool. The water has the effect of making you weightless, thus taking all pressure off your joints whilst you exercise and allowing you to put your joints through their full movement range without any damage and with minimum pain.

Swelling can be alleviated with either ‘hot’ or ‘cold’ regimes. In the first hot wax can be applied to the worst affected joints and infrared lamps used in the same manner. In the later, ice bags are applied and this can have the same result.

Physiotherapy can be structured ...

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