THE NON-PHARMACOLOGIC TREATMENT OF RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is a chronic, progressive, destructive and deforming arthropathy, characterized by symmetrical erosive synovitis and multisystemic injury. Despite the progresses of pharmacological therapy for RA, many patients continue to have active disease with the risk of developing disability. A number of non-pharmacological therapies are used in addition to the regular treatment of RA. On October 7th, 2008, American Physical Activity guidelines were released, based on the latest physical activity techniques, with impact on the health of people with arthritis, grouped under the acronym SMART. A comprehensive management program for RA includes patient education, psycho-social interventions, adequate rest, exercise, physical and occupational therapy, nutritional and dietetics counseling, interventions to reduce the risk of cardiovascular diseases, osteoporosis and immunizations to reduce the risk of complications from immunosuppressive treatment. The objectives of this program are: disease stabilization, preventing deviations, deformities and ankylosis, combating retractions and stiffness, partial or complete restoration of motor functional capacity of patients. For achieving these goals, the treatment must adhere to the following general conditions: to be initiated early, to be continuous and complex. In conclusion, education and counseling of the patient are important for the management of RA. The physicians should explain to the patient all the treatment options and develop with him a longitudinal treatment plan, which includes the association of the pharmacological therapy with the non-pharmacological one.