Medicine
Can Rheumatoid Arthritis Be Cured if the Joint Pain is Persistent?
How to judge condition of rheumatoid arthritis stability is not repeated?
Just meet these three conditions!
Rheumatoid arthritis, once known as the “cancer of immortality,” this statement undoubtedly shows that rheumatoid arthritis causes severe physical and mental damage to patients, its harm is no less than cancer.
In daily life, there are a lot of rheumatoid arthritis patients feel joint pain relief or no pain, rheumatoid arthritis is cured, in fact this view is not comprehensive.
First of all, rheumatoid arthritis can not be cured at present, so can only be the maximum extent of the disease control in a stable period, and not a thorough cure.
Furthermore, to judge whether the condition of rheumatoid arthritis is stable or not, these three conditions should be met:
Basic conditions: Improved joint symptoms
If the patient has a sustained reduction in joint swelling and pain, a shortened morning stiffness, and a gradual return to range of motion, this means that the rheumatoid arthritis is improving, but not meeting the requirements for stability.
If the patient’s joints do not have obvious swelling and stiffness in the morning, they can wash, wear and take off clothes, walk and other basic activities, which reaches the primary condition of stable condition.
But that’s the bottom line, and the patient must continue taking the medication.
Key condition: Decreased inflammatory markers
At present, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are the main inflammatory markers to determine the severity of rheumatoid arthritis.
Generally speaking, the heavier the joint symptoms, the higher the inflammatory indicators, and the more obvious the improvement of joint symptoms, the greater the decrease of erythrocyte sedimentation rate and C-reactive protein level.
Clinically, some patients showed significant improvement in self-induced joint symptoms, or even no joint discomfort symptoms, but the level of erythrocyte sedimentation rate and C-reactive protein was still high or only slightly decreased.
This may be related to the temporary use of drugs (e.g. hormones, biological agents, etc.) that act quickly and have obvious effects.
Therefore, the current improvement in joint symptoms is temporary and can easily be repeated.
The condition is stable only when the patient has no obvious joint discomfort for a long time, and the erythrocyte sedimentation rate and C-reactive protein level are normal or nearly normal.
If you meet the “basic conditions + key conditions”, does that mean that rheumatoid arthritis long-term stability is not repeated?
No, there is a third condition.
Ideal condition: Imaging improvement
We know that the main pathological change of rheumatoid arthritis is synovitis, synovial dysplasia is the culprit leading to joint lesions, all the drugs on the treatment is also to minimize and inhibit synovial hyperplasia.
Joint symptoms improved, inflammatory indicators decreased, synovial hyperplasia will be reduced, but the reduction does not mean that there is no hyperplasia.
In fact, at this point, many patients are still in the state of mild synovial hyperplasia, but has not been able to cause joint symptoms and inflammatory indicators of abnormalities, which is the cause of the disease again and again.
Clinically, joint ultrasound, mri and other examination methods are generally used to check synovial hyperplasia and make the next treatment plan according to the degree of synovial hyperplasia.
However, in terms of the current medical level and treatment status, it is still difficult for the vast majority of rheumatoid arthritis patients to achieve imaging improvement.
Of course, rheumatoid arthritis treatment should not be erratic until doctors assess whether the condition is stable.
After the diagnosis of rheumatoid arthritis regardless of the severity of symptoms, should be treated to the hospital in a timely manner, at the same time, the patient should be tailored according to their own conditions, using different drugs, medication, drug withdrawal should be under the guidance of the doctor, the patient can not because of no pain and swelling, the symptoms are relatively light, without authorization to reduce drug withdrawal, self-determination.
Because unauthorized withdrawal may cause these symptoms:
- Rebound phenomenon: Some patients have been taking hormone drugs for a long time, and their condition has been completely alleviated. If the drug is suddenly stopped or the dosage is reduced too much or too fast at this time, the original disease may relapse or worsen.
- Withdrawal syndrome: During the withdrawal process, patients may experience severe fatigue, joint muscle pain, low mood, lack of food and drink, and even nausea and vomiting. A few patients may also experience collapse.
In addition, in medication process, want to measure liver function, blood to wait for index regularly, in medication initial stage, disease activity period reexamines can be a bit more often, after the condition is stable, every 2 ~ 3 months check can.
