To avoid pain and joint damage, start to control the disease as early as possible. If you are diagnosed "rheumatoid arthritis", the first two years of treatment, follow these general guidelines. The body of each person is unique, so discuss with your doctor whether you approach this sequence.

What to do

When the first symptoms. Make an appointment with a therapist for a diagnosis. To determine the damage to the joints using X-ray or MRI. Prediction is determined depending on the age, results of analyzes, the presence of other rheumatic diseases, lung injury, heart, spleen, or blood vessels.

During two months. Typically, the first means, prescribed for rheumatoid arthritis, methotrexate is. Its effect is noticeable within one to two months, so the first time you can also use nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics, methotrexate is not to act.

During the six months. If methotrexate does not work, your doctor may prescribe another antirheumatic agent or biological agent added. Analysis of liver function should be performed every one to two months, if you are taking Arava, methotrexate or Remicade, periodically, if you are prescribed cyclosporine, once a year, if you are taking salicylates or other NSAIDs.

In a year. If the tests and examinations show that the disease progresses, there are joint damage, your doctor may prescribe stronger medications.

In two years. Each time the doctor should assess the development of the disease. Discuss the effectiveness of treatment and any health problems with a professional.

Always. Regardless of the treatment period, make sure health. It is useful to obtain as much information about the disease, do regular exercise, lose weight, if necessary, to be socially active and protect joints.

Drugs for Rheumatoid Arthritis

For the treatment of rheumatoid arthritis is used a lot of drugs. Some of them improve the symptoms of the disease, while others are designed to slow or stop the course of the disease and prevent joint damage. Most drugs are one of the following categories.

NSAIDs - non-steroidal anti-inflammatory drugs (NSAIDs, or - non-steroidal anti inflammatory drugs) - more than a dozen different drugs (some are sold freely, while others - only by prescription), which are used to reduce pain and inflammation in arthritis. Among NSAID drugs such as ibuprofen Ibuprofen: anti-inflammatory drug   (Advil, Nurofen), ketoprofen (Ketonal, Flamaks) and naproxen (Aleve). If you have had a stomach ulcer or likely Gastric ulcer - such dangerous snacks , Your doctor may prescribe celecoxib (Celebrex), which is less harmful to the stomach.

Corticosteroids - Corticosteroids, including prednisone, prednisolone Prednisolone - against inflammation, allergy and pain, but with complications   and methylprednisolone - is powerful and potent anti-inflammatory drugs. In rheumatoid arthritis, they can be used to control possible damage caused by inflammation in the initial phase of treatment has not yet become effective NSAIDs and DMARDs. Because of potential side effects, doctors try to prescribe corticosteroids in minimal doses and short-term.

DMARDs - Basic anti-inflammatory drugs work slowly, but do affect the course of the disease. In recent years, the most popular of these drugs is methotrexate. However, in this category there are also other drugs, such as hydroxychloroquine (Plaquenil), sulfasalazine, leflunomide (Arava) and azathioprine (Imuran). Doctors are trying to prescribe DMARDs as soon as possible after diagnosis, because it can help prevent irreversible joint damage.

Biological agents - is the latest means. For the treatment of rheumatoid arthritis Rheumatoid arthritis - debunking myths about the disease   approved six such funds - abatacept (Ourense), adalimumab (Humira), anakinra (Kineret), etanretsept (Enbrel), infliximab (Remicade) and rituximab (Rituxan). Each of these drugs is blocking a separate stage of the inflammatory process. Humira, Enbrel and Remicade block cytokine called TNF-alpha. Kineret blocks the interleukin-1. Orensakh blocks T cell activation. Rituxan blocked B-cell. Since these drugs are directed to the individual steps of the process, they do not suppress the entire immune response, as some other drugs for the treatment of rheumatoid arthritis. For many people, the biological agents can slow or stop the progression of the disease, even if other medications did not help them.

Torticollis - a disorder characterized by the curvature of the neck, wherein the head can be tilted in one direction, while the jaw is rotated in the opposite direction.

Torticollis may be:

• Inherited - is caused by certain genetic changes;
• Acquisitions - is caused by damage to the nervous system or muscles.

If the causes of the disease are unknown, it is called idiopathic torticollis.

Torticollis may develop at any age. Congenital torticollis can be the result of improper position of the fetus in utero, or muscle damage blood vessels in the neck of the fetus and birth trauma Birth injuries - than they threaten your child? .

Symptoms

The symptoms of torticollis may be:

• Limited range of motion of the head;
• Headache;
• Tremor of the head;
• Pain in the neck;
• Stiff neck;
• One Shoulder significantly higher than the other;
• Swelling of the neck muscles.

Diagnostics

The main task of diagnosis is to identify the causes of torticollis. During a medical examination may be detected too short muscles of the neck, because of which the head leans to one side.

For a more accurate diagnosis of various methods of medical imaging.

Treatment

In congenital torticollis is used for the treatment of stretch shortened muscles of the neck. Such treatment is often successful if it started within the first three months of life.

If conservative methods to cure torticollis can not be appointed surgery - usually, it is carried out as early as the preschool years.

Acquisitions torticollis treated, depending on the underlying disease. To facilitate headaches Headache: Causes and Complications   and pain in the neck used massage and spinal traction Spinal traction: dry or snorkeling - what is right for you? . Stretching exercises and special fixing corsets for help to cope with the neck muscle spasms.

For the treatment of torticollis used as medicaments, for example, an anticholinergic drug called baclofen. Injections of botulinum toxin can temporarily relieve the patient's condition, but every three months, it will be required to re-injection.

Surgical procedures used to treat torticollis is very rare.

Forecast

The easiest way to treat torticollis in infants and young children. If the disease becomes chronic, it may cause compression of the nerve roots in the neck.

Constant stimulation of the muscles of the neck sometimes leads to hypertrophy.