Katherine Trujillo Useche
Dr. Marimie Rodríguez, Physiatrist, specialist in pain management and former president of the Puerto Rican Association of Physical Medicine and Rehabilitation, who in an exclusive interview for the Journal of Medicine and Public Health (MSP) tells us about the different treatments for rheumatic diseases.
Rheumatic diseases, says the Dr. Rodríguez, are a fairly wide range of multiple conditions, both inflammatory and non-inflammatory, with osteoarthritis being one of the most common. Through history review and physical examinations, which must be accompanied by laboratory examinations, a more accurate diagnosis is determined. There are some laboratories that use serums, joint aspirations and some with plaques and / or radiographs that can determine the type of disease.
In response to questioning about the symptoms that determine these diseases, the doctor states that they are joint pain, numbness, swelling, stiffness in the morning and in many cases systemic manifestations such as tiredness and involvement of cardiovascular and pulmonary organs.
An important point is the rehabilitation treatment for these cases, which mainly consists of joint work with rheumatologists, meanwhile, for the inflammatory arthritis Specific medications will be required for this condition. It should be clarified that the rehabilitation program “obviously this will not cure the condition, but will control or prevent the progression of the disease.” In the rehabilitation program, strengthening exercises are necessary to correct muscle imbalances, in conjunction with heat or cold therapy. Cold therapy is recommended in the first instance to avoid inflammation and then the combination of cold and heat. In addition, electrical stimulation is usually used as part of the treatment to relieve pain caused by this condition.
Regarding new methods and treatments, it is specified that immunomodulatory drugs and stem cell-based treatments are coming onto the market. These treatments are under study and have not yet been approved by the FDA; Stem cell treatments regenerate cartilage and joints, as do protein-rich plasma treatments, serum treatments from the same patient, and accompanying the aforementioned stem cells.
Dr. Rodríguez considers that one of the most important diseases of this genre is osteoarthritis, which despite not being an inflammatory disease, can present manifestations of inflammation and is one of the most common conditions due to joint wear, which it usually comes with age, it being understood that we are all going to reach it. Some athletes, for example, develop this condition younger due to high impact sports that generate early joint wear. For this reason it is very important to clarify that not all joint wear is a manifestation of rheumatoid arthritis.
Among the recommendations for the treatment of these diseases are: carry out constant physical activity in search of strengthening muscle mass, manage an adequate weight avoiding obesity, a predominant factor in the joints and maintain a balanced diet “there are studies that have been done with supplements such as glucosamine and colchicine, which is one of the most recommended. “There are very good studies that if the recommendation works as such that the physiatry area recommends is that it be used for six months” it is reiterated that these treatments do not stop the disease, but they do alleviate the symptoms; Another recommendation is exercise taking into account that it is not of high impact such as swimming, cycling, gentle exercise without having an effect on the joints.