If I were asked what is the most common treatment mistake in inflammatory rheumatism, I would say without hesitation that PREVENTIVE EXERCISES are forgotten. Many doctors successfully provide drug treatment for frequently encountered inflammatory rheumatism such as rheumatoid arthritis, ankylosing spondylitis and psoriasis arthritis. It should not be forgotten that drug therapy is very important and an indispensable part of the treatment, but another treatment that is equally important is preventive exercises.
Inflammatory Rheumatisms
The main effect of inflammatory rheumatism is joint destruction. The disease starts from the structure that covers the space inside the joint, which we call synovia. The rheumatic process then leads to cartilage damage and eventually bone damage and deformities. In other words, it makes the joint unable to function normally.
For example, let's take a rheumatoid arthritis or ankylosing spondylitis patient with hip joint involvement. Hip joint involvement due to inflammatory rheumatism initially manifests itself as groin pain on that side. As the disease progresses, the inward rotation of the hip is restricted. Then the movements of the hip in other directions are restricted and finally the hip freezes in a slightly folded position and becomes unable to move. In inflammatory rheumatism, medications can seriously slow down this process, but they cannot stop it completely. Therefore, giving medication to the patient will slow down the restriction of hip joint movements, but since the patient tends not to move the hip with pain, hip joint movements will still be restricted, albeit later.
What does preventive exercise mean? ?
There is an immutable physiological rule; The less a joint moves, the more its movements are restricted over time. Part of the damage caused by a rheumatic disease is due to the disease's direct damage to the joint, and part of it is due to the patient moving that joint less due to pain and functional limitation. The joint that is moved less and the surrounding soft tissues become stiff over time, the muscles that move that joint weaken, and deformities occur as a result of mechanical imbalance. We see this frequently, especially in the finger joints of patients with rheumatoid arthritis. Protective exercise protects joints from the disabling effects of rheumatic diseases It is all the exercises done for k.
What are the preventive exercises?
A rheumatoid arthritis patient is protected from the disease. The patient may tend not to use the more affected hand due to pain or fear of harm. Not using the patient's hands actually harms the hand joints, not benefits them. In such patients, pain is reduced with medication and finger deformities are tried to be prevented with preventive exercise. Muscle strengthening exercises, joint range of motion exercises, and stretching exercises are the most frequently used exercises in patients with inflammatory rheumatism. These exercises are initially made by the patient by the physiotherapist. The patient is then taught and told to continue at home.
The joints of patients whose exercise is not effective enough to prevent deformities must be protected with special mechanical supports called splints. However, when these are done, the destructive effect of the disease on the joint can be minimized. Biological agent treatments such as Enbrel, Remicade, and Humir greatly reduce pain, especially in cases that cannot be controlled with standard treatments. In this way, even in seriously ill patients, an environment is created where the patient can do his exercises without or with less pain. Even if the disease cannot be completely controlled, the disease can be prevented from causing deformity in the joints with exercises.
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