Treatment of Acute Flare-ups of Rheumatoid Arthritis

Written by Li Jing
Rheumatology
Updated on September 19, 2024
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During the acute phase of rheumatoid arthritis, typical treatment includes absolute bed rest and avoiding intense physical activities, followed by a diet rich in fresh fruits and vegetables containing vitamins. Medication-wise, sodium diclofenac or meloxicam are used, which are non-steroidal drugs that relieve joint pain. If these drugs are not effective, steroids such as methylprednisolone are administered, initially at doses of 20 mg or 40 mg, until the pain eases, then gradually reducing the steroid dosage. During steroid treatment, it's also important to prevent side effects, namely, by supplementing with calcium and incorporating drugs that protect the stomach lining. (The above medications should be used under medical supervision.)

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Written by Yang Ya Meng
Rheumatology
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Rheumatoid Arthritis Diagnostic Criteria

The diagnostic criteria for rheumatoid arthritis include, first, the presence of swelling and pain in multiple joints, especially characterized and significant in the smaller joints. Second, serological tests show elevated levels of antibodies, commonly rheumatoid factor and anti-CCP antibodies. If both are elevated, it is most meaningful. Third, the duration of joint swelling and pain should be more than six weeks. Fourth, we must also check some inflammatory markers for joints, such as elevated erythrocyte sedimentation rate and C-reactive protein. If these markers are elevated, and the patient has swelling and pain in multiple joints, then we can consider a diagnosis of rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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How is rheumatoid arthritis treated?

Rheumatoid arthritis, also commonly referred to as internal rheumatoid arthritis, primarily has three major categories of treatment. The first category is anti-inflammatory and pain relief. The medications for anti-inflammatory pain relief include two types: the first type is non-steroidal pain relievers; for patients with very severe pain, a low dose of corticosteroids can be considered. The second category, which is also the most important treatment, involves the use of immunosuppressants. These immunosuppressants include drugs such as methotrexate and leflunomide. If the patient does not respond well to anti-inflammatory pain relief and immunosuppressants, treatment with biologics can also be considered.

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Written by Yang Ya Meng
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Foods to Avoid with Rheumatoid Arthritis

Patients with rheumatoid arthritis should adhere to a light diet and avoid spicy foods, overly nourishing and greasy foods. Specifically, the following foods should be avoided: vegetables such as celery, coriander, shiitake mushrooms, leeks, and seaweed. In terms of meat, one should reduce consumption of warming foods like lamb, beef, and dog meat. Also, it is advisable to limit intake of high-protein seafood such as shrimp, crab, and sea cucumber. Regarding fish, preference should be given to freshwater fish, while the consumption of sea fish should be minimized. These are the foods that should be avoided by those suffering from rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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Can people with rheumatoid arthritis drink alcohol?

Patients with rheumatoid arthritis should avoid drinking alcohol. Due to joint pain, patients with rheumatoid arthritis inevitably consume anti-inflammatory pain relievers or steroids for pain relief. These anti-inflammatory drugs are already harsh on the stomach, and alcohol is similarly harmful. Consuming both anti-inflammatory pain relievers and alcohol can easily lead to gastrointestinal bleeding. Some patients may even develop complications such as gastric ulcers or severe gastrointestinal bleeding. Therefore, it is not recommended for patients with rheumatoid arthritis to drink alcohol. (Medication should be used under the guidance of a doctor.)

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Written by Liu Li Ning
Rheumatology
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Rheumatoid arthritis hurts more at night or during the day?

The pain of rheumatoid arthritis is irregular. It can hurt at night or during the day, and it varies from person to person. The onset of rheumatoid arthritis is somewhat related to streptococcal infection. Clinically, it mainly presents as migratory swelling and pain in the large joints of the limbs, generally without leaving joint deformities. The onset of rheumatoid arthritis is related to streptococcal infection, so it requires treatment with penicillin antibiotics. During the acute phase, it is also recommended to use non-steroidal anti-inflammatory drugs to alleviate symptoms. Commonly used drugs include sustained-release capsules of diclofenac sodium, meloxicam, or etoricoxib.