I have rheumatoid arthritis. Can physical therapy help me?

Hello,

Welcome to icliniq.com.

I understand and heard your concerns.

Thank you for reaching out.

I understand how frustrating it can be when rheumatoid arthritis (RA) continues to limit daily activities despite Methotrexate therapy. RA is a chronic autoimmune condition where the immune system attacks the joints, causing inflammation, pain, and swelling.

Based on your description, you seem to have Rheumatoid arthritis with complications. So I suggest you get a few tests, like:

1. CBC (complete blood count), LFTs (liver function tests), and RFTs (renal function tests) to monitor Methotrexate safety.

2. Inflammatory markers such as CRP (C-reactive protein), ESR (erythrocyte sedimentation rate).

3. X-ray or ultrasound to assess joint damage.

Since you are immunocompromised, I advise you to do the following tests, which help in the management of associated issues and guide you for DMARDs (disease-modifying antirheumatic drugs).

1. HIV (human immunodeficiency virus), HBV (hepatitis B virus), and HCV (hepatitis C virus).

2. Sputum AFB (acid-fast bacillus).

Get all the above investigations before starting biologic agents. You might experience similar symptoms in other conditions, such as:

1. Active rheumatoid arthritis flare despite Methotrexate.

2. Secondary osteoarthritis in hands or knees.

3. Other inflammatory arthritis (for example, psoriatic arthritis).

4. Infection-related or crystal-induced arthritis (rare).

5. Rheumatoid arthritis with complications.

When standard medications are not fully controlling symptoms, biologic therapies may be considered, but first optimize Methotrexate and other adjuvant medications before proceeding to biological agents such as Adalimumab. Do not worry, I can guide you thoroughly.

First-line medications include DMARDs. Adjust Methotrexate dose, titrated up, and then we can add tablet Hydroxychloroquine 200 mg twice a day before jumping to consider biologic therapies.

Second-line treatments include biologic therapy (for example, Adalimumab). It is considered when inflammation persists or joint damage progresses despite DMARDs. It prevents further joint damage and improves function

Infection risk exists; screening and monitoring are essential, as I mentioned already. Some tips that can help you manage your condition are:

1. Supportive or medicated shoes and ergonomic chairs.

2. Scheduled rest to reduce joint stress.

3. Weight management to ease joints.

4. Regular physiotherapy and exercise.

5. Routine laboratory tests: CBC (complete blood count), LFTs (liver function tests), and RFTs (Renal function tests).

6. Chest X-ray and ECG (electrocardiogram) for early complication detection.

7. Prompt infection treatment and vaccination.

8. Report new symptoms early.

Follow-up is extremely important, as we know that rheumatoid arthritis is a lifelong disease, so I strongly recommend regular follow-up with me to review your laboratory, imaging, and symptoms.

During these visits, we can:

1. Decide the right time to start or adjust biologics.

2. Monitor for treatment response and any side effects.

3. Integrate physical therapy and lifestyle measures with your medical plan.

Video consultations allow convenient, timely review and guidance without frequent in-person visits. Regular follow-up will help you spend your life with ease.

Thank you.