The joy of the medical profession over having something to use in arthritis that will quite certainly help most cases is now widely apparent. Since the condition is now recognized as one of the body as a whole and not just the joints, the treatment is changed considerably. Nevertheless, the methods that helped when most of the attention was focused on the joints were not lost and are still valuable in a direct approach to the control of the pain and disability which are features of the disease.
The sooner good treatment can be applied to rheumatoid arthritis the better are the results secured in stopping the progress and the damage done by the disease. While the disease is active, rest and freedom from motion are helpful. If there is fever and severe pain certainly confinement to bed is desirable. Then as these troubles subside motion is permitted, but never to the point of fatigue. During the severe stages the patients are anxious and disturbed, often by solicitous people, and the doctor must protect the patient against emotional upsets.
No special diet cures arthritis. Nevertheless the patient with rheumatoid arthritis needs to be sustained with sufficient proteins, vitamins and minerals and enough carbohydrates and fats to provide needed energy and to avoid damage to tissues. Good animal proteins, calcium and iron must be adequate in the diet.
Europeans with arthritis go regularly to spring and mineral-water resorts, but there is no evidence that these are helpful beyond getting the patient away from his usual surroundings and under a well-regulated routine of rest, diet, baths, and physical therapy. Drugs are prescribed to relieve pain and permit rest. Bee stings, snake poison, and similar methods are not proved to have any real curative value beyond their psychological effect.
For many years a mainstay in treating arthritis has been the application of heat. Heat may be applied by hot bricks wrapped in towels, hot water bottles, electric heat pads, infra-red heat lamps, heat cradles containing incandescent bulbs, and other methods. If many joints are involved relief frequently comes from a hot tub bath once or twice a day, but prolonged hot baths are weakening.
Doctors help the patient with painful joints by several devices which require medical knowledge and application. The orthopedic surgeons control movements by splints, braces, and casts. These have to be released several times daily to permit help by rubbing and slight controlled motion. A local anesthetic like procaine may be injected around a joint and relieve pain from the pulling of muscles and ligaments. New drugs are known of the curare type which prevent spasm of muscles and thus relieve pain. While preventing pain, the doctor must be sure there is sufficient motion to prevent wasting of the tissues. After long-continued arthritis deformity of joints may be so severe that surgical orthopedic procedures may be necessary to relieve crippling.
The innumerable treatments of arthritis over the years have reflected the lack of certain knowledge as to the causes and mechanisms concerned in its development. Iodides, sulfur, salicylates and, more recently, gold have been used. Vaccines, serums, and non-specific proteins have been tried. Antibiotics and sulfonamides have been used but have been unavailing, since the condition is not an infection that could be controlled with these drugs. The greatest promise of any medical treatment thus far known has come from ACTH and Cortisone. A new form called Prednisone sold as Meticorten, Sterane, or Deltra is superior because it does not disturb water and salt balance. The dosage and duration of use must be strictly controlled by the doctor.