| Chronic inflammation throughout the body, one example of which is rheumatoid arthritis, can have devastating effects on the body over time. Many of these conditions are autoimmune diseases, in which the immune system thinks that healthy tissue is actually something to attack, and so white cells can attack tissue.
Over time, the inflammation does not only affect bones and joints – it can also wreak havoc on other organs as well. Conditions such as as rheumatoid vasculitis, which refers to swelling of the blood vessels, can cause damage throughout the body. Symptoms include infections, ulcers of the stomach and skin, numbness, tingling, and pain. Depending on which parts of the blood system the inflammation affects, one may encounter a heart attack or stroke. If the heart muscle or outer lining develop inflammation, it can quickly lead to congestive heart failure.
Other forms of inflammation can lead to anemia, because the swelling of blood vessels and joints inhibits the production of new red blood cells in the bone marrow. Other forms are instability of the cervical spine as a result of swelling, and injury to lung tissue as a result of rheumatoid lung.
There are a variety of ways to treat these chronic inflammatory conditions, ranging from prescription and over-the-counter medicines, “biologic” drugs, physical therapy, and surgery.
The most common medicines designed to fight inflammation that are available by prescription include methotrexate and leflunomide; however, there are significant risks of side effects, so the blood must be monitored while taking them. Celecoxib (a COX-2 inhibitor) also fights inflammation, but its risks include stroke and heart disease. NSAID's such as naproxen can be effective, but they are dangerous as long-term medicines, because of their potential effect on the heart, and stomach ulcers. Corticosteroids are another medical option, but their side effects over the long-term make them a short-term (and low-dose) solution as well.
When it comes to biologic substances, there are some that are helpful. White blood cell modulators such as rituximab and abatacept can help keep the cells from attacking healthy tissue. Tocilizumab is an Interleukin-6 inhibitor that has been used with some success, and agents like infliximab and certolizum help with tumor necrosis factor (TNF). The risks associated with biologic agents include leukemia; viral, fungal and bacterial infections, and (in some cases) psoriasis.
 Physical therapy for chronic inflammation generally includes teaching of ways to protect the joints, the application of cold and hot treatments, and the use of orthotic devices to keep joints lined up properly.
Surgery is another option for patients with chronic inflammation. Generally, the first procedure will remove the joint lining, or the synovium, and is called a synovectomy.
If you feel like chronic inflammation affects you, you'll want to talk to your doctor to see what treatment he recommends. Many physicians combine treatments from several different types of care in order to make an individualized plan for each patient. While all of these ideas have merit and have proven helpful for many patients, since everyone has different needs your doctor will be able to come up with the best combination for your own situation. |
