Rheumatoid arthritis
Rheumatoid arthritis (RA) - chronic inflammatory disorders of joints
with destruction of cartilage, soft tissue and bone.
No
single factor is known to cause RA but initial insult (infection)
interacting with genetic altered immune response can trigger
development of RA. The initial event is inflammation and infiltration
with PMN leukocytes, plasma cells and B and T lymphocyte in synovial
membrane of joints and immune complex deposition at
cartilage-bone junction. As a result hypertrophy of
synovial membrane occurs causing formation of pannus that invades
adjancent soft tissue, cartilage and bone. Hypoxia in inflamed joint
lead to capillary vasodilatation with edema that lead to deformity and
loss of function of joints.
RA as a systemic disease involves
many extra-articular organ such as skin (vasculitis and rheumatoid
nodule), eye (corneal ulceration, retinitis, glaucoma and cataract),
lung (pleuritis, interstitial fibrosis and pulmonary
hypertension), heart and blood vessels (pericarditis, myocarditis and
coronary arteritis) and nervous system (mononeuritis and sensory
neuropathy).
Clinical symptoms:
- Pain, stiffness and limitation of motion
- Joint swelling with warmth and erythema
- Joint deformity with contractures and subluxation
- Tenosynovitis with spontaneous tendon rupture
- Systemic
manifestation such as: fatigue, ischemic polyneuropathy,
trophic
ulcer Raynaud’s and Carpal tunnel syndrome and other
extra-articular manifestation mentioned above
Clinical application of HBO:
- Relief of hypoxia by increasing oxygen transport to the
ischemic tissue
- Suppresses inflammation
- Reduces swelling by vasoconstriction, reapsorption of
tissue fluids and increasing microcirculation.
- Prevents or arrest joint damage and further destruction of
bone and cartilage
- Relieves pain, stiffness and allows better range of
movement by improving local circulation
- Increasing the bone and cartilage recovery
- Increasing the peripheral nerve regeneration
- Improves effectiveness of physical rehabilitation and
exercise capacity
- Enhancing systems immune system response
- Increasing the effect of antirheumatics drugs
