Evidence-based non-pharmacological treatment of inflammatory rheumatic diseases
Authors:
Tonko Vlak
Summary
The treatment of inflammatory rheumatic diseases is a complex and demanding process. In an effort to achieve remission, the holistic and individual approach to patients suffering from inflammatory rheumatic diseases compels us to use all available means, both pharmacological and non-pharmacological, regardless of the particular disease that is being treated. In this review, established on the research of evidence-based medicine literature, I have discussed the importance of non-pharmacological treatment that became a fundamental part of all related treatment algorithms, with medical exercise being the method with the greatest effect amongst all other treatment methods. A whole series of evidence showing that muscle is, in fact, a secretory organ, proved that, with every cycle of exercise, numerous proteins, so-called myokines, are released from the muscle, with IL-6 being the most important one because of its TNF-α inhibition and stimulation of pro-inflammatory cytokines: IL-1-Ra (receptor antagonist) and IL-10 in mononuclear blood cells, which create an anti-inflammatory effect. So, contrary to popular belief that physical activity can increase and exacerbate the inflammatory process, it is now considered that medical exercise could potentially be used as a potent cure for the treatment of inflammatory rheumatic diseases due to its synergistic effect when used in combination with biological therapy. All things considered, other methods of non-pharmacological treatment, such as various forms of physical therapy and nutritional support, should not be neglected because of their symptomatic and supportive effect.
