Rheumatoid arthritis: the role of the kinder and gentler therapies.

Abstract

Rehabilitative therapies, as adjuncts to pharmacological and surgical therapies in rheumatoid arthritis (RA), help minimize pain and inflammation, improve functional capabilities, and, above all, enhance quality of life. The effects of heat, cold, and electrical stimulation on neurohumoral, inflammatory, and immunological mechanisms has been noted, although knowledge about their mode of action is lacking. There is, however, much that these modalities, in addition to splints, bracing, exercise, activities-of-daily-living training, and psychological, social, and vocational counseling can offer to reduce suffering and disability in patients with RA. Far more, however, needs to be learned to provide precise prescriptions and more effective applications.