PRINCIPLES OF JOINT PROTECTION FOR RHEUMATIC DISEASES ( BRADDOM - 5TH EDI )
1 respect pain as the signal to stop the activity
2 maintain muscle strength and joint ROM
A ) maintain daily activities within the limitation of patient pain prevents disuse atrophy
B ) strengthening around the unstable joint can increase stability and reduce pain
3 use each joint in its most stable anatomic and functional position
4 avoid positions of deformity and forces in their direction ( eg - turning resistive door knobs in an ulnar direction if finger MCP jts are subluxed volarly and ulnarly should be avoided by the use of lever door opener )
5 use the largest and strongest joints available for the job ( using a belted waist pack rather than holding purse with hook grip )
6 ensure correct pattern of movement ( eg - to push up when arising from a chair by using the flat surface of palm rather than by fingers to avoid deforming forces )
7 avoid staying in one position for longer periods
8 avoid starting an activity that cannot be stopped immediately
9 balance rest and activity
10 reduce the force -
A ) building up handles to avoid tight grip
B ) use of assistive devices such as jar openers to reduce the stress of hand and wrist joint
C ) avoid repetitive use of force ( OA )
D ) use alternative methods to complete the task ( use of hand rail while going up and down )
MEDICATIONS ASSOCIATED WITH PERIPHERAL NEUROPATHY
1 amiodarone
2 amitryptyline
3 chloramphenicol
4 cisplatin
5 colchicine
6 dapsone
7 disulfiram
8 hydralazine
9 isoniazid
10 lithium
11 nitrofurantoin
12 phenytoin
13 pyridoxine
14 thalidomide
15 vincristine