In the early days of the twentieth century very little was known about rheumatoid arthritis.  It might have been called chronic infectious arthritis, proliferative arthritis or atrophic arthritis. Rheumatology was not a specialty. There were no rheumatologists. It was not a good time to have RA.

Arthritis treatment at the Mayo Clinic  included bed rest. Patients were admitted to the hospital and put on bed rest for several weeks. They were given a balanced diet.

Physical therapy was an important therapy. It improved range of motion, strengthened muscles and prevented deformities. Heat and massage were used  to improve circulation and to remove toxins. Bracing and casting were used to support joints and reduce contractions. Canes were prescribed. Shoe corrections were prescribed.

Vaccine therapy, fever therapy and sympathectomy were popular treatments at the Mayo Clinic based on the theories of the time. As medical knowledge grew these therapies fell out of favor.

Salicylates were drugs of choice. Remember this was before sulfa, penicillin and cortisone. It a was long time before ibuprofen would be formulated. Any drug that was made could be bought without prescription. Drug potions and untested remedies were plentiful. There was no drug testing, drug control or FDA. The world was a different place.

The twenty-first century opened with new hope for rheumatoid arthritis sufferers. Methotrexate is the gold standard for care. And if not tolerated there is leflumomide. There is a pantry full of biologics that affect different parts of the inflammation process including Enbrel and Orencia. The process of RA is being slowed. We are grateful for that.

We can still be grateful for the old basics of a balanced diet, physical therapy, massage, heat, canes and shoe corrections. They are still an important part of the RA patient’s tool chest.