Phases of Chikungunya: Treatment is divided into acute, subacute, and chronic phases, each with specific management strategies.
Acute Phase Treatment: Focuses on symptom relief with antipyretics (like paracetamol) and analgesics (e.g., tramadol, NSAIDs) as no antivirals or antibiotics are effective.
Rest and Hydration: Emphasized the importance of adequate rest and hydration during the acute phase. Cold compresses can help alleviate joint pain.
Avoiding Steroids Early: Steroids should not be used in the initial weeks as they can prolong viremia and lead to long-term complications.
Subacute and Chronic Phase: Treatment depends on the severity of joint pain, which can be assessed using parameters like the number of joints involved and pain intensity on a visual analog scale.
Stepwise Medication Approach: Mild pain can be managed with paracetamol, moderate pain with NSAIDs, and severe or persistent pain may require short-term steroids.
Steroid Use: If steroids are necessary, they should be used in low doses and for short periods, not exceeding one month to avoid side effects like gastritis, peptic ulcers, increased blood sugar, and osteoporosis.
DMARDs for Chronic Pain: If pain persists despite steroids, Disease-Modifying Antirheumatic Drugs (DMARDs) like hydroxychloroquine are recommended, with other DMARDs considered only after 8-12 weeks if necessary.
Non-Pharmacological Methods: Ice fermentation and cold compresses during acute phases; physical activity, stretching exercises, and physiotherapy in subacute and chronic phases to maintain joint mobility and muscle strength.
Overall Approach: Encourages a balanced approach combining pharmacological and non-pharmacological treatments, avoiding over-reliance on drugs with potential side effects, and promoting physical activity and physiotherapy.