Rheumatoid Arthritis (RA) Overview

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that affects many tissues and organs, but principally attacks the joints. This disease causes inflammation of the tissues around the joints leading to joint swelling, stiffness and pain. Rheumatoid arthritis (RA) can cause significant loss of function and even minor day-to-day tasks can become an effort for the patients. Being progressive in nature, in the long term, rheumatoid arthritis can lead to joint destruction, severe disability and loss of mobility.

Affecting almost 1 to 2% of the population globally and attacking women thrice as commonly as men, rheumatoid arthritis (RA) is one of those conditions on which billions of dollars are spent every year for treatment as well as research. Homeopathy has good scope in rheumatoid arthritis treatment, especially in the early stages before deformities set in.

Double-blind studies have clearly shown that those patients who were prescribed homeopathy experienced better results than those who were prescribed a certain class of non-steroidal anti-inflammatory drugs (salicylates) for rheumatoid arthritis (RA). Moreover, the group that received homeopathy treatment did not experience any toxic effects as compared to the other group. Homeopaths have time and again demonstrated cases where their patients have experienced significant benefits with homeopathy treatment resulting in a better quality of life. The beauty of this holistic 'mind and body' medicine is that the remedies are so effective yet without any harmful effects as seen with conventional rheumatoid arthritis (RA) medicines. Opt for homeopathy at the earliest and experience freedom from the pain of rheumatoid arthritis!

What is Rheumatoid Arthritis?

An auto-immune disease by nature, rheumatoid arthritis affects multiple systems of the body (hence called a systemic disease) though primarily it attacks the joints. Auto-immune disorders are those in which the body's protector cells ( immune system) mistakenly start attacking the body's own tissues. In this case, the immune system attacks the joints and surrounding tissues and gradually progresses to attack other systems and organs of the body as well.

Rheumatoid arthritis has a global prevalence and affects females three times more commonly as compared to males. It can occur at any age though in most cases, it begins between 25 to 55 years of age.

Rheumatoid arthritis is a potentially crippling disease which runs an intermittent course marked by phases of unpredictable exacerbations and spontaneous remissions. The disease primarily attacks peripheral joints which include the proximal interphalangeal joints (PIP) and metacarpophalangeal (MCP) joints of the hands, wrists, shoulders, elbows, knees, ankles, and metatarsophalangeal (MTP) joints of the feet. The muscles, tendons and ligaments surrounding the joints are also affected by the disease.

The process of inflammation in rheumatoid arthritis progresses through four stages that are as follows:

  • Synovitis - Inflammation of the synovial membrane that lines the inside of the joint; results in pain and swelling
  • Gradual destruction of the joint capsule, cartilage and bone
  • Disturbed alignment of the joints leading to dislocation and subluxation; visible deformities and muscle atrophy are also seen in this stage
  • Fusion of the joint resulting in total immobility of the joint

Around 10% of the people who suffer from rheumatoid arthritis progress to the fourth stage resulting in total disability. Treatment can help to keep the disease under check and slow down its rate of progress.

Chronic pain and disability are amongst the hallmark features of rheumatoid arthritis besides symmetric affection of the joints in many cases. Apart from causing polyarthritis, rheumatoid arthritis also affects skin, eyes, nerves, heart and blood vessels thus earning the name of a systemic disorder.

Rheumatoid Arthritis Causes

Scientists across the world are still researching on and enlisting numerous probable causes of rheumatoid arthritis and the exact cause has not been understood till date.

There are a number of theories which point towards various causative factors such as genetic inheritance, infectious cause, environmental factors, etc.

Increased incidence of rheumatoid arthritis in family members of the patients points towards the genetic nature of this disease. Certain genes have also been implicated as the reason for rheumatoid arthritis; however not all people suffering from rheumatoid arthritis carry these genes. On the other hand, there are also people who test positive for these genes but have no signs or symptoms related to rheumatoid arthritis. Thus, this is clear evidence that it's not just genes that make one prone to rheumatoid arthritis but there are other factors involved as well.

Infections (bacterial, viral or fungal) or certain factors in the environment are also suspected to be a trigger for an abnormal response by the immune system in an individual who is susceptible.

Irrespective of what has triggered the onset of rheumatoid arthritis, the consequence is that there is an abnormal response by the immune system whereby it mistakenly starts attacking joints, tissues surrounding the joints and other organs of the body. Over a period of time, this results in destruction of the cartilage and bone within the joint. There is weakening of the tendons and ligaments around the joint resulting in disturbed alignment of the joint.

Apart from the aforementioned, there are certain factors which put an individual at a higher risk of developing rheumatoid arthritis. Cigarette smoking increases the risk of developing rheumatoid arthritis and giving up smoking can help in reducing this risk. Hormonal changes may cause the disease to flare up after pregnancy and during breast-feeding.

Symptoms

Rheumatoid arthritis symptoms have a gradual onset in most cases. Patients notice a slow development of signs and symptoms over a period of weeks to months. The disease has an intermittent course wherein there are phases of flare-ups (when the disease activity increases) and remission phases (when the disease remains silent) making the diagnosis and treatment difficult at times. Again non-specific symptoms or certain atypical presentations may further add to the problem in diagnosing rheumatoid arthritis.

Signs and symptoms of joint affection in rheumatoid arthritis:

  • One of the characteristic features of rheumatoid arthritis is symmetric involvement of joints (seen in many but not all cases)
  • Polyarticular involvement - usually five or more joints are involved (this is highly variable). Over a period of time, more and more joints tend to be involved sequentially.
  • Symptoms vary in severity from case to case and even from time to time in the same patient
  • The disease primarily attacks peripheral joints which include the proximal interphalangeal joints (PIP) and metacarpophalangeal (MCP) joints of the hands, wrists, shoulders, elbows, knees, ankles, and metatarsophalangeal (MTP) joints of the feet.
  • During the flare up, the affected joints become red, swollen, painful, and tender. The pain usually gets worse from movement and there is stiffness of joints.
  • Joint stiffness (and even swelling at times) is usually quite marked in the morning (morning stiffness) and it may last up to few hours.
  • Stiffness may also be worse after periods of inactivity like sitting for a long time
  • Joint deformities may be seen in chronic cases whereby the joints of fingers may be fixed in a certain way giving rise to 'swan-neck deformity' or 'boutonniere deformity'
  • Low grade fever is quite common
  • Weight loss is seen in many cases of rheumatoid arthritis

On account of the symptoms described above, simple tasks of daily living may also become an effort for rheumatoid arthritis patients. Turning door knobs, working in the kitchen, opening jars, combing hair, dressing themselves, etc. can also become quite difficult during the phase of relapse. Not being able to perform daily tasks with ease may become a cause of depression, anxiety and helplessness for rheumatoid arthritis patients.

Non-articular symptoms (other than those related to joints) of rheumatoid arthritis include the following:

  • Rheumatoid nodules: These are small, firm, painless bumps of tissue under the skin and are commonly seen on arms, elbows, knees and on pressure points on feet.
  • Tingling or numbness in feet and hands due to affection of the nerves (neuropathy)
  • Heart affection: Pericarditis (inflammation of the membrane that surrounds the heart)
  • Lungs affections: Pulmonary nodules, pulmonary fibrosis, pleuritis (inflammation of the membrane that surround the lungs)
  • Eye affection: Episcleritis, Scleritis (inflammation of the white part of the eyes)
  • Affection of the blood vessels, especially small vessels of the fingers leading to infarcts along the nail beds
  • Osteoporosis: Loss of calcium form the bones that makes them fragile and porous (and thereby more easily prone to fractures)
Diagnosis

The history given by the patients is usually sufficient to arrive to a probable diagnosis of rheumatoid arthritis. However, certain tests may be required to confirm the diagnosis:

  • Complete blood count: This usually reveals mild anemia along with increased white blood cell count sometimes.
  • Erythrocyte sedimentation rate (ESR): This is usually elevated in most cases of rheumatoid arthritis.
  • Rheumatoid Factor: This test is positive in almost 70 to 90% of patients with RA symptoms but may not be necessarily present in all cases. The titer of Rheumatoid factor is important to judge the clinical course of the disease. Patients with a high titer usually exhibit more severe joint disease and greater functional disability. Those with a low titer have a mild course of the disease. There may also be cases in which the Rheumatoid factor is positive but the patient may have no signs and symptoms of rheumatoid arthritis at all.
  • Serum albumin: This may be lower than normal.
  • Anti-nuclear Antibody: This test is also frequently positive in cases of rheumatoid arthritis.
  • C-reactive protein test: This can be used to monitor the response to therapy in rheumatoid arthritis patients.
  • X-rays of joints: In early stages, there may be only soft tissue swelling seen on the X-rays. In the later stages, loss of joint spaces may be seen. Advanced stages of rheumatoid arthritis are marked by erosions of the bones and deformities.
Homeopathy Treatment

Homeopathic treatment aims at offering symptomatic relief to patients of rheumatoid arthritis and correcting the altered immunity in order to control the progress of the disease. The treatment also helps in delaying the onset of complications such as deformities or disability as far as possible.

Being a holistic system of medicine that heals the body as well as mind, Homeopathy can effectively target auto-immune disorders especially those in which stress is the known trigger. Rheumatoid arthritis also belongs to the group of auto-immune disorders and there have been multitudes of patients who have reaped the benefits of this wonderful science of homeopathy.

Conventional treatment for rheumatoid arthritis consists of non-steroidal anti-inflammatory drugs (NSAIDs), which risk damaging the stomach lining causing bleeding ulcers, or corticosteroids that cause high blood pressure and bone brittleness amongst other side effects. Homeopathy, on the other hand, provides safe and sure solutions. It relieves pain and stiffness associated with rheumatoid arthritis as well as strengthens body immunity so that patients may live productive and pain-free lives.

In a double-blind controlled study conducted in Britain in 1980, 82% of the group that received homeopathic treatment reported significant improvement in their symptoms of rheumatoid arthritis (RA) as against just 21% of the control group that was given placebos. The subjects in this study had received individually prescribed constitutional homeopathic remedies.

In another study, 54 patients of rheumatoid arthritis were treated with homoeopathy and 41 patients were treated with high dose of salicylate (non-steroidal anti-inflammatory drug). Both these groups were compared with 100 patients who received placebo. The study concluded that patients who received homoeopathy did better than those who received salicylate. In addition, patients who received homoeopathic treatment did not experience toxic effects. This study clearly demonstrates that homeopathy provides effective solution for rheumatoid arthritis and one that is safe from side effects. It is strongly suggested that patients opt for Homeopathic treatment as early as possible for their condition.

Living with RA

Living with rheumatoid arthritis may not be very easy but certain changes in diet and lifestyle can surely go a long way in simplifying the lives of patients. Based on our experience of treating a large number of cases of rheumatoid arthritis with good results in most cases, we have seen that the following self-help tips are immensely useful to patients suffering from RA:

  • Exercise regularly in moderation - this strengthens muscles, reduces the load on joints, prevents stiffness and increases the range of movements
  • Swimming is a good exercise for conditioning the joints and strengthening muscles
  • A warm shower or bath after prolonged period of sitting or sleeping helps reduce stiffness
  • At work place, take frequent short breaks to avoid stiffness; you may simply get up take a walk around the office and come back to work
  • Shed the excess weight, if any
  • Give adequate rest to affected joints during a flare-up
  • Take up stress management techniques like meditation, yoga, etc. to curb the stress
  • Get enough calcium and vitamin D to prevent osteoporosis (include eggs, cereals, milk, whole-grain products, fortified breads in food)
  • Omega-3 fatty acids found in walnuts, flax seeds, soybean kernels (also found in salmon, tuna fish and sardines) have been found to control inflammation well
  • Antioxidants (found in fruits, veggies, nuts and tea) also help in controlling inflammation besides many more health benefits
  • Red meat, high carbohydrate foods and fatty items are best avoided
  • You may not be able to perform all your daily activities as well as before so don't be disappointed. Get someone to help you with those which need too much effort from you.
  • Above all, listen to your body. Rest when you feel tired but don't rest for prolonged periods to avoid stiffness that stems up later.

Homeopathy treatment along with these diet and lifestyle changes can certainly go a long way in treating Rheumatoid Arthritis and controlling the symptoms as far as possible.