Rheumatoid Arthritis

What is Rheumatoid arthritis?

Rheumatoid arthritis (RA) is an inflammatory disease known by arthritis of multiple joints (polyarthritis). The peripheral joints get affected in RA . The other characteristic of RA is symmetrical involvement of polyarthritis. Due to the chronicity of Rheumatoid arthritis, polyarthritis mostly ends in joint damage and physical disability.

Rheumatoid arthritis is not just a disease of joints. It is a systemic disease with a variety of extra-articular symptoms such as fatigue and weakness, subcutaneous nodules, involvement of lungs, heart disease causing pericarditis, neuropathy of the peripheral nerves, vasculitis etc.

Therefore, Rheumatoid arthritis, is an autoimmune, systemic ,chronic inflammatory disease having its manifestations of articular origin such as polyarthritis and extra-articular manifestations with involvement of skin, lungs, heart, blood and nerves.

The treatment strategy for Rheumatoid arthritis requires patients to approach doctors in the early stages of the disease for prompt diagnosis and initiation of treatment which gives scope in achieving best results.

Causes :

There is no specific causative factors known for Rheumatoid arthritis. It is the result of complex interaction of genetic , environmental and immunologic factors which result in weakening susceptibility of the person, breakdown of self –tolerance and improper regulation of immune system.

• Incidence
  Rheumatoid arthritis is commonly seen between the age group of 25 to 55 years . The incidence increases between 25 to 55 and decreases thereafter. For reasons unknown, RA is common in women than men.
• Signs and Symptoms
  Rheumatoid arthritis patients present with characteristic symptoms . Rheumatoid arthritis being a systemic disease,there are two set of presentation, Articular manifestations and Extra-articular manifestations
• Articular manifestations :
  Pain in joints, tendons and bursae
  Stiffness of joints in the early morning hours which is better by physical activity or walk.
  Symmetrical involvement of the joints
  Initially, arthritis begins in single joint (monoarticular) to 4 or 5 joints (oligoarticular) but later multiple joints polyarticular) get affected.
  Serum Rheumatoid factor (RF) is positive on lab test.
  Physical disability.
• Extra-articular manifestations :
  There is evidence that Extra-articular manifestations may develop prior to the start of arthritis. It is also stated that patients who are mostly likely set to develop extraarticular manifestations have a history of smoking, have early onset of physical disability and a lab test positive for serum RA factor. The symptoms of extra-articular manifestations of Rheumatoid arthritis are :
  Skin : Subcutaneous nodules,pyoderma gangrenosum, purpura
  Heart : Mitral regurgitation, Pericarditis, Myocarditis, Ischaemic heart disease, cardiomyopathy ,Secondary Sjogren’s syndrome, Arrhythmia
  Lungs : Pulmonary nodules, Pleural effusion, Interstitial lung disease, Pulmonary vasculitis
  Blood (Haemotologic) : Anaemia, Neutropenia, Splenomegaly, Felty’s syndrome, lymphoma, Leukaemia
  Endocrine : Hypoandrogenism
  Gastrointestinal : Vasculitis of the intestinal tract
  Renal or Kidney :Membranous nephropathy, secondary Amyloidosis
  Neurologic : Cervical myelopathy
  Eyes or Ocular : Keratoconjunctivitis sicca, Episcleritis , Scleritis
  Mouth or Oral : Xerostomia, Periodontitis

How smoking affects Rheumatoid arthritis ?

Smoking poses a risk factor for development of Rheumatoid arthritis with positive RA of 1.5 to 3.5. Particularly in women who smoke , there is 2.5 times greater risk of Rheumatoid arthritis. And interestingly, risk for developing RA persists even 15 years after cessation of cigarette smoking.

Is RA Factor same as Rh factor ?

No, they are not the same. RA factor, Rheumatoid factor, is the autoantibody that was first found in Rheumatoid arthritis ,so the name RA. It is also found in other diseases such as, SLE, Sjogren syndrome, Hepatitis B, Leprosy, Sarcoidosis, Systemic sclerosis and many other diseases. Whereas, Rh factor is the Rhesus factor which was first discovered in Rhesus monkeys, hence the name Rhesus. Rh factor is an antigen present on the red blood cells of many humans. The blood group is positive if Rh factor is found and negative if it is not found. Rh factor is found in about 85% of the humans.

Complications :

Rheumatoid arthritis is a progressive chronic disease. Therefore in its chronicity, it causes joint damage and disability. The complications of Rheumatoid arthritis can be

:Flexor tendon tenosynovitis which cause decreased range of motion, reduction in grip strength and notable “trigger” fingers.
Ulnar bone deviation due to subluxation of the metacarpophalangeal joints.
“swan-neck deformity” – This is due to hyperextension of the Proximal interphalangeal joint with flexion of the distal interphalangeal joint.
“Boutonniere deformity” –which is due to flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint.
“Z-line deformity” — This happens when there is subluxation of the first metacarpophalangeal joint with hyperextension of the first interphalangeal joint.
Piano-key movement of the ulnar styloid bone.
“Flat feet” may develop due to chronic inflammation of the ankle and midtarsal regions.

What if ignored :

Rheumatoid arthritis is a chronic and a progressive disease and therefore treatment is must for it otherwise it leads to many changes in the body.The changes in the joints can be to the extent of joint damage with the development of various kinds of deformities. There will be physical disability because of the weakness in the joints. On the other hand, extra-articular manifestations may get severe such as vasculitis, anaemia, eye changes, heart problems such as carditis, arrhythmias, kidney and lung affections etc.

How Homeopathy helps in Rheumatoid arthritis

Homeopathic medicines work on the principle of symptom similarity and not based on disease names per se. Homeopathy intends to cure the ‘Man in sickness’ than ‘Sickness in man’. Therefore , a Homeopath takes entire case taking of the patient which includes disease complaints, physical appearance of the patient, characteristics of the mind and then the general behaviour. There are specific homeopathic medicines for RA which have their sphere of action on joints and other systems involved. Homeopathy reverses the progress of disease and helps restore the health.

Positive Homeopathy’s SPECIALITY in treating Rheumatoid arthritis

Rheumatoid arthritis patients on finding treatment tend to look for solution in other medical systems. Positive Homeopathy since the beginning has had the will and enthusiasm to treat autoimmune diseases which include RA. And now, we have gained experience and expertise in managing and treating RA cases with full confidence and accountability. The best of homeopathic medicines for Rheumatoid arthritis are made available for the patients to provide safe and good treatment at Positive Homeopathy.

Is rheumatoid arthritis a disease of old people ?

No. RA is seen in the age group of 25 to 55 years. It is though most commonly seen in young and middle-aged adults but incidence is seen in elderly people also.

How is RA diagnosed ?

Rheumatoid arthritis affects differently in different people. But there are certain characteristic symptoms suggestive of RA to the physician which are : Symmetrical involvement of one to multiple joints, pain and stiffness of joints persisting since 6 weeks or more, lab test becoming positive for RA factor or ACPA or both, abnormal C-reactive protein and/or ESR.

Can I get pregnant if I have RA?

Rheumatoid arthritis is an autoimmune systemic disease but it is not seen as affecting the ability to get pregnant. It also should not be a cause of concern for having a healthy baby. But it should be noted that the medicines used for RA may have to be regulated as per the physician’s advice as some drugs could cause birth defects.

Is there a cure for Rheumatoid arthritis ?

The cure for RA depends on the progress of the disease. Though there is no cure as yet found for RA in conventional medicines, homeopathic medicines help regulate , manage and treat RA in most of the cases. It is very essential that the patient who has pains consult a physician and get treated in the initial stages of the disease. It is very imperative that an early diagnosis and quick start of treatment in order to stop the progress of RA and thereby also reverse the process. Homeopathy helps regulate immune system thereby a large percentage of RA cases can be cured.

What is the role of stress play in RA ?

The cause for Rheumatoid arthritis is not known and what is known behind RA is the interplay between autoimmunity, genetic, and environmental factors. A person’s stress and lifestyle are found to be affecting the autoimmune disorders with the involvement of environmental factors. Therefore it is true that stress plays an important factor when RA actually began. Stress and lifestyles strain are also responsible for the progress of Rheumatoid arthritis.

Does Rheumatoid arthritis also involve internal organs or others parts of the body?

Yes. Since RA is a systemic disease, it affects internal organs. Infact, the effect of RA on other systems begins before the symptoms of pain in joints is felt. Important systems which get affected by RA are lungs, heart, skin, eyes and blood.

What are the test done for RA ?

Typical characteristic symptoms of Rheumatoid arthritis are easy to diagnose it such as symmetrical involvement of multiple joints lasting from more than 6 weeks. RA diagnosis is also supported by lab tests which are Rheumatoid factor (RA factor) , anti-CCP , ESR and C-Reactive protein. A negative RA factor or anti-CCP does not exclude Rheumatoid arthritis. The physician judges based on lab tests and symptoms presented.