Rheumatoid arthritis is an immune inflammatory disease that affects joints and extra articular tissues.
RA is a multifactorial disease involving
- Genetic factors: There is significant association with HLA DR4 & HLA DR1.
- Environmental factors: Infections , bacteria like mycobacteria , viruses like Epstein barr virus.
- Precipitating factors: Mental, physical, smoking & cold
- Gender: Females are more often affected than males.
- There is immunologically mediated inflammation of the synovium.
- Antibody producing plasma cells are formed from B cells.These plasma cells produce antibodies against RHEUMATOID FACTOR.
- Rheumatoid factor forms immune complexes with antibodies.
- There is histamine release , drilling of pores in the membranes.
- These inflammatory mediators lead to damage of the articular cartilage, demineralisation of underlying bone, erosion of the joint margins, laxity of the joint capsule and ligaments and finally total derangement of the affected joint leading to joint deformities.
- Fever,loss of weight
- Morning stiffness
- Symmetrical involvement of small joints of hands and feet
- May be monoarticular (large joint)
- Deformities of hands and feet (chronic cases- swan neck, button hole,Z deformity, cock up toe, calcaneovalgus, flat foot)
- Muscle wasting,bursitis,tenosynovitis
- Rheumatoid nodules
- Features of vasculitis (ulcers,nail changes,neuritis,pyoderma)
- Presence of rheumatoid factor (s)
- Splenomegaly, lymphadenopathy(felty’s syndrome)
- Episcleritis, scleromalacia, kerato conjunctivitis sicca ( sjogren’s syndrome)
- Pericarditis, endocarditis, myocarditis, aortitis, aortic incompetence, coronary vasculitis, heart block
- Pleural effusion, nodules, bronchiolitis, fibrosing alveolitis
- Mononeuritis multiplex, cervical cord compression
- ESR- raised
- CRP-high levels
- Immunological – RA factor,ANA, anti CCP antibodies
- Synovial fluid analysis- leucocytosis, neutrophilia,raised protein and low glucose levels
- X ray of joints-narrowing, deformities
- Xray of chest- fibrosing alveolitis,bronchiolitis,pleural effusion
- CT scan
- Physical rest, passive exercises,physiotherapy, occupational therapy, patient education and counselling play a key role.
- In conventional treatment NSAIDs, disease modifying drugs, immune modulator drugs are used. Surgery is recommended in later stages when joint damage has occurred.
Homoeopathy has great action on joints. Arthritis symptoms are well covered by many homoeopathic medicines. Aspects determining prognosis of cases for homeopathy are extent of disease, past history and other physical and mental health of patient.
Rheumatoid Arthritis progression can be arrested to a great extent by constitutional or totality based homeopathic medicine. For acute episodes of pain there are many acute remedies which can be used for control of pain and inflammation. Regular use of constitutional remedy brings the ESR, CRP and RA factor values down. Right medicine can lead a patient to lead a pain free and normal life.
Its advisable to consult a registered homeopathic practitioner and take advise for a right homeopathic remedy.
Homoeopathy has great action on joints. Arthritis symptoms are well covered by many homoeopathic medicines.
Few medicines useful in acute pain for RA are:
RHUS TOXICODENDRON: Suitable to rheumatism affecting fibrous tissues, sheaths of muscles etc. Rheumatism from exposure to wet when overheated & perspiring. There is great restlessness & all symptoms are relieved by motion.
BRYONIA: The joints are affected producing articular rheumatism. The joints are sore & swollen.Pains are sharp, stitching in character.There is aggravation from slightest motion.
CAUSTICUM: There is stiffness of the joints. Restlessness of this remedy occurs at night. Pains impel constant motion, which does not relieve. Rheumatism caused by dry, cold, frosty air.
KALMIA: It has wandering rheumatic pains. Hering says that the rheumatism of kalmia “ generally goes from the upper to the lower parts”. Pains are worse when going to sleep.
- Davidson’s principles and practice of medicine, 21st edition
- Api textbook of medicine
- Boericke W. Boericke O.E. New Manual of Homoeopathic Materia Medica and Repertory(with relationship of remedies)
- W.A. Dewey Practical Homoeopathic Therapeutics