How can we define Rheumatoid arthritis?

Rheumatoid arthritis is a type of inflammatory disease where the immune system starts to attack the tissue lining of the joints on both sides of your body. Rheumatoid arthritis can affect any joint but mainly the small joints in the hands and feet are more affected. The inflammation can sometimes affect organs as well, for instance, the eyes, skin, heart or lungs. 

What is the average age of onset for Rheumatoid arthritis?

Rheumatoid Arthritis can occur at any age. Although, women are more commonly affected than men. In most cases, it usually begins in the middle age. Sometimes children and younger teenagers can also be diagnosed with juvenile idiopathic arthritis. People with a family history have a higher risk of developing Rheumatoid Arthritis. 

What are the causes of Rheumatoid arthritis?

The exact cause of Rheumatoid Arthritis is still unknown. Although, It is believed to be an auto-immune disease where the immune system of the body starts to attack its own cells by releasing inflammatory chemicals   

But there are certain contributing factors which may cause it are:- 

1. Family History and Genetics:  A positive family history increases the chances of Rheumatoid Arthritis along with various genetic factors. First degree relatives of people with Rheumatoid arthritis are about three times more likely to develop Rheumatoid arthritis. 
2. Excessive weight: People with high body mass index have a higher risk of developing the disease. Obesity or excessive weight is also associated with increased pain and reduced quality of life. 
3. Smoking-Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. 
4. Miscellaneous factors: Alcohol intake, smoking, birth weight, low socioeconomic status and a heavy non diet has also been seen to have a co-relation with the disease.  

What are the signs and symptoms of Rheumatoid arthritis?

The signs and symptoms vary from patient to patient, some patients may develop symptoms in a short period whereas certain patients may take a long time to manifest signs and symptoms. Some of the commonly seen presentations in such patients are – 

• Joint stiffness-Joint stiffness that lasts longer than 30 minutes, typically after walking in the morning or after resting for a long period of time. The stiffness of the joints is mainly worse in the morning time. 

• Joint Swelling– Swelling of the affected joint that may interfere with daily activities, such as difficulty making a fist, combing hair, buttoning clothes or bending knees. Redness and tenderness of the affected part. 

• Joint Pain-Joint pain at rest and when moving, along with tenderness, swelling, and warmth of the joint. Difficulty in the movement of joints. 

• Joint Deformities-In severe cases Rheumatoid arthritis can cause joint deformities in the hands, feet and other parts of the body, these deformities can include Swan neck deformity, ulnar drift, Hammer toe etc. 

• Symmetrical affection of joints- The symptoms often happen on both sides of the body, in a symmetrical pattern, for example if you have RA in right hand, you may also have it in the left hand. 

• Loss of appetite– Loss of appetite is a common symptom associated with the rheumatoid arthritis, often occurring due to the systemic inflammation caused by the condition, which can lead to fatigue, pain and a decreased desire to eat. 

• Fever– Occasional fever are noticed. Fevers are usually low-grad, and are often a result of inflammation. 

• polyarthritis -In cases where there is involvement of multiple joints; it is known as polyarthritis. 

• Rheumatoid Nodules-In severe cases the formation of round, painless nodules under the skin known as rheumatoid nodules. 

• In some cases, the inflammation of the lung may be known as pleurisy. 

• Anaemia due to low red blood cell counts. 

Is Rheumatoid Arthritis only genetic? 

Yes, Increased chances of Rheumatoid arthritis have been linked to variations in the human leukocyte antigen (HLA) genes. But, there are certain non-genetic factors such as exposure to irritants and pollutants and sex. 

Are there any risk factors associated with Rheumatoid Arthritis? 

Yes, there are certain risk factors associated with this condition. These include: 

• Family History- First degree relatives of people with Rheumatoid arthritis are about three times more likely to develop Rheumatoid arthritis 

• Sex- women are more commonly affected than men. In most cases, it usually begins in the middle age. 
• Smoking- Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. 
• Obesity- People with high body mass index have a higher risk of developing the disease 

Are there any diagnostic criteria for rheumatoid Arthritis? 

Yes, although not all patients have all the symptoms. But most of them match the diagnostic criteria for rheumatoid arthritis which include: 

• Clinical Criteria-Inflammatory arthritis in two or more large and smaller joints (shoulders, elbows, hips, knees and ankles. Joint stiffness that lasts at least for an hour in the morning. 

• Blood Tests-Positive tests like rheumatoid factor (RF) or CCP antibodies, and increased levels of C-reactive protein (CRP) and Erythrocyte sedimentation Rate (ESR). 

• Imaging-some imaging tests like X-RAY and MRI can help assess signs of Rheumatoid arthritis, such as inflammation and the condition of the synovial membrane. 

• Symptoms lasting for more than six weeks

Is there any cure for Rheumatoid Arthritis?

Early cases of rheumatoid arthritis fairly have a good prognosis, and the treatment plan includes a holistic approach. Removal of certain contributing factors such as obesity and exposure to irritants and pollutants also play a major role along with individualized homoeopathic treatment. 

Does diet and nutrition play any role in treating Rheumatoid Arthritis? 

Yes, maintaining a nutrition-dense diet helps in the symptomatic management of the disease. Changes in diet can reduce the symptoms of inflammation in the body, thus reducing the tenderness and pain in the joints.  

Foods that are anti-inflammatory in nature and nutrition-dense should be included in the diet- 

Calcium rich Diet– calcium rich foods, such as yogurt, tofu, cheese, are necessary to strengthen the bone. 

Fiber rich Diet-Fiber rich foods such as whole grains like jowar, bajra, and Nachni, help maintain weight. 

Anti-inflammatory Diet– foods such as garlic, ginger, turmeric, and foods rich in omega-3fatty acids such as flax seeds, nuts, chia seeds and walnuts. 

Protein rich Diet-Protein rich foods, such as sprouts, pulses, help in avoiding muscle loss. 

Drink water– Drinking enough water plays a crucial role in managing symptoms and improving overall joint health by maintaining proper hydration. so, keep yourself hydrated; drink 2-3liters of water daily. 

What are the differential diagnoses of Rheumatoid arthritis?

• Fibromyalgia-Fibromyalgia is a disorder characterized by pain and tenderness throughout your body. It causes musculoskeletal pain and fatigue with functional impairment. 
• Osteoarthritis-A degenerative disease caused by mechanical wear and tear on joints. Joint pain and stiffness that worsens with weight bearing, often in knees, hips or spine. It can be caused by aging, obesity, joint injuries and diabetes. 

• Psoriatic arthritis-It is a chronic inflammatory condition associated with psoriasis. The most common symptoms are joint pain and stiffness, with skin rashes. It tends to affect only few joints than rheumatoid arthritis. 

• Sjogren syndrome– It may have joint pain but less severe. Dry mouth and Dry eyes are a hallmark feature of this syndrome. Sjogren’s syndrome predominantly affects women. 

Is there any difference between rheumatoid arthritis and osteoarthritis?

 Arthritis is a condition which causes inflammation of the joints. There are different types of arthritis, including rheumatoid arthritis and osteoarthritis. 

• Rheumatoid Arthritis- is an autoimmune condition which can affect any joint but mainly the small joints in the hands and feet are more affected.it causes joint pain and swelling and sometimes numbness and tingling sensation also present. 
• Osteoarthritis- It is a primarily degenerative condition of the joint. it often affects a single joint at first and it can be caused by aging, obesity, joint injuries, diabetes, smoking and infections. Joint stiffness, bony bumps and decreased range of motion are the common symptoms of Osteoarthritis. 

How to diagnose rheumatoid arthritis?

Rheumatoid Arthritis can be diagnosed by signs and symptoms which can be gathered by  

• Case Taking- This includes gathering information about the patient’s symptoms, duration of the illness, and any factors that could contribute to Joint damage. A family history of joint disease can suggest a hereditary component. It is also important to assess for underlying medical conditions that may predispose a person to joint disease, such as autoimmune disorders, obesity or previous illnesses.  

• Family history- A positive family history increases the chances of Rheumatoid Arthritis along with various genetic factors. First degree relatives of people with Rheumatoid arthritis are about three times more likely to develop Rheumatoid arthritis then the general population. 

• Smoking History: Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. 

• Physical Examination-The physical examination of the patient is also done and we see the inflammation in the affected part. Check for joint swelling, redness or any joint deformity. It also observing how a patient moves and performs daily activities. 

What Are the Diagnostic Tests for Rheumatoid Arthritis? 

Various diagnostic tests can confirm the presence of Rheumatoid Arthritis 

• RA factor test-High levels of rheumatoid factor in the blood are most often related to autoimmune diseases such as Rheumatoid arthritis and Sjogren syndrome. RA factor test can also help determine the severity of Rheumatoid arthritis and whether it’s likely to affect organs. 
• CBC (Complete blood count)-It can help diagnose rheumatoid arthritis and monitor its complications like if low red blood cell count it indicates anemia, which is common in Rheumatoid arthritis. 
• ESR (Erythrocyte Sedimentation Rate)-It is a blood test that measures inflammation in the body. It’s often elevated in people with Rheumatoid arthritis. 
• C-Reactive proteins (CRP)- The level of CRP increases when there is inflammation in the body’s can help to assess a person’s risk of developing complications from Rheumatoid arthritis, such as heart diseases. 
• Synovial fluid analysis-It can help in diagnosis of rheumatoid arthritis by evaluating the appearance, composition and chemical properties of the fluid in joint. 
• Presence of anti- CCP antibodies-This test looks for the presence of anti-ccp antibodies in the blood which appear in many people with Rheumatoid arthritis. These antibodies are a type of auto antibody, which are abnormal proteins produced by the immune system.  

Is rheumatoid arthritis a serious condition?

Yes, there are mild cases of rheumatoid arthritis. Those cases get treated with anti-inflammatory medicine but in some cases, it is a serious disease condition and it depends upon the susceptibility of the patient.

What is the general management of Rheumatoid arthritis?

Some of the measures that can easily be done at home and provide relief to the patient are:   

• Cold Therapy-Applying a cold pack can be helpful especially when a Rheumatoid arthritis flare-up brings inflamed, swollen joints. Cold therapy can constrict blood vessels, which reduces blood flow. This may help reduce inflammation and swelling and also help ease chronic pain and stiffness of joints. 

• Heat therapy– This helps to relive pain and stiffness by dilating blood vessels, which increases blood flow and improve blood circulation. You can use heat therapy in the morning, when the joints are stiffest. 

• Exercise Regularly: Physical Activity has numerous benefits for Joint health. Simple low impact exercises, yoga and meditation helps to reducing inflammation of joints. Exercise can also improve mental health by reducing anxiety and depression, which are common in patients with chronic conditions. Maintain healthy weight and avoid a sedentary lifestyle. 

• Rest-Adequate Rest is essential for the body it allows inflamed joints to recover, reducing pain and inflammation and helps manage fatigue. Sleep well and reduce stress, sufficient sleep ensures that the immune system functions optimally and inflammation is controlled.  

What are the complications of Rheumatoid arthritis?

Prolonged disease and untimely and delayed treatment of the condition can lead to various complications which can later affect many systems. Some of these diseases are:  

• Cardiovascular diseases-If you have Rheumatoid arthritis, you are at a higher risk of developing CVD. It includes life threatening problems such as heart attack and stroke. Chronic inflammation in rheumatoid arthritis also causes narrowing of blood vessels and blocks blood flow, and is the main cause of heart attack and stroke in RA. 

• Joints damage-If Rheumatoid arthritis is not treated early or is not well controlled, the inflammation in your joints could lead to significant and permanent damage. This damage most commonly seen in the hands, wrists and feet, and can result in pain, stiffness and loss of function. 

• Carpal tunnel syndrome-it is a common condition in people with Rheumatoid Arthritis. It caused by compression of the median nerve that controls sensation and movement in the hands. It causes aching, tingling or numbness in the thumb and fingers of hand. 

• Cervical myelopathy-This condition leads to dislocation of joints at the top of the spine, which puts pressure on the spinal cord, leading to neurological symptoms like weakness, numbness and difficulty in walking. 

Can homoeopathy help in Rheumatoid arthritis?

Yes, homoeopathy can help to manage symptomatically in this case. The severity of the symptoms depends from person to person. Some of the homeopathic medicines are: 

1. Rhus Toxicodendron: It is anti-inflammatory medicine. Rheumatic pains spread over a large surface at the nape of neck, loins and extremities which is better by motion. The pain increases during the rest and the first movement of the patient.  
2. Natrum Muriaticum-This medicine is suitable for those patients who may have developed Rheumatoid arthritis after prolonged stress in the form of grief. It is the emotional trauma that leads to disturbance of the immune system. Such patients may have associated headaches with sensitivity to sunlight. 
3. Pulsatilla: It is useful in shifting types of pain and stabbing aching kind of rheumatic pains. Boring pain in the heels towards the evening; Suffering worse from letting the affected limb hang down. 
4. Ledum palustre: This type of rheumatic pain starts from the feet and travels up to other joints of the body. Cracking in joints; worse from warmth of bed. 
5. Bryonia: Treats the rheumatic pains, especially in the joints and knees. Joints red swollen and hot, with stitches and tearing pain; worse on least movement. Every spot is painful on pressure. 

Disclaimer: The information provided is for educational purposes only and should not be construed as medical advice. Always consult a qualified healthcare professional or physician before starting any treatment or using any medication. Self-medication without professional guidance can be harmful to your health. The content provided here is not intended to replace professional medical advice, diagnosis, or treatment.