Arthritis

RHEUMATOID ARTHRITIS

Introduction Rheumatoid arthritis (RA) is a type of arthritis (chronic inflammatory polyarthritis) that typically affects hands and feet, although any…

Dr. Shweta Bairagi · 23 Mar 2011

IntroductionRheumatoid arthritis (RA) is a type of arthritis (chronic inflammatory polyarthritis) that typically affects hands and feet, although any joint in the body may be affected such as wrists, knees, hips and shoulders. Over time, joint destruction can occur resulting in permanent damage, bone destruction and deformity.What causes rheumatoid arthritis?The cause of RA is not known, however it is thought that some people inherit genes that affect the way the immune system works making them more susceptible to the disease than others. Environmental factors such as an infection may also trigger RA and generate an immune response. In RA, synovial cells found in the joint lining grow and increase in numbers and size, thereby invading and destroying the joint’s articular cartilage. This process is driven by a cytokine called tumor necrosis factor (TNF). In healthy people, TNF levels are maintained at normal levels by a variety of anti-inflammatory cytokines. But people with an immune disease such as RA have too much TNF in their bodies. This excess of TNF-alpha leads to inflammation in joints of people with RA.Cause of Rheumatoid Arthritis:Ø Exact cause is not known. - Evidence points to autoimmune etiology. - Genetic predisposition common. - Precipitating factors:Physical or emotional stress. • After childbirth (remission during pregnancy)Ø Hormonal disturbance:Puberty. • Menopause.Ø Age: 20 - 45 years - Sex: common in females.Pathogenesis: Joint deformity occurs in RA because the cartilage & then the bone are eroded by the proliferative synovial tissue. This process leads to increased laxity of ligaments around the joints, subluxation of tendons & subsequently of joints & inflammation of many other tissues in the body.Clinical symptoms include:Ø Stiffness occurs commonly in the morning.Ø Joint swelling that can occur in any joint but most often occurs in small joints of the hands and feet and often symmetrically.Ø Tiredness, fever, weight loss and depression.Symptoms of Rheumatoid ArthritisProdorme - Fatigue. - Malaise.Symptoms- Joint stiffness more marked in morning. - Pain in joints - Limitation of movement of joints. - Fever. - Malaise. - Night sweats. - Loss of grip strength. - Weight loss. - Joint deformities.Signs- Joints involved:• Small joints. • Bilaterally symmetrical. • Joints swollen, hot & tender. • Limitation of movements.- Subcutaneous rheumatoid nodules present on extensors surfaces. - Bursitis. - Tenosynovitis. - Muscle wasting above & below affected joints. - Ulnar deviation of wrist. - Swan neck deformity of fingers. - Boutonniere deformity of fingers. - Z-thumb deformity. - Tender prominent metatarsal heads with secondary corns. - Lateral deviation & over-riding of toes with pressure sores. - Baker’s cyst: - Herniation of synovial cavity into back of knee causing pain & tenderness of calf.Diagnosis of Rheumatoid Arthritis1) X-Ray joint. 2) Synovial biopsy. 3) CBC. 4) Synovial fluid analysis. 5) Rheumatoid factor.Complications of Rheumatoid Arthritis- Subluxation of atlanto-axial joint. - Carpal tunnel syndrome. - Fibrosing alveolitis. - Sjogren’s syndrome. - Septicarthritis.Homeopathic Remedies for Rheumatoid ArthritisHomeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc.The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.AconiteSudden onset after exposure to cold dry air. Pains with fornication and numbness. Rheumatic inflammation of joints; pains intolerable, intense bright - red swelling of parts, sensitive to contact, high fever, worse at night with the rheumatism anxiety, fear, restlessness is well marked in aconite. Arthritic and rheumatic drawing and tearing pains, especially in the limbs. Acute and violent pulling in the joints and the bones, mitigated by the heat of a bed. Contraction of the tendons and stiffness in the flexor muscles of the limbs. Cramp - like contraction of several limbs. Aconite is generally indicated in acute or recent cases occurring in young persons, especially girls of a full, plethoric habit who lead a sedentary life; persons easily affected by atmospheric changes; dark hair and eyes, rigid muscular fiber.ArsenicumAcute drawing pains in the arms and in the hands. Swelling of the arms, with blackish pustules of a putrid smell. Acute drawing pains in the night, beginning from the elbow and extending to the armpits acute pulling and shooting in the wrists. Cramps in the fingers. At night, sensation of fullness and swelling in the palms of the hands. Excoriation between fingers. Hard swelling of the fingers, with pain in the finger-bones. Cramp in the legs. Acute drawing pains in the hips, extending to the groins, the thighs, and sometimes even to the ankle-bones, with uneasiness, which obliges one to move the limb constantly. Tearing and stinging in the hips, legs, and loins. Tearing in the tibia. Rheumatic pain in the legs, and especially in the tibia. Paralytic weakness of the thigh. Pain, as from a bruise in the joint of the knee. Affections of the shin-bones. Fatigue in the legs and in the feet. Pains in the fleshy part of the toes, as if they were galled by walking. Great Prostration, with rapid sinking of the vital forces; fainting.The disposition is:a. Depression, melancholy, despairing, indifferent. b. Anxious, fearful, restless, full of anguish. c. Irritable, sensitive, peevish, easily vexed. The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move. Indicated by its periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its intense restlessness, mental and physical: its anxiety and prostration.BelladonnaJoints swollen, red, hot, shining. Exquisitely sensitive to touch or jar. Red streaks radiate from inflamed joint. Recurrent fever with pains attacking nape of neck. Pains in the joints and bones. Rheumatic pains (in the joints) flying from one place to another. The pains are aggravated, chiefly at night, and in the afternoon towards three or four o'clock. The least touch, and sometimes also the slightest movement, aggravates the sufferings. Some of the symptoms are aggravated, or make their appearance after sleep. Jerking in the limbs, muscular palpitations and shocks of the tendons. St.Vitus dance. Sensation in the muscles, as if a mouse were running over them. Cramp, spasms, and convulsive movements, with violent contortion of the limbs, convulsive fits, with cries, and loss of consciousness, epileptic convulsions, drawing back of the thumbs. Renewal of the spasms by the least contact, or from the glare of light. Burning in the inner parts. Attacks of immobility and of spasmodic stiffness of the body, or of some of the limbs, sometimes with insensibility, swelling of the veins, bloatedness and redness of the face, pulse full and quick, with copious sweat. Spasms in single limbs, or of the whole body, in children, during dentition. Adapted to bilious, lymphatic, plethoric constitutions; persons who are lively and entertaining when well, but violent and often delirious when sick.BryoniaOver-sensitiveness of the senses to external impressions. Rheumatic and gouty pains in the limbs, with tension, worse from motion and contact. Tension, drawing pains, acute pulling and shootings, especially in the limbs, and chiefly during movement, with insupportable pains on being touched, sweat of the part affected, and trembling of that part when the pains diminish. Stiffness and shootings in the joints, on being touched and when moved. In the evening, pain, as from fatigue, in the limbs, with paralytic weakness. Torpor and numbness of the limbs, with stiffness and pain of fatigue. Pale, tense, hot, swelling. Red, shining swelling of some parts of the body, with shooting during movement. Pain, as from a bruise, or of subcutaneous ulceration, or as if the flesh were detached from the bones. Dragging, with pressure, on the periosteum. It is best adapted to persons of a gouty or rheumatic diathesis; prone to so-called bilious attacks. Bryonia patients are irritable, inclined to be vehement and angry; dark or black hair, dark complexions, firm muscular fibre; dry nervous, slender people. A "worse cold, dry weather" remedy. Acute articular rheumatism; swelling; tension. Worse slightest movement. Wants to lie still. White tongue; dry, dark, hard stools. Thirsty for large drinks. Perspiration relieves. The characteristic pains of Bry. are stitching. Affects especially synovial membranes (joints, pleura, pericardium, meninges). Local inflammation violent, parts very hot.CausticumArthritic and rheumatic drawing and tearing pains, especially in the limbs. Acute and violent pulling in the joints and the bones, mitigated by the heat of a bed. Contraction of the tendons, and stiffness in the flex-or muscles of the limbs. Cramp-like Contraction of several limbs. Torpor and paleness of some parts, or of the entire left side of the body. From cold dry weather. Better wet weather: warm wet. Burning pain in joints. Rheumatism of articulation of jaws. Stiffness, hips, back; rises with difficulty. Adapted to persons with dark hair and rigid fiber; weakly, psoric, with excessively yellow, sallow complexion; subject to affections of respiratory and urinary tracts.ColchicumArthritic pains; a jar makes patient scream. Affects periosteum and synovial membranes. Redness, head, swelling of affected joints. Worse cold, wet weather; checked sweats. Worse autumn. Better warmth. Patient is cold, weak, sensitive, restless. Loathes the smell or sight of food.DulcamaraFrom a chill when hot; suppressed sweat or eruptions. From cold wet weather. Sudden change to cold weather. Neck stiff, back painful, loins sore and lame. Better moving about. Tearing, shooting, or drawing pains in the limbs. Sufferings, as from a chill in various parts. Rheumatic pains and other complaints, from a cold. Aggravation of sufferings, chiefly in the evening or at night, an during repose, better by movement. Pains with coldness of the body.MedorrhinumRheumatic pain in top of left shoulder, worse from motion, occasional little darts of pain if kept still. Rheumatic pain in (right) shoulder and arm. Cracking of joints, especially elbows. Much pain in left arm, cannot hold a paper, veins become enlarged, worse raising arm. Trembling of arms and hands. For persons suffering from gout, rheumatism, neuralgia and diseases of the spinal cord and its membranes - even organic lesions ending in paralysis - which can be traced to a psychotic origin.Nux Vomica"Whole body burning hot, especially face red and hot, yet cannot move or uncover in the least without feeling chilly." "Rheumatic fever: vertigo, chilliness alternating with heat, pains in head, back and limbs; thirst; dry skin; scanty, dark urine; delayed stool. Evening fever < towards morning." Lumbago; pains drawing and spasmodic. Must sit turn over. Attacks especially trunks of muscles and large joints; pale tensive swellings. Worse motion; dread of motion. Worse least jar, and cold. Very chilly; cannot bear to uncover. Better for warmth, hot things, getting warm. Nux is irritable, sullen, surly. Is worse in dry, better in wet weather.PhytolaccaAcute rheumatism which is prolonged; worse at night. Worse from warmth of bed, and warm applications. Restlessness; pain unbearable. Gonorrheal rheumatism.RhododendronLike Rhus. Worse cold, wet, stormy weather. Better motion. But pains shift more than those of Rhus. Move from above downwards.Rhus ToxHot, painful swelling of joints. PAINS TEARING IN TENDONS, LIGAMENTS AND FASCIAE. Rheumatic pains spread over a large surface at nape of neck, loins, and extremities; better motion. Soreness of condyles of bones. LIMBS STIFF, PARALYZED. THE COLD FRESH AIR IS NOT TOLERATED; IT MAKES THE SKIN PAINFUL. Tenderness about knee-joint. Loss of power in forearm and fingers; crawling sensation in the tips of fingers. Tingling in feet. Adapted to persons of rheumatic diathesis; bad effects of getting wet, especially after being over-heated. "Worse cold, wet". Worse wet; bathing; washing; strain. Drawing, tearing pain, especially fibrous tissues; joints; round joints. Restlessness; must move, though first movement painful. Better from dry, warm application.Salicylic acidAcute, inflammatory rheumatism of one or more joints, especially elbows or knees. Great swelling and redness. High fever. Very sensitive to least jar. Motion impossible.StictaAcute inflammatory rheumatism, esp. of knee. Worse from motion. Loquacity; must talk. Levitation; limb as if not resting on bed.The Scope of homoeopathic treatment in rheumatoid arthritis is very favorable. But the patient needs to understand that the homeopathic system is aiming to clear out the disease from the body and not trying merely to suppress or give temporary relief .Thus it could take a while before one experiences relief. The time for its treatment is dependent on various factors-The chronicity of the disease (the duration since the disease has been in the body), genetic propensity and the extent of damage.Firstly one has to realize that rheumatoid arthritis is a complex chronic disorder and needs to be evaluated properly before any prescription is made. Secondly, homeopathy is a very individualized system of medicine. For example the prescription for the arthritis patient that gets an increase of symptoms in cold weather will be totally different from the one who shows an increase during wet weather. That is why Homeopathy is called as a symptom based system of medicine. Selecting the right homeopathic medicine also requires complete analysis of our body on various levels- mental physical and the symptoms of rheumatoid arthritis. Thus one should completely avoid self medication.