Rheumatoid Arthritis

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What does Rheumatoid Arthritis mean?

Rheumatoid Arthritis is a chronic autoimmune disease in which your immune system mistakenly attacks the lining of your joints (synovium), causing pain, swelling, irritation, and inflammation in the joints. Along with joints, it can also damage other parts of the body, such as the eyes, skin, lungs, heart, and blood vessels. RA usually occurs on both sides of the body. Uncontrolled inflammation can damage cartilage, which is a smooth, soft covering layer that works as a cushion. With time, it can deform your joints, which can result in fusion of your joints.

Stages of Rheumatoid Arthritis

RA has four stages, which are explained below:

• Early Stage: In this stage, the inner lining of your joints gets irritated and swollen. You will feel slight pain and stiffness in your joints, but there are no destructive changes in this stage.
• Moderate Progression: Your cartilage in the joints starts getting damaged due to inflammation. You might start noticing decreased range of motion and persistent stiffness.
• Severe Disease: Your bones and cartilage get destroyed by the inflammation. You start experiencing intense pain, swelling, and further loss of mobility. 
• End Stage RA: In this stage, your joints keep getting worse, and your inflammation may stop. Your bones may fuse together, and you may face severe functional loss, permanent immobility, and chronic pain. 

Risk Factors of Rheumatoid Arthritis

RA has the following risk factors:

• Genetics: A family history of rheumatoid arthritis can raise your risk of joint issues in the body.
• Age: RA can start at any stage, but the risk usally increase as you get older; it is most commonly found in adults between 50 and 59 years.
• Biological: Women are two to three times more likely to develop RA.
• Obesity: Carrying extra weight can put pressure on your joints, mainly those that carry your whole body weight, knees and hips. 
• Smoking: Cigarette smoking is a major factor that can cause RA and even make it worse.
• Environmental Exposure: If you constantly inhale harmful substances such as silica dust or asbestos present in the environment can raise the risk of RA.
• Periodontitis: If a person has severe gum inflammation, it can also result in RA.
• Lung Disease: A person who has any type of lung disease may also get RA.

As you cannot change any of the above, knowing what puts you at risk is the first step in protecting your joints.

Common Symptoms Associated With Rheumatoid Arthritis

Unlike normal wear and tear, RA affects your whole body cause specific type of joint pain in the body. Common symptoms of RA include:

• Tender, puffy joints: Your joints may feel warm to the touch, visibly swollen, and hurt when you press them.
• Pain on both sides: You will feel pain on both sides of the body; if your right wrist hurts, then your left wrist will also hurt.
• Severe morning stiffness: Your joint may feel stiff or hard when you wake up in the morning.
• Feeling sick or tired: Because your immune system is actively causing the swelling, you may feel sick and tired because of that.
• Tingling or numbness: You may feel numbness or tingling in your hands due to nerve pressure in the wrist.

If you have any of the above symptoms going on in your body, then immediately visit a doctor to control it at the first stage.

Diagnosis of Rheumatoid Arthritis

RA is hard to diagnose in the early stages because the early symptoms can be like those of other common conditions. Your healthcare professional can do the following tests for the diagnosis of the disease in your body:

• Medical History & Physical Examination: The doctor will check your joints for any type of swelling, tenderness, and warmth and assess if the pain is on both sides of the body. 
• Pulse Diagnosis (Nadi Pariksha): The doctor will do a Nadi pariksha to check which of your internal body energies is out of balance.

• Tracking Toxins: They will ask very detailed questions about your digestion to figure out if sticky toxic waste (Ama) is behind your pain or not.

• Blood Test: People with RA may have high levels of CRP and ESR in their bodies, as this may show a higher level of inflammation in the body. The doctor may also ask for Rheumatoid Factor and Anticyclic citrullinated peptide (anti-CCP) antibodies. 
• Imaging Tests: X-Rays, MRI & Ultrasound to detect joint space narrowing, bone erosions, or early soft-tissue inflammation. 

Finding out why exactly your joint is hurting is the primary step to move forward for the right care and treatment.

Rheumatoid Arthritis In Ayurveda

In Ayurveda, Rheumatoid arthritis is called Amavata, and it is believed to start from your stomach instead of your joints. When your digestion is weak, your food is not able to be digested properly, which creates a toxic, heavy, and sticky waste in your body, known as Ama. We have a natural energy in our body, known as Vata, which controls air and movement in your body and pushes away this waste into your joint spaces, where it gets completely trapped. When this toxic waste gets stuck down there, your body tries to fight it back. This internal reaction makes your joints hot, swollen, and stiff. So Ayurveda focuses on fixing this internal imbalance by treating your digestion and removing toxins from your body. 

Management of Rheumatoid Arthritis Through Ayurveda

Ayurveda provides many preventive measures to minimize joint pain by treating the root cause of the disease. It focuses on fixing digestion and removing the toxic waste, AMA, from the body and balancing the whole body. Based on the management and treatment procedures of Ayurveda, it includes the following approaches:

Panchakarma (Detoxification) Therapies

Ayurveda uses Panchakarma therapies such as basti, virechana, and vaman to help manage RA and remove Ama, toxins from the body, and calm the aggravated Vata energy causing stiffness and pain in the joints. These therapies help clean the digestive tract and help in making digestion strong again.

Herbal Remedies 

Ayurveda uses potent herbs such as ashwagandha, guggul, and shallaki for their anti-arthritic properties. These herbs help in managing the pain caused by RA, reduce stress, and lower inflammatory markers in the body. These herbs also help in reducing swelling and stiffness in the joints. 

Dietary Adjustments

Ayurveda puts great emphasis on diet; it believes it is an excellent approach to manage and control RA. It suggests warm, freshly cooked food, healthy fats, and anti-inflammatory spices such as ginger, turmeric, or garlic to add to your food. It also asks you to avoid processed, refined, packaged food, as they contain excessive amounts of salt, sugars, and artificial ingredients.

Lifestyle Changes 

Ayurveda says that for good health, a balanced lifestyle is very important. It asks you to fix your routine by managing your stress, sleeping properly, drinking enough water, eating clean, doing breathing exercises and yoga, and meditation for better mental well-being as well as physical well-being.

Prevention Tips for Rheumatoid Arthritis

Here are some of the prevention tips that can help to lower the risk and protect your joints:

• Maintain your weight because extra body weight puts a lot of pressure on your joints, which makes them slowly weaken.
• Have a good and balanced diet plan to get the right nutrition.
• Avoid heavy weight lifting, as it can burden your joints; instead, do low-impact exercise to keep your body active.
• Avoid consuming alcohol and tobacco, because it is harmful to your body.
• Protect your gums by brushing your teeth and visiting a dentist regularly.

Making these changes today is the best way to protect your joints.

Red Flags To Watch Out For

RA is a serious medical condition; if it gets serious, it can show you the following signs, which cannot be ignored:

• If your morning stiffness that lasts more than 30 minutes.
• If you have visible swelling in your joints.
• If you have pain and tenderness affecting the joints on both sides.
• If you experience extreme fatigue that doesn't go away even after proper rest.
• If you have unexplained weight loss and loss of appetite.
• If you feel chest pain or shortness of breath.
• If you experience rapid joint deformity or an inability to move the joint freely.  
• If you have rheumatoid nodules developing under the skin near pressure points like elbows or knuckles. 

If you experience these red flags, then immediately see a doctor.

References

Rheumatoid Arthritis - StatPearls - NCBI Bookshelf

Overview of Rheumatoid Arthritis and Scientific Understanding of the Disease - PMC