Rheumatoid Arthritis is an autoimmune disease, characterised by chronic inflammation of joints lining, that causes swelling, which can result in joint deformity due to bone erosion. It is a progressive disease usually affecting smaller joints of hands and feet and may also affect wrist, ankle and other joints as the disease progresses.
Rheumatoid Arthritis – Causes and Risk Factors
According to modern science the exact cause of rheumatoid arthritis is unknown and not yet fully understood, although it is known that an abnormal response of the immune system is the main reason causing the inflammation of the joints.
Rheumatoid Arthritis may be genetically inherited. It is also suggested that few environmental factors trigger the immune system in risky individuals.
Smoking, obesity and chemical exposures like pollution, insecticide, few cosmetics may increase the risk for rheumatoid arthritis.
Women are more susceptible for Rheumatoid Arthritis and it commonly begins between the ages of 40 and 60 years.
Signs and Symptoms of Rheumatoid Arthritis
- Tenderness and swelling around joints.
- Unbearable pain similar to scorpion sting.
- Feeling of warmness over the joints.
- Morning stiffness that may last for hours.
- Formation of Rheumatoid nodules. These nodules are firm lumps that grow under the skin. The nodules grow close to the affected joints. It can be as large as a walnut or as small as a pea.
- Fatigue, fever and weight loss.
- Joint redness.
- Decrease in range of joint movements.
- In chronic cases there will be joint deformity.
Diagnosis of Rheumatoid Arthritis
Blood test and physical examination will confirm the diagnosis.
- Erythrocyte Sedimentation Rate (ESR) – In rheumatoid arthritis there will be elevation in your ESR reading.
- Blood tests for C-reactive protein (CRP), anti-cyclic citrullinate-d peptide (Anti-CCP) antibodies and RA Factor.
- X-ray to determine the degree of degeneration. It will be usually seen in advanced stage of RA.
Complications of Rheumatoid Arthritis
- Rheumatoid arthritis in itself and in combination with rheumatoid arthritis medication could increase the risk of osteoporosis.
- Rheumatoid arthritis in wrists, can compress the nerve that serves most of your hand and fingers leading to carpal tunnel syndrome.
- Rheumatoid arthritis can increase your risk of heart disease, as well as inflammation of the pericardium of your heart.
- There is an increased risk of inflammation of lung tissue and scarring that can cause shortness of breath.
- It can also affect your eyes causing episcleritis, scleritis and blood vessels leading to vasculitis and ulcer formation.
- Rheumatoid arthritis patients are more susceptible to repeated infections.
Management of Rheumatoid Arthritis
- To reduce pain and inflammation NSAIDs and corticosteroids are given
- DMARDS- Disease modifying antirheumatic drugs to modify the course of disease may be administered.
These medicines have their own side effects on your body and suppresses your natural immunity, making you to fall sick often.
Rheumatoid Arthritis in Ayurveda
In Ayurveda, Rheumatoid arthritis is described under Amavata. There is detailed description about Ama, which is considered as the main culprit for most of the diseases and amavata as well.
In modern medicine the cause of Rheumatoid Arthritis is unknown, whereas in Ayurveda it is very well explained. By avoiding the causative factors, Rheumatoid Arthritis can be definitely prevented in susceptible individuals, progression of the disease and joint deformation can be checked in persons who are already suffering with Rheumatoid Arthritis.
According to Ayurveda, Ama is defined as the toxins produced in the body due to imbalance in body metabolism. These toxins circulate in the whole body and gets accumulated in the weaker joint and triggers the immune system leading to joint inflammation.
Causes for Imbalance in Body Metabolism and Decreased Immunity
- Agnimandya – Low level of digestive fire due to unhealthy food habits – having very heavy food, left over stale food, junk, deep fried or frozen and processed food. Overeating or eating before previous meal is digested, eating food at irregular times, late night dinner, etc.
- Viruddha ahara – Consuming foods having opposite qualities at a time. Example- Drinking ice cold water while having hot meals, eating fish along with milk, etc.
- Viruddha vihara – Doing activities which are opposite in nature. Example – Taking cold shower immediately after exposure to hot sun, sitting in AC for prolonged hours.
- Avyayama – Sedentary lifestyle devoid of exercise.
- Ati Vyayama – Over physical exertion leading to joints degeneration
- Manasika karanas – Mental stress or emotional disturbance
Line of Treatment for Amavata according to Ayurveda
- Agni deepana and ama pachana – Correction of body metabolism by activating the digestive fire
- Ama shodhana – Removal of ama
- Pathya – Following dietetic regimens and lifestyle changes to prevent ama formation
- Shamana chikitsa – Internal medications to reduce pain and joint inflammation
- Rasayana – Medications to improve immunity and joint stability.
- To improve your digestive capacity you can take chitrakadi vati or agni tundi vati and include garlic, ginger, pepper, jeera, turmeric and asafoetida sufficiently in cooking.
- Drink hot or lukewarm water.
- Removal of toxins through virechana or by vamana followed by virechana depending on your dosha predominance and basti.
- Avoid curds, paneer and cheese completely.
- Avoid refrigerated, stored and frozen foods.
- Eat freshly prepared light food and avoid reheating leftover food.
- Don’t drink cold beverages.
- Minimise the intake of fermented foods like idli, dosa.
- Avoid exposure to cold breeze.
- Take hot water shower to reduce pain and joint stiffness.
- Do regular exercise according to your body capacity.
- Overcome stress and emotional disturbance by meditation, pranayama and cultivating new hobbies.
- Avoid sleeping in afternoon.
- Reduce the intake of sprouted grams.
- Avoid tubers like potatoes, include snake gourd, ridge gourd, drumstick and other bitter and fibrous vegetables.
- Avoid constipating foods like sandwich, burger, pizza, etc.
- Kashayam – Guluchyadi kashayam, amruthotharam kashayam, balaguluchyadi kashayam, Rasnapanchakam kashayam, Rasnadi kashayam
- Tablets – Simhanada guggulu, Maha yogaraja guggulu, sadharana gulika, amavatari rasa, vyoshadi guggulu
- Churnas – Vaishvanara churna, panchakola churna, pathyadi churna
- Taila- Eranda taila (castor oil) used internally is very effective in amavata. You can drink 1-2 tsp of castor oil with a cup of hot water before going to bed. Beware of dosage according to your gut, as castor oil may cause drastic purgation. Oil massage is contraindicated in initial stages of amavata.
- Swedana (fomentation) – Hot fomentation with sand bag will reduce pain and stiffness in amavata.
Early detection and prompt treatment will definitely cure Rheumatoid arthritis through Ayurveda. In chronic conditions, ayurvedic treatment helps to prevent complications of rheumatoid arthritis and you can minimise the use of allopathic drugs.