A women complaint of stiffness and later pain and swelling in the joints of the fingers, and later there is affection of the larger joints. This condition progresses and is associated with constitutional symptoms and some pyrexia, the condition is probably RHEUMATOID ARTHRITIS.
Rheumatoid arthritis is a chronic multi-systemic disease of unknown etiology, the characteristic expression of rheumatoid arthritis persistent inflammatory synovitis, usually affecting the peripheral joints in systemic distribution. But there is a possibility of Varity of systemic manifestation.
Rheumatoid arthritis usually presents with insidious onset of pain and stiffness, in the small joints of the hands and feet which eventually lead to characteristic bilateral symmetrical peripheral polyarthritis. These pains are worse in the morning on waking up, and may improve with activity. Often there are pains in the night and sleep gets disturbed. The morning stiffness often lasts for long hours. Fatigue and general malaise are common. There are also non-articular symptoms present like swelling, caused by effusion, warmth, tenderness on pressure or movement. Deformities occur in later stages of disease.
Specific symptoms of rheumatoid arthritis
- Morning stiffness in and around joints, lasting more than 1 hour
- Arthritis of 3 or more joints areas involved simultaneously
- Arthritis of at least 1 area in a wrist, metacarpophalangeal, or proximal interphalangeal joint
- Symmetric arthritis involving the same joint areas
- Rheumatoid nodules
- Positive rheumatoid factor
- Radiographic changes typical of rheumatoid arthritis on hand and wrist radiographs, including erosions, or unequivocal bony decalcification in or adjacent to the involved joints
- No evidence of other disease such as lupus
Investigations of rheumatoid arthritis
Immunological tests– (a) rheumatoid factor – RF is an antibody directed against the Fc segment of immunoglobin G (IgG).
Tests for inflammation – raised ESR, C-reactive protein and plasma viscoty. Other laboratory tests to support inflammatory disease – normochromic, normocytic anemia(with low iron levels and iron-binding capacity0, thrombocytosis, elevated hepatic alkaline phasphatase, polyclonal gammopathy, and elevation of acute phase proteins e.g. ferritin
Radiology – sequence of changes – (a) periarticular osteopenia with soft tissue swelling
(b) erosions at joint, margins, at junction of synovium, subchondral bone and articular cartilage.
© loss of joint space
(d) deformity such as subluxation or complete dislocation of affected joints.
Synovial biopsy – rheumatoid pattern (villus formation with thickening of synovial layer and Infilteration with abnormal sells) in rheumatoid arthritis
Synovial fluid – not helpful in different diagnosis from other types of inflammatory arthritis
Arthroscopy – will not distinguish rheumatoid arthritis from various inflammatory seronegative arthritides. In acute rheumatoid arthritis synovium is edematous, diffusely erythematous and friable. In more chronic conditions, it becomes thickened, polypoid.
Renal biopsy – if rediced glomerular or tubular function
Pulmonary biopsy – to distinguish rheumatic nodules from carcinoma or to establish diagnosis of fibrosing alveolitis.
Homeopathic treatment rheumatoid arthritis
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat rheumatoid arthritis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved remedies are available for rheumatoid arthritis treatment that can be selected on the basis of cause, location, sensation, modalities and extension of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some important arthritis remedies are given below for the treatment of rheumatoid arthritis:
It is an excellent remedy for rheumatoid arthritis symptoms, persons of scrofulous type, who take cold easily. Tendency to grow fat,. Disorders caused by working in water. In the back there is pain as if sprained, can scarcely rise from over lifting. Vertebrae feel loose, painful on pressure. Rheumatism of lumber region with weakness in the small of back, neck stiff and rigid. Faulty development of bones. Calcaria has cold clammy feet as if wet stockings are on, with lot of growing pains. Joints as if sprained. Rheumatoid pain as after exposure to cold. The joints look deformed, especially the knee. Arthritis nodosites, cold, sour, swelling, perspiration, burning of soles of feet are some of the characteristics. While taking the history for rheumatoid arthritis apart from the local symptoms of the pains in the joint these characteristic qualities will be considered.
There are bony growths, exostosis, and deformities of bones. Cracking in joints and easy joint dislocation, and synovial swellings. Chronic synovitis of the knee joint. Joints are worse at the beginning of the movement. Worse with the cold weather but always better in warmth. There is crepitation of joints from lack of synovial fluid. Piercing, darting, grinding pains in all joints. Cramps in muscles of leg.
It forms serious inflammation with effusion, extreme sensitive to touch, great burning and stinging in the affected parts- worse from heat in any form. Rheumatic pains in the back. Stiffness in the back of the neck. Knees are swollen, sensitive shining sore with stinging pains. Any joints that are affected looks puffy and red, shining and sensitive to touch.
Causes many rheumatic and gouty pains, pains which appear suddenly and dart from place to place. Rheumatism comes on suddenly, with restlessness. Muscles feel torn from their attachment. Stiffness and contracture of joints.
Tearing and stinging in the limbs. Contractions of the affected parts. Marked stiffness of the affected limbs. Contractions of the affected parts. Marked stiffness of the affected limb. Joints are swollen, puffy and hot. Can not tolerate pressure or heat.
It is a cold damp weather remedy especially in spring and autumn. It acts on the fibrous tissue, on the periosteum, and synovial membranes of joints, especially the small joints. It does not tend to suppuration. The joints are swollen and puffy, sensitive to touch or jars. Large joints are intensely red and hot, small joints are swollen numb and stiff, drawn tightly to palms, pains go from left to right. Stitches in the right shoulder.
Wandering pains shift rapidly from place to place, and ever-changing symptoms. Caused by getting wet in the rains or water and protracted hot weather.
Useful in chronic periosteal rheumatism of syphilitic origin. The condition is aggravated at night and lying on painful side. Jerking of tendons, contractions, tendons are hard and stiff, drawn tightly to palm, chilliness predominates.
Other important remedies for rheumatoid arthritis
- Bryonia Alba. – Pain with inflammation which, is aggravated by movement and relieved by moderate pressure and rest.
- Ledum pal. – Excellent remedy for gout and rheumatism which is of ascending nature, better by cold application.
- Rhus Tox. – Pain aggravated by first movement, damp weather and better by continuous motion.
- Kalmia lot. – descending type of pain, pain with palpitation of heart and slow pulse
- Benzoic acid – gouty concretions of joints, knee pain due to abnormal deposition of uric acid
- Hypericum. – Remarkable remedy for rheumatoid arthritis has outstanding action over nerve pain.
Other natural and alternative modes of treatment – Include Physiotherapy, Ayurveda, Acupuncture, massage, yoga, acupressure, naturopathy etc