Arthritis

Arthritis is a general term used for complaints of bones and joints. The medical terminology is ‘Rheumatology’ which means conditions involving affection of the musculoskeletal system which leads to pain, stiffness, swelling and inefficient functioning of the involved part. The musculoskeletal system is a systematic arrangement of more than 200 bones and 600 muscles in the body so as to promote stability, flexibility, support and strength to the human body. It includes not just the bones and muscles but also the tendons, ligaments, connective tissue and bursae, all of which help to maintain the architecture of the bony framework

What are the types of arthritis?

Arthritis can exist as a disorder of a single joint or multiple joints.

It can exist as an isolated pathology of joints or as a part of a multisystem disorder.

It can be a result of different types of disease processes in the body, be it inflammatory, metabolic or degenerative.

Following are the commonly encountered types of arthritis,

• Rheumatoid arthritis
• Osteoarthritis
• Spondylosis
• Gout and crystal deposition diseases
• Systemic lupus erythematosus
• Ankylosing Spondylitis
• Psoriatic Arthritis

What are the symptoms of arthritis?

Pain is the most common presenting feature along with stiffness of joints especially on attempting to walk after prolonged inactivity.

Heat, swelling and redness is a feature of acute arthritis or an acute episode of chronic arthritis.

Limited mobility of the joint occurs initially due to acute inflammation and later due to development of contractures.

Depending upon the type, other symptoms may appear as part of the underlying disease.

What investigations need to be done?

A proper history of the patient along with clinical examination is mandatory which helps to confirm the diagnosis in many cases.

Other investigations which can be done are

Radiological -

• X-ray of the affected part
• CT-scan or MRI if required

Biochemical -

• A complete blood count with ESR
• C-reactive protein
• Immunological tests like RA factor, ANA
• HLA – B27
• Serum uric acid levels

Interventional -

• Arthroscopy
• Biopsy

How do we treat arthritis?

Treat the underlying cause – Identification of the exact pathology helps to chart the line of treatment.

Acute episodes can be managed by rest and suitable Homoeopathic medicines.

For chronic arthritis, Homoeopathy helps in slowing the progress of the disease as evidenced by clinical and radio-biochemical improvement.

Supportive therapy like physiotherapy, warm fomentation, RICE protocol, regular exercises help in managing the disease in its chronic phases.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, destructive arthritis that frequently involves multiple joints in a symmetric fashion. It is systemic in nature, meaning that apart from joints it also affects different tissues like eyes, blood vessels. lymph nodes, skin, nerves, heart, lungs etc. It is a chronic disease which runs a variable course interspersed with acute exacerbations. It is more commonly seen in female patients. It is generally (not in every case though) associated with a positive rheumatoid factor which is a high titre of circulating antibodies against own tissues of the body.

What causes RA?

The cause remains obscure although it is widely accepted that it is an immune mediated disease. In people who may be carrying a faulty gene, certain environmental factors trigger a reaction which may be exaggerated and faulty which results in a persistent automated inflammatory reaction. The result is destruction of tissues and onset of clinical manifestations of RA.

What are the symptoms of RA?

The onset may be gradual or sudden(uncommon) and it generally presents with loss of appetite, fever, tiredness and vague muscle pains. At this stage diagnosis of RA is difficult until symptoms of joint involvement clearly point to the aetiopathogenesis. The musculoskeletal symptoms occur due to inflammation of the synovial membrane which is the membrane covering the bones at the site of joint articulations. The symptoms vary in intensity in individual patients and this variation is due to differing responses to the immune aberration. The common symptoms encountered are

Pain in affected joints usually small joints of hands and legs (although the larger joints are also affected in due course)

Swelling of joints which is felt more as a doughy, boggy swelling due to soft tissue inflammation

Redness and heat are more a feature of acute episodes in the course of chronic RA

Stiffness is a very prominent feature especially after resting for awhile.

Limitation of joint mobility is a common feature especially in those patients with frequent acute episodes which further progression of joint destruction. Initially mobility restriction is due to pain, later on it i due to the repair processes in the body which results in fibrosis, contractures and ankyloses(fusion) of the joint.

Other features depend upon the tissue affected.

When blood vessels are involved, it may cause vasculitis which may impede blood supply to the distal portion of the blood vessel resulting in cold, blue extremities or neuropathies or other symptoms of involvement of the organ supplied by that blood vessel

The eye when affected gives rise to a ‘red eye’ or a ‘dry eye’.

Skin involvement is witnessed by presence of nodules especially near joints.

Lungs may become affected leading to diffuse fibrosis and nodule formation.

The blood composition may show a depleted count of all components.

What is the course and prognosis of RA ?

Once you are diagnosed with RA, it helps to know where and what to expect.

RA is a disease with a variable course which differs from one person to another.

Some patients may exhibit a mild course with single joint involvement and reduced severity of complaints. In some others, the disease may take a moderate course with multiple symmetric joint affection and mild extra-articular features. Still others may suffer a lifetime of frequent acute exacerbations leading to joint destruction and disability and a plethora of systemic symptoms.

The disease may show a relentless progression or a prolonged quiescent state. Generally these features correspond to the titres of circulating antibodies.

How can Homoeopathy help?

Homoeopathic medicines help in addressing the root cause of the disease by favourably modifying the immune mechanisms of the body. The effects are seen in Reduction in frequency of acute episodes which means fewer onslaughts on the body.

Delay in progression of the disease.

Mitigating the severity of the pathological process as seen by a reduction in pain, swelling and stiffness of joints Enabling the patient to have a gradually increasing range of movements.

Helping her live a near to normal life.

Rheumatoid arthritis is a multisystem disease, hence it helps to implement a multi-pronged approach of Homoeopathy along with physiotherapeutic interventions.