© 2023 IJRAR June 2023, Volume 10, Issue 2 www.ijrar.

org (E-ISSN 2348-1269, P- ISSN 2349-5138)

LET’S REVERSE THE EFFECTS OF

RHEUMATOID ARTHRITIS WITH
HOMOEOAPTHY
1Dr.Puja
S.Dabhi
1
Associate Professor
1
Homoeopahtic Materia Medica,
1
Sumandeep Homoeopathic Medical College and Hospital, Vadodara, India
Abstract: Rheumatoid arthritis is an inflammatory disease that involves joints as well as extra articular tissues. It is a multifaceted
disease involving genetic and environmental elements within a sphere. Rheumatoid arthritis is one of the most common clinical
conditions that clinicians come across in everyday practice. It primarily affects women as opposed to men. Homoeopathy can
reduce the symptoms of the disease as well as the progression of the disease. The holistic approach of homoeopathy offers
promising and remarkable results with improved quality of life.

Abbreviations – RA-Rheumatoid Arthritis, HLA- human leukocyte antigen, ESR- erythrocyte sedimentation rate and CRP- C-
reactive protein , ACPA- anti-citrullinated protein/peptide antibody,RF- rheumatoid factor, DVT -deep vein thrombosis.

Keywords –Rheumatoid Arthritis, joints, bursa, tendon, stiffness, Homoeopathy.

INTRODUCTION:
Rheumatoid arthritis is a widespread kind of inflammatory arthritis that affects people of all racial and cultural backgrounds.
In Europe and the Indian subcontinent, the prevalence of RA is roughly 0.8–1.0%, with a female–to–male ratio of 3:1. South-east
Asia has a lower prevalence (0.4%). The Pima Indian population has the greatest prevalence (5%) in the world. It is a chronic
condition defined by remissions and flare-ups in its clinical course1

EPIDEMIOLOGY:

An estimated 0.5 to 1% of persons worldwide have rheumatoid arthritis, which varies geographically. Prior to the menopause,
the prevalence of the condition is approximately three times higher in women than in men, for reasons that are still unknown. Any
age can experience rheumatoid arthritis. Rheumatoid arthritis affects roughly 40 per 100,000 women annually, compared to about
50 per 100,000 men. Due to the fact that rheumatoid arthritis is a chronic condition, its prevalence rises or stays constant with
advancing age2

PATHOPHYSIOLOGY

RA is a complicated condition with genetic and environmental triggers. The higher concordance of RA in monozygotic twins
(12–15%) compared with dizygotic twins (3%), as well as a heightened prevalence of the disease in first-degree relatives of
patients, serve as examples of the significance of genetic variables. Nearly 100 loci have been found to be related with the risk of
getting RA by genome-wide association studies. The HLA region's variations have the strongest connection. According to current
thinking, RA happens when an external trigger, like an infection, causes autoimmunity in a genetically vulnerable host by
changing host proteins through procedures like citrullination to make them immunogenic. Smoking is a significant environmental
risk factor that is also linked to more severe disease and a worse response to therapy. Remission can happen throughout
pregnancy, and RA sometimes shows up for the first time after delivery. There is proof that CD4+ T lymphocytes and B cells
interact with other synovial cells to contribute significantly to the pathogenesis of RA. Within the synovial membrane, lymphoid
follicles develop where T- and B-cell interactions take place, activating T cells to create cytokines and activating B cells to
produce autoantibodies such RF and ACPA.

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Vasodilatation brought on by prostaglandins and nitric oxide produced by the inflamed synovium results in swelling and pain.
Acute phase proteins are produced by the liver in response to systemic release of IL-6. Joint erosions are brought on by the
inflammatory synovium's (pannus) direct invasion of bone and cartilage at the joint periphery. Later, there could be fibrous or
bony ankylosis. Nearby muscles to swollen joints deteriorate and may have lymphocyte infiltration. This causes gradual
biomechanical dysfunction and could accelerate damage.
Rheumatoid nodules primarily impact the extensor tendons in patients who test positive for RF or ACPA. They are made up of a
palisade of mononuclear cells that are proliferating around a core region of fibrinoid material. Granulomatous lesions can develop
in the sclera, pleura, lung, and pericardium1

CLINICAL FEATURES

The common symptoms include symmetrical pain, joint swelling, and stiffness in the tiny joints of the hands, foot, and wrists.
Extra-articular characteristics, systemic symptoms, and large joint involvement may also occur 1
The prevalence of RA rises between the ages of 25 and 55, reaches a plateau until the age of 75, and then starts to decline. The
common cause of the RA's initial symptoms is inflammation of the joints, tendons, and bursae. Patients frequently complain of
morning joint stiffness that lasts longer than an hour and goes away with exercise. The tiny joints in the hands and feet are
frequently the first to become damaged. Asymmetrical distribution is typically present in the initial pattern of joint involvement,
which can be monoarticular, oligoarticular, or polyarticular (>5 joints). Some inflammatory arthritis patients may have too few
afflicted joints when they first arrive for diagnosis, which is known as undifferentiated inflammatory arthritis3
Acute RA episodes can include severe morning stiffness, polyarthritis, and pitting oedema. This happens more frequently as
people age. Proximal muscle stiffness mimicking polymyalgia rheumatica is another manifestation. Palindromic in onset, with
brief episodes of pain, stiffness, and oedema that recur every few hours or days.
The afflicted joints often show swelling and pain upon examination. Erythema is uncommon, and its existence indicates sepsis
that is also present. Long-term uncontrolled disease may cause distinctive malformations to appear, though they have been less
prevalent in recent years due to more aggressive therapy. They include a Z deformity of the thumb, the boutonnière or "button
hole" deformity, ulnar deviation of the fingers, and the "swan neck" deformity.
Rupture of the fourth and fifth extensor tendons can be caused by dorsal ulna subluxation at the distal radio-ulnar joint.
Nodules in the flexor tendon sheaths may cause the fingers to trigger. Damage to the ankle and subtalar joints can lead to a valgus
deformity of the calcaneus in the hind foot. This is frequently accompanied by a flat foot (loss of the longitudinal arch) as a result
of the tibialis posterior tendon rupturing. Popliteal (Baker's) cysts are not exclusive to RA; they can develop in people with knee
synovitis. Synovial fluid communicates with the cyst but is blocked from returning to the joint by a valve-like mechanism. Knee
flexion may cause a rupture, which could cause calf pain and swelling that resembles a deep vein thrombosis (DVT). With more
vigorous RA treatment in its early phases, these joint abnormalities are becoming considerably less prevalent and are typically
only seen in older patients with long-standing disease.1

SYSTEMIC FEATURES

Fatigue, weight loss, and anorexia could all develop during the course of the illness. A typical consequence is osteoporosis,
and systemic inflammation and decreased exercise can lead to muscle wastage. Extra-articular characteristics can occasionally be
seen at presentation, especially in men, but they are most frequently seen in patients with long-standing seropositive erosive
illness. The majority are brought on by vasculitis, serositis, or granuloma and nodule development.

SPINAL CORD COMPRESSION

This uncommon condition results from dislocation of the cervical spine at the atlanto-axial joint or at a subaxial level, which
compresses the spinal cord. Erosion of the transverse ligament posterior to the odontoid peg is the cause of atlanto-axial
subluxation. Following slight trauma or manipulation, it can cause cord compression or abrupt death 1

COMPLICATIONS

Amyloidosis is an uncommon side effect of a chronic illness that typically manifests as nephrotic syndrome. Splenomegaly,
neutropenia, and thrombocytopenia coexist in Felty's syndrome, an uncommon consequence of seropositive RA.Patients with
active illness can develop localised or generalised lymphadenopathy, but if it persists, it could be a sign that lymphoma, which is
more common in people with long-term RA, is developing1

INVESTIGATIONS

Although studies are helpful in verifying the diagnosis and gauging the severity of the disease, the diagnosis of RA is
primarily clinical. Normal results do not rule out the diagnosis, especially if only a few joints are affected. The ESR and CRP are
typically elevated. In roughly 70% of cases, tests for ACPA are positive and highly specific for RA, appearing in many people
before the clinical beginning of the disease. Similar to ACPA, RF also tests positive in roughly 70% of cases, with ACPA being
positive in the majority of cases. However, RF is less accurate than ACPA, and positive tests can happen in cases of other
illnesses1

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MANAGEMENT

The purpose of treatment is to reduce inflammation, manage the symptoms, and guard against joint injury. This requires the
use of both pharmaceutical and non-pharmacological treatments1

NON-PHARMACOLOGICAL THERAPY

All patients must undergo assessments by occupational therapists and physiotherapists in order to receive the necessary
guidance and treatment. Physical and occupational therapy both play significant roles in patient care.1

HOMOEOPATHIC MANAGEMENT:

Apis Mellifica:

Odematous tissues. Synovitis. Shiny, painful, sensitive, and swollen knee with stinging pain. stiff and swollen feet. feel too
big. Back and limb rheumatic pain; worn-out, bruised sensation. Hands and the tips of the fingers are numb. Itchy hives that are
intolerable4.

Arnica Montana:

The majority of the time, arnica is used for severely sore joints. Due to discomfort and tenderness, a person has a strong fear
of touching the affected joint. Intense swelling and a severe, bruised ache in the knee are also present 4.

Bryonia Alba:

Tight and sore knees. Feet swelled up hot. Joints are heated, swollen, red, and torn, and they get worse with even the slightest
movement. Pressure causes pain in every area. Continuous movement of the left arm and leg. every muscle aches. The pain is
generally stitching or tearing in nature and is made worse by movement4.

Colchicum Autmnale:

Significantly impacts the periosteum, synovial membranes, and muscle tissues of joints. has the special ability to relieve gouty
paroxysms. The left arm is in acute discomfort. In warm weather, limbs tear, whereas in cold weather, they sting. Numb fingertips
and pins and needles in the hands and wrists. Eliminated right plantar reflex. Lame, and tingling limbs. Pain is worse at night and
in hot conditions. Joint stiffness and fever; rheumatism that shifts; nighttime pains. Great toe inflammation and gout in the heel
make it intolerable to be touched or moved. Nail tingling in the fingers. Knees collide, making it difficult to walk. Coldness and
odematous swelling of the legs and feet4.

Ledum Palustre:

A gout ache shoot in the joints, especially the tiny ones, and throughout the foot and limb. Feverish, pallid, and swollen. a
right shoulder throb. Poorer motion due to shoulder pressure. Joint cracking is made worse by bed warmth. gout-related nodules.
Rheumatism starts in the lower limbs and progresses up. Swollen ankles.Can hardly step on my sore soles. Ankle spraining easily.

Lithium Carbonicum:

A field for this treatment is chronic rheumatism linked to heart lesions and asthenopia. Nodes in the joints. Tophi and gout.
total rigidity due to paralysis. joints are itching. Generally speaking, rheumatic aches affect the shoulder, arm, fingers, and tiny
joints. Foot pain that travels to the knee. Joint pain and swelling in the fingers and toes; hot water is preferable. Joint swellings
with nodules. walking with hurting ankles4 All limbs are paralysed and rigid, as if they had been beaten; the bones, joints, and
muscles throughout the entire body are all stiff and aching5.

Pulsatilla nigricans:

Drawing, tensing pain in the thighs and legs, along with agitation, insomnia, and a chill. Pain in the limbs that is tensing and
releasing suddenly. numbness in the elbow area. Hip joint discomfort. Swelling, ripping, and pain in the knees. Dull heel
discomfort in the evening, made worse by letting the injured limb dangle down. Hands and forearms have enlarged veins. Red,
swollen, and irritated feet. Legs are heavy and exhausted. 4

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Rhus Toxicodendron:

Joint swelling that is hot and unpleasant. ripping pains in the fascia, ligaments, and tendons. The nape of the neck, the loins,
and the extremities all experience widespread rheumatic symptoms; mobility is improved. pain in the bones' condyles. Paralysed,
rigid limbs. The skin hurts from the cold, fresh air, which is intolerable. Sciatica is worst under cold, wet, and nocturnal
conditions. After overworking and exposure, numbness and formication. following exercise, trembling and paralysis. Loss of
strength in the fingers and forearm; the tips of the fingers feel like they are crawling4.

Stellaria Media:

It causes all functions to become stagnant, backed up, and slow. Morning annoyance. All around, there are severe rheumatic
aches that are sharp and changing. Rheumatism causes motion, practically constant darting pains, stiff joints, and aching body
parts. Rheumatism that persists. shifting discomforts.Psoriasis. big, swollen, and painful gouty finger joints. 4 Rheumatic pain that
shoots down the right arm and into the middle of the left index finger.Rheumatic pains: below the r kneecap, in the r hip, the left
foot, ankle, and knee, as well as in the sensitive calves.5

Guaiacum:

Primary effect on fibrous tissue, and is particularly suited to tonsillitis, rheumatism, and arthritic diseases. Subsequent
syphilis. incredibly helpful for severe rheumatism. Free odious secretions. Whole-body stench is foul. supports abscess
suppuration. Sensitivity to and irritation from the heat in the area. Legs contracting, becoming stiff, and becoming immobile. he
felt the need to stretch. shoulder, arm, and hand rheumatic discomfort. Painful growth.Puncturing Nate. both lumbago and
sciatica. contractions together with gouty tearing. absolute rigidity. Lameness is brought on by ankle pain that travels up the leg.
Swollen, uncomfortable, and unable to withstand pressure, joints also cannot tolerate heat. Muscle contractions are followed by
arthritic lancinations. A burning sensation in the affected limbs4.

RFERENCES:
[1] Ralston SH, Penman I, Strachan MWJ, Hobson R, editors. Davidson’s principles and practice of medicine. 23rd ed. London,
England: Elsevier Health Sciences; 2021.

[2] Goldman L, Schafer AI. Goldman-Cecil medicine, 2-volume set. 26th ed. Philadelphia, PA: Elsevier-Health Sciences
Division; 2019.

[3] Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison’s principles of internal medicine 19/E (vol.1
& vol.2) (ebook). 19th ed. McGraw-Hill Education/Medical; 2015.

[4.] Boericke W. Pocket manual of homeopathic materia medica &; repertory [cited 2023 June 28];Available from
:http://www.homeoint.org/books/boericmm/

[5] CLARKE JH, M.D, DICTIONARY OF PRACTICAL MATERIA MEDICA,[cited 2023 June 28];Available from:
http://www.homeoint.org/clarke/

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