Rheumatoid Arthritis is a progressive, disabling chronic multisystem disease, which is characterized by pain, welling and stiffness of the synovial joints, often worse in the morning. After periods of inactivity It exhibits symmetrical, destructive and deforming polyarthritis affecting small and large synovial joints with extra-articular manifestations, including fatigue, subcutaneous nodules, lung involvement, pericarditis, peripheral neuropathy, vasculitis and haematologic abnormalities. It is associated with systemic disturbances and presence of circulating antiglobulin antibodies.
It can be corelated with Amavata , a disease condition characterized by a constellation of symptoms, including .
- ( generalized bodyacha )
- ( tastelessness)
- ( thirst )
- ( lethargy )
- ( heaviness)
- ( fever )
- ( indigestion )
- ( Oedema )
- ( heaviness in the cardiac region )
- ( weakness )
- ( stiffness of the whole body )
Etiology
- Viruddha Ahara
- Viruddha Chesta
- Mandagni
- Nischalata
- Engaging in exertion immediately following the intake of Snigdha Ahara.
Characteristic Symptomatology
- Pain in all joints ( minor and major joints )
- Pain similar to scorpion bite
- Diminution of Agni
- Excessive Salivation
- Anorexia
- Heaviness of body
- Lack of enthusiasm
- Altered tase sensation
- Burning Sensation
- Polyuria
- Hardness of abdomen
- Colicky pain in the abdomen
- Altered sleep
- Thirst
- Vomiting
- Giddiness or dizziness
- Syncope / attacks of swooning
- Stiffness in cardiac region
- Constipation
- Dullness
Sign and Symptoms on physical examination
- Joint pain
- Early morning joint stiffness lasting for more than I have that eases with physical activity
- Joint tenderness
- Swelling of joint
- Redness of joint
- Limited range of motion
Deformities exhibited is R.A.
- Ulnar drift of the hand
- Boutonniere deformity
- Swan neck deformity
- Flexion deformity
- Hallux valgus
- Hammer toe etc.
Essential Investigation
- Rheumatoid factor (RF)
- Anti-citrullinated Peptide Antibody ( ACPA)
- C-Reactive Protein 9 CRP)
- Erythrocyte Sedimentation Rate ( ESR)
- X Ray
- MRI
- Ultrasound
Principles of Management
- Langhana
- Swedana
- Intake of tikta and Katu substances
- Virechana
- Basti
Pathyas
- Property cooked fresh and favourable food intake on approach timing in appropriate quality.
- Aged Cereals like wheat and rice, green gram, Yava Kulatha ( horse gram ) , syamaka, raktashali , Kodrava.
- Vegetable like
- Potato / Parval
- Vastuka ( Bathua )
- Shigru ( Drumstick )
- Karvela ( Bitter Gourd
- Ginger
- Garlic
- Drinking lukewarm or warm water or boiled water brought to normal temperature, water processed with Panchakola.
- Atapa Sevana ( Sun bath with mild sun rays )
- Comfortable matters for sleeping
- Warmwater bath
- Appropriate exercise and appropriate aount of rest.
Apathya ( Don’ts)
- Curd
- Fish
- Jaggery
- Milk
- Blackgram
- Rice Flour
- Virudhaahara
- Ecessive intake of dried/ preserved /frozen vegetables on foods
- Regular and excessive intake of lentils like peas, sprouts now vegetables and salads, cabbage, cauliflower celery brinjal, potatoes and tomatoes.
- Refined foods such as bakery products made of maida and vegetable oil, junk food reheated or burnt food.
- Cold drinks
- Beeverags
- Chilled food and ice cream
- Smoking
- Insufficient sleep at night
- Habitual postprandial day sleeping
- .Inadequate diet intake, irregular meal timings
- Eating untimely, frequent overeating.
- Suppression of natural urge especially of hunger, bowl and urine and emotion.