Dr Anusha G
Rheumatoid arthritis is a persistent inflammatory systemic autoimmune disorder causing symmetrical polyarthritis of small and large joints, typically presenting between the ages of 30-50 years, commonly seen in females. It affects the lining of the joints, causing painful swelling that can eventually result in bone erosion and deformity.
Rheumatoid arthritis occurs in about 5 per 1000 people and can lead to severe joint damage and disability. Early diagnosis and treatment can slow down the progression of joint damage in 90 % of the patients suffering from Rheumatoid Arthritis.
- Signs and symptoms may vary in severity, there may be period of flare up alternating with the period of remission. The diagnosis of RA is primarily Clinical.
- Typically presents with polyarticular symmetrical joint pain with stiffness, swelling mostly involving the small joints in the beginning. Some patients may present with oligoarticular asymmetric joint involvement
- The onset is usually insidious, with joint symptoms emerging over weeks-months and often accompanied by anorexia, weakness, or fatigue.
- Patients usually complains of early morning stiffness which last for more than one hour
- Commonly involved joints are the wrists , proximal interphalangeal joints metacarpophalangeal ,metacarpophalangeal , distal interphalangeal joints
- On examination – there may be tenderness, swelling and atrophy of the neighboring muscles seen
On investigation –
- Elevated markers of inflammation like ESR , C – reactive protein
- Positive RA factor.
- X ray may be done to look for the joint damage.
Conventional treatment includes NSAID and anti rheumatic drugs which has its own adverse effects on excessive consumption. Homoeopathic medicines on the other hand improve the Quality of Life in patients along with reducing pain and disability.
The treatment for Rheumatoid Arthritis may vary from case to case. It also depends upon the duration and severity of the disease. There are various factors which can trigger RA such as Genetic, Emotional and Physical, Environmental factors, so it is important for a homoeopathic physician to consider all this before we begin with the treatment. It should be given based on the law of similar. The remedies in homeopathy moderate the overactive immune system and thus help in reducing inflammation in the bones
The following homoeopathic remedies can be considered in Rheumatoid Arthritis cases;
- Belladonna – Indicated in the acute stage of arthritis. When there is sudden redness, swelling with severe throbbing pain in joints. Joints very hot to touch , looks red .Worse in cold better ,by warmth
- Bryonia – one of the common remedy prescribed in RA. Patient’s complaints of severe stitching type of pain in small joints, swollen, hot, red joints. Every spot is painful on pressure. Relieved by complete rest. least movements aggravates the patient
- Rhus tox – useful for rheumatoid arthritis when there is severe pain and stiffness which is worse in the morning , cold , first movement makes the pain unbearable , patient feels better by continuously moving around , warmth relieves the pain . Patient becomes restless with the pain .tearing type of pains in tendons, ligaments.
- Rhododendron ferrugineum – Rheumatism worse before a storm is a guiding symptom of this remedy. Rheumatic tearing pain especially on right side. Pain worse at rest.
- Ruta graveolens – Arthritis with great stiffness worse from cold and damp weather also from over use of joints
- Arnica – used in chronic arthritis when patient complaints of soreness and bruised sensation in joints. Pain worse from touch, everything on which they lie feels very hard. Rheumatism begins from lower limbs and then extend upwards .
- Ledam pal – Painful swelling of joints relieved by cold application, worse from warmth usual affected areas are ankles, feet, rheumatism which begins from feet and extend upwards.
- Calcarea carbonica – Arthritis with nodosities in the affected joints. Pain and stiffness of joints aggravated by damp weather. Patients is easily fatigued from slightest exertion along with chilliness and laziness is an indication for the remedy.
- Calcarea flourica – Indicated in swollen joint, with hard nodosities with the history of injury to joints. Pain is better by warmth and motion.
- Pulsatilla – Indicated when the pain changes its place from one joint to another and also if the pain is not localized. Symptoms tend to worse in warmth, heat . better from cold application , fresh air
- Dulcamara – Pain and stiffness in joint worse from damp weather. Rheumatic affections after acute skin affection.
- Colchicum – Arthritis worse in warm wet weather. Worse from change of climate, commonly affects the small joints of hands and fingers slightest motion aggravates the pain.
- Caulophyllum – Arthritis commonly in femles. Affecting the small joints especially the hands, fingers, toes, ankles. Pain and stiffness alternates from one joint to another.
- Guaiacum – Rheumatism of small joints especially the wrist and fingers worse from warmth better from cold application
- Kali carbonicum – Extremely stiff and painful joints in the early morning
- Causticum – Rheumatic pains better by warmth especially heat of bed, restless legs at night. patient has a unsteady gait
- Aurum metallicum – Is indicated when the patient complaints of wandering pain especially at night .tearing pains in joints at night especially indicated when there is deformity of joints .
- Kalmia latiflora – Indicated in severe acute pains in joints. Pain and inflammation begin in upper limbs and ten spreads downwards. Pain worse at night .Pain usually affects the large joint
- Formica rufa – Arthritic remedy indicated in gout and articular rheumatism right sided joints mostly affected. Pain better by pressure and worse from motion. Sudden rheumatism with restlessness. Muscle feels strained and torn from their attachments. Relieved by rubbing the part and from pressure.
- Kali iodatum – Indicated in chronic inflammation of the knee. Pains usually aggravate at night, severe bone pain with sensitiveness to touch. Rheumatism of knee with effusion. Aggravates at night, cannot remain in bed.
- Salicylic acid – Indicated in acute rheumatism, knees painful and swollen with shifting pains aggravated at night . continued treatment with moderate doses prevents new attacks in chronic arthritis
- Silicea terra – chronic inflammation of the knee joint with great swelling with icy cold feet sweat.
- Phytolacca Decandra -indicated in rheumatism where pain is worse in the morning. Shooting pain with stiffness especially in right shoulder. Pains like electric shock. Shooting and shifting suddenly pain in ankles and feet patient dreads to get up.
- Staphysagria – Drawing pain with stiffness especially at shoulder on bending neck forward . Pain better by heat. extremities feel beaten and painful
- Apis – Indicated in acute inflammatory swelling of the joints. Joint looks shiny , swollen with stinging pain
- Led pal –Indicated in ascending type of rheumatism, swollen hot pale small joints. Pain in right shoulder aggravated from motion, painful soles, easy spraining of ankles.
- Lithium Carb – Indicated in rheumatism when affected with heart affections. People with rheumatic nodes and uric acid diathesis. Rheumatism mainly affecting shoulder, finger joint with nodular swellings. Better by hot. Pain in ankle while walking
- Benzoic acid – Indicated for patients with uric acid diathesis .Rheumatic pains, painful nodosities of joints with strong smelling urine is the characteristic of this remedy.
Some of the Rubrics which can be considered for the Rheumatoid Arthritis from Murphy’s Homoeopathic Medical Repertory are
Chapter – JOINTS
Rubric – Arthritic Nodosities
Some important 3 marks remedies include – APIS, BEN ACID, CALC, CAL F, LITH CARB, GRAPH, LYCO, CAUL
Some important 2 marks remedies include – ant c, aur, bry, form, guaic, urt urens
Chapter – JOINTS
Rubric – Arthritis Joints
3 marks remedies are – ACON, APIS, BELL, BRY, KALI C, LED, RHUS T
2 marks remedies are – aur, arn, kalmia, puls, psor, Ruta, rhod etc
Chapter – JOINTS
Rheumatism in general
3 marks remedies include – ARN , ARS, AUR , BEN ACID , BRY , CAUST , CHAM , CHEL , COLCH ,KALMIA, PULS , SAL ACID ,MERC etc
2 marks remedies include – abr, acon, Apis, caul, guaic, nit acid etc
At the end would want to conclude saying Rheumatoid Arthritis is a autoimmune disorder, and in homoeopathy holistic approach is advised so that the treatment is effective when we consider the totality of symptoms and prescribe the medicine accordingly.
- Harrison Principles of Internal Medicine. 16 th ed. Mac Grow Hill Medical Publishing Division; 2005
- Miller G. Remedy relationship chart. Repertory of Homoeopathic Materia Medica. In: Kent JT, editor. 6 Th ed. New Delhi: B. Jain publisher Pvt. Ltd
- Gibson RG, Gibson SL, MacNeill AD, Buchanan WW. Homoeopathic therapy in rheumatoid arthritis: Evaluation by double-blind clinical therapeutic trial. Br J Clin Pharmacol 1980;9:453-9
- Homoeopathic materia medica by WILLIAM BOERICKE
Dr Anusha G, MD (Hom. Pharmacy) Part I
Father Muller Homoeopathic Medical College
University Road, Deralakatte ,Mangalore, Karnataka.
Email ; email@example.com