Dr. Anjana kumari,Dr.Pardeep kumar,Dr. Hemlata baswal,Pushpandra Maharshi.
PG Scholar Department of Organon of Medicine, Dr. MPK Homoeopathic Medical College Hospital & Research Centre (Under Homoeopathy University), Saipura, Sanganer, Jaipur, Rajasthan, India.
Abstract -Rheumatoid Arthritis (RA) is a chronic inflammatory disease characterised by progressive, symmetric joint inflammation and subsequent deformity. The disease affect females four times more frequently than males Rheumatoid arthritis is a persistent inflammatory systemic autoimmune disorder causing symmetrical polyarthritis of small and large joints,. It affects the lining of the joints, causing painful swelling that can eventually result in bone erosion and deformity.. Rheumatoid arthritis most commonly affects the joints of the hands, feet, wrists, elbows, knees and ankles. The joint effect is usually symmetrical. That means if one knee or hand if affected, usually the other one is, too. Because RA also can affect body systems, such as the cardiovascular or respiratory systems, it is called a systemic disease. Systemic means “entire body.homeopathy is effective in reducing the symptoms of joint inflammation in rheumatoid arthritis (RA).
Keywords– rheumatoid arthritis ,various repertorys, Homeopathy Remedy.
Introduction –Arthritis is derived from the Greek term “disease of the joints.” It is defined as an acute or chronic joint inflammation that often co-exists with pain and structural damage. Arthritis affected both the Neanderthals and ancient Egyptians, but It was not until 1886 that Dr. John K. Spencer coined the term “osteoarthritis.”
Arthritis describes a set of symptoms that includes pain, stiffness, and joint deformities subsequent to an inflammatory process. The destructive process can occur through multiple pathways. These include:
- Degenerative disease (osteoarthritis)
- Auto-immune or auto-inflammatory processes (rheumatoid arthritis and ankylosing spondylitis)
- Crystal deposition (gout and pseudogout)
- Infection (septic arthritis)
- Idiopathic (juvenile idiopathic arthritis).
A chronic multi system disease of unknown etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric fashion. Although cartilaginous destruction, bony erosions, and joint deformity are hallmarks, the course of RA can be quite variable. An association with HLA-DR4 has been noted; both genetic and environmental factors may play a role in initiating disease. The propagation of RA is an immunologically mediated event in which joint injury occurs from synovial hyperplasia; lymphocytic infiltration of synovium; and local production of cytokines and chemokines by activated lymphocytes, macrophages, and fibroblasts. There are several different types of RA. Knowing which type you have may help your healthcare provider provide the best type of treatment for you.
Prevalence – In Germany, about 1% of all adults have rheumatoid arthritis. It affects women twice as often, and usually develops in people over the age of 50. But women in particular may get rheumatoid arthritis at a younger age. Sometimes even children and teenagers are affected.
Symptoms – The typical presentation is with pain, joint swelling and stiffness affecting the small joints of the hands, feet and wrists. Large joint involvement, systemic symptoms and extra-articular features may also occur. Sometimes RA has a very acute onset, with florid morning stiffness, polyarthritis and pitting oedema. This occurs more commonly in old age. Other patients may present with proximal muscle stiffness mimicking polymyalgia rheumatica . Occasionally, the onset is palindromic, with relapsing and remitting episodes of pain, stiffness and swelling which last only for a few hours or days.
The first sign of RA is swelling of particular joints, develop pain and stiffness, especially in the finger joints. Other symptoms of RA develop after a time, like muscle weakness. But RA can also be caused other general symptoms in some peoples, like exhaustion or loss of appetite, or sometimes even a mild fever.
The typical symptoms of RA is following:
- Warm, swollen joints: .
- Painful joints
- Stiffness of joints
- Rheumatoid nodules
Extra-articular manifestations of rheumatoid disease
Fever , Fatigue,Weight loss ,Susceptibility to infection.
Muscle-wasting , Bursitis,Tenosynovitis • Osteoporosis
Episcleritis • Scleromalacia
Scleritis • Keratoconjunctivitis sicca
• Digital arteritis • Mononeuritis multiplex
• Ulcers • Visceral arteritis
• Pyoderma gangrenosum
Pericarditis • Conduction defects
• Myocarditis • Coronary vasculitis
• Endocarditis • Granulomatous aortitis
Nodules • Bronchiolitis
• Pleural effusions • Caplan’s syndrome
• Fibrosing alveolitis
Cervical cord compression • Peripheral neuropathy
• Compression neuropathies • Mononeuritis multiplex
Characteristics that increase risk
- Age. are aged 60 years or above
- Sex. higher in women than men.
- Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA (human leukocyte antigen) class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
- Smoking. Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can make the disease worse.
- History of live births. Women who have never given birth may be at greater risk of developing RA.
- Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood.
- Chronic Lyme disease
- Septic arthritis
- Psoriatic arthritis
- Sjogren syndrome
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.
- Chronic anemia
- Gastrointestinal cancers
- Pleural effusions
- Heart disease
- Sicca syndrome
- Felty syndrome
Repertorial Totality related to RA with important medicine in various repertorys
- EXTEREMITIES-PAIN-Joints- Arg, Arn , Bry , Calc-p, Led , Nux-v , Plb, Puls, Rhus-t
- EXTEREMITIES-PAIN, Joints ,morning- Nux-v
- EXTEREMITIES-PAIN, Joints,bed,in – Aur, Nux-v, Puls
- EXTEREMITIES-PAIN, Joints,night-Iod, Merc
- EXTEREMITIES-PAIN, Joints,cold after exposure,to- Calc-p, Dulc,Rhus-t
- EXTEREMITIES-PAIN, Joints, motion Bry, colch,Led
- EXTEREMITIES-PAIN, Joints, motion, amel- Aur, Rhus-t
- EXTEREMITIES-PAIN, Joints,Warmth agg- Led,Puls
- EXTEREMITIES- STIFFNESS,Joints, -Ars, Caust,Led, Lyc,Rhus-t, Sep, Sil,Sulph
- EXTEREMITIES-STIFFNESS,Joints,morning- kali bi , led
- EXTEREMITIES- SWELING,Joints- Act-s,Bell, Bry, Colch,Hep,Led,Sulph
- UPPER EXTREMITIES – Pain,simple,joints- Am-c
- LOWER EXTREMITIES – Pain,simple,joints- Pho,Sul
- JOINT , Affection in – COLCH,MERC
- Clinical-RHEUMATISM general,small joints,especially in hands- act-sp
- Joints –ARTHRITIS – ACON,BELL, BRY,KALI-C,LED,RHUS-T
- Joints-RHEUMATISM,chronic- CAUST,LYC
- JOINTS-STIFFNESS,morning- RHUS-T
Homoeopathic remedies can be considered in Rheumatoid Arthritis
ACONITUM NAPELLUS- Numbness and tingling sensation shooting pains, icy coldness and insensibility of hands and feet. Arms feel lame, bruised, heavy, numb. Pain down left arm . Hot hands and cold feet. Rheumatic inflammation of joints; worse at night; red shining swelling, very sensitive. Hip-joint and thigh feel lame, especially after lying down. Knees unsteady; disposition of foot to turn . Weak and lax ligaments of all joints. Painless cracking of all joints. Bright red hypothenar eminences on both hands. Sensation as if drops of water trickled down the thigh
ARNICA MONTANA- Gout. Great fear of being touched or approached. Pain in back and limbs, as if bruised or beaten. Sprained and dislocated feeling. Soreness after overexertion. Everything on which he lies seems too hard. Deathly coldness of forearm. Cannot walk erect, on account of bruised pain in pelvic region.Rheumatism begins low down and works up .
BELLADONNA-Shooting pains along limbs. Joints swollen, red, shining, with red streaks radiating. Tottering gait. Shifting rheumatic pains. Phlegmasia alba dolens. Jerking limbs. Spasms. Involuntary limping. Cold extremities. Sciatic pain aggravated on inspiration.
BRYONIA ALBA- Knees stiff and painful. Hot swelling of feet. Joints red, swollen, hot, with stitches and tearing; worse on least movement. Every spot is painful on pressure. Constant motion of left arm and leg .
CALCAREA PHOSPHORICA-Stiffness and pain, with cold, numb feeling, worse any change of weather. Crawling and coldness. Buttocks, back and limbs asleep. Pains in joints and bones. Weary when going upstairs.
LEDUM PALUSTRE-Gouty pains shoot all through the foot and limb, and in joints, but especially small joints. Swollen, hot, pale. Throbbing in right shoulder. Pressure in shoulder, worse motion. Cracking in joints; worse, warmth of bed. Gouty nodosities. Ball of great to swollen . Rheumatism begins in lower limbs and ascends . Ankles swollen. Soles painful, can hardly step on them . Easyspraining of ankle.
PULSATILLA PRATENSIS-Drawing, tensive pain in thighs and legs, with restlessness, sleeplessness and chilliness. Pain in limbs, shifting rapidly; tensive pain, letting up with a snap. Numbness around elbow. Hip-joint painful. Knees swollen, with tearing, drawing pains. Boring pain in heels toward evening; suffering worse from letting the affected limb hang down . Veins in forearms and hands swollen. Feet red, inflamed, swollen. Legs feel heavy and weary.
RHUS TOXICODENDRON-Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fascić. Rheumatic pains spread over a large surface at nape of neck, loins, and extremities; better motion . Soreness of condyles of bones. Limbs stiff paralyzed. The cold fresh air is not tolerated; it makes the skin painful. Pain along ulnar nerve. Tearing down thighs. Sciatica; worse, cold, damp weather, at night. Numbness and formication, after overwork and exposure. Paralysis; trembling after exertion. Tenderness about knee-joint. Loss of power in forearm and fingers; crawling sensation in the tips of fingers. Tingling in feet.
RHODODENDRON FERRUGINEUM- Joints swollen. Gouty inflammation of great toe-joint. Rheumatic tearing in all limbs, especially right side; worse, at rest and in stormy weather.Stiffness of neck. Pain in shoulders, arms, wrists; worse when at rest. Pains in bones in spots, and reappear by change of weather. Cannot sleep unless legs are crossed.
RUTA GRAVEOLENS-Spine and limbs feel bruised. Small of back and loins pain. Legs give out on rising from a chair, hips and thighs so weak . Contraction of fingers. Pain and stiffness in wrists and hands. Ganglia . Sciatica; worse, lying down at night; pain from back down hips and thighs. Hamstrings feel shortened . Tendons sore. Aching pain in tendo-Achilles. Thighs pain when stretching the limbs. Pain in bones of feet and ankles. Great restlessness.
- Ma L, Cranney A, Holroyd-Leduc JM. Acute monoarthritis: what is the cause of my patient’s painful swollen joint? CMAJ. 2009 Jan 06;180(1):59-65.
- Senthelal S. Li J. A. M. Thomas. Arthritis. 2019;. December 17.
- Ralston S, Penman I, Britton R, Strachan M, Hobson R, Davidson S. Davidson’s principles and practice of medicine
- Rheumatoid Arthritis: Overview. Rheumatology. 2016;.
- Psychological Interventions for Rheumatoid Arthritis: An Overview of Systematic Reviews. Rheumatology. 2016;. 148
- .Krati Chauhan; Jagmohan S. Jandu; Mohammed A. Al-Dhahir. Rheumatoid Arthritis 2019 October 25
- 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
- Bogar CM, Bogar Boeninghausen ‘s Characteristics and Repertory. B Jain Publisher (P) Ltd, New Delhi 2018.
- Phatak S.R. A concise repertory of homoeopathic medicine . B Jain Publisher (P) Ltd, New Delhi 1994.
- Murphy R. Homoeopathic Medical Repertory .2nd ed New Delhi : B. Jain Publishers (P) Ltd;2002.
- Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. 9th Edition. New Delhi: B. Jain Publishers (P) Ltd; 2009.
- Clarke, J.H. A Dictionary of Practical Materia Medica. New Delhi: B. Jain Publishers; 1999.
- Nash EB. Leaders in Homoeopathic Therapeutics with Grouping and Classification. Low price edition. New Delhi: B.Jain Publishers (P); 2014