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Arthritis: Rheumatoid Arthritis

Posted Feb 02 2012 4:40pm

So, from my previous post, as I mentioned, there are different forms of arthritis, which we will focus on Rheumatoid Arthritis (RA). Lets look at the Latin breakdown of the word first to fully understand what the term means Rheum: To suffer from
Arthron: joint
-Itis: inflammation

Well, this definition is not far from the truth. If you know anyone who suffers from chronic, or bouts of, RA, they are truly suffering. Its hard for them to walk, to grasp objects, to find comfortable positions, to stop the throbbing pain, etc. Unlike my last post, about osteoarthritis, RA’s pathology does primarily involve inflammation that affects the joints, and may work on other areas including, but not limited to, muscles, blood vessels, lungs, etc. [Compared to osteoarthritis, which primarily is from wear and tear, and secondarily brings in inflammatory cells to that area; major distinction in the pathology!]

The main problem with RA is that the etiology (principal cause) is unknown to the medical community. Many doctors, pathologists, and immunologists believe it to be an autoimmune disease, where immune fighting cells (white blood cells – T cells, neutrophils, macrophages, complement proteins) are attacking antigens (specific markers – largely unknown) in the joints. This attack on self (auto-immune), is what causes destruction, inflammation, pain, and serious problems for the individual.

The major indications of inflammation: Swelling (tumor), Redness (rubor), Heat (calor), and Pain (dolor) are all present in the affected joint(s) of an RA patient. The symptoms can have partial or complete remission, but can return at any time. Limited movement, deformities, ligament and joint capsule destruction ensue. As with the picture at the top of the post, the joints can become severely malformed, and function is greatly reduced.

Clinical Picture > Fatigue
> Low-grade fever
> Joint pain, stiffness, and swelling (usually bilateral, meaning on both sides)
> Could have deformities in joints
> Pain on passive movements
(Typically begins in the hands, then may progress to the wrists, ankles, knees, and even affect the cervical spine)
Some other systemic manifestations of RA include > Vasculitis
> Muscle atrophy
> Pericarditis
> Lymphadenopathy
> Splenomegaly
> Anemia

There is a specific set of diagnostic criteria that is required to be met in order to diagnose rheumatoid arthritis, clinically. You can check out University of Maryland’s description here if you are interested in a more in depth perspective.

Predisposing conditions that would lead someone to develop RA > Autoimmune conditions
> Food allergies (which increase permeability of the gut, causing proteins and other molecules to leak out of the gut, stimulating the immune response)
> Genetic susceptibility / Family hereditary

What are some therapies that can be done for RA patients?
> Homeopathic
> Cold to Warm compresses on the affected joint
> Cold laser treatment
> TENS
> Omega 3 fatty acids
> Folate
> Vitamin K, E, C
> Dietary modifications
> Curcuma longa (Tumeric) – eaten or applied topically is a great anti-inflammatory. Caution: tumeric applied to the skin may cause temporary yellowing.
> Harpagophytum procumbens (Devil’s Claw) – will reduce inflammation, help to clear the liver and gall bladder {Extreme caution if pregnant}
> Menyanthes trifoliatum (Bogbean) – from a Chinese medical perspective will clear the damp heat from the joints and increase circulation to the area to take away toxins {Extreme caution if pregnant}

Always be cautious with herbs – do not self prescribe. Please speak with your ND or PCP if you are thinking of taking an herb for the correct dosage. This is not, in anyway, intended to replace a treatment plan from your primary care physician. Please consult with your doctor to ensure the best treatment strategy for your condition.

References Kumar, Vinay, Abul Abbas, and Nelson Fausto. Robbins and Cotran: Pathologic Basis of Disease. 7th . Philadelphia, PA: Elsevier Saunders, 2005. Print.
Rheumatoid Arthritis, NIH site
Rheumatoid Arthritis, Diagnosis (University of Maryland)

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