Rheumatoid Arthritis Treatment in Indore

Rheumatoid Arthritis (RA) – Elaboration

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder in which the immune system mistakenly attacks the synovium, the lining of joints. This causes inflammation, swelling, pain, and stiffness, primarily affecting small joints such as those in the hands, wrists, and feet.

Unlike osteoarthritis, which is due to wear and tear, RA is systemic and can affect other organs, including the heart, lungs, and eyes.

Aetiology & Risk Factors

1. Autoimmune Dysfunction

The immune system produces antibodies that attack joint tissues, causing chronic inflammation and joint damage.

2. Genetic Susceptibility

Certain genes, like HLA-DR4, confer susceptibility.

Family history of autoimmune diseases is a risk factor.

3. Environmental Triggers

Infections, smoking, and stress can precipitate or exacerbate RA.

4. Hormonal Factors

RA is more common in women, especially between the ages of 30–60.

How RA Affects the Body

Autoimmune attack → inflammation of the synovial membrane: synovitis

Chronic inflammation → thickening of the synovium → joint pain with swelling

Inflammatory mediators → erosion of cartilage and bone

Reduced joint function → deformities and loss of mobility

Systemic inflammation may affect the heart, lungs, and blood vessels.

Symptoms

Joint Symptoms

Pain, swelling, and tenderness of the joints

Morning stiffness lasting >1 hour

Warmth and redness around affected joints

Symmetrical involvement (both sides of the body)

Limited range of motion

Systemic Symptoms

Fatigue and general malaise

Low-grade fever in episodes

Weight reduction

Muscle weakness

Advanced Symptoms

Joint deformities: swan-neck, boutonniere deformities

Nodules beneath the skin around joints

Osteoporosis in affected bones

Complications

Joint deformity and disability

Cardiovascular disease- increased risk of heart attack.

Lung involvement: interstitial lung disease

Inflammation of the eye (scleritis, uveitis)

Anaemia, the risk from medications leading to infection susceptibility

Diagnosis

1. Clinical Examination

Swelling, tenderness, warmth, and symmetry of joints

2. Blood Tests

Rheumatoid factor (RF)

Anti-cyclic citrullinated peptide (anti-CCP) antibodies

ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) - inflammatory markers

3. Imaging

X-rays to evaluate erosion of the joints

Ultrasound or MRI to assess early synovial inflammation

4. Other Tests

Arthrocentesis to rule out infection or other etiologies of arthritis

Medical Treatment CONVENTIONAL

1. Non-steroidal anti-inflammatory drugs (NSAIDs)

Reduce pain, swelling, and inflammation

2. Corticosteroids

Short-term use in flare-ups

Reduce inflammation quickly

3. Disease-Modifying Anti-Rheumatic Drugs

Methotrexate, sulfasalazine, and hydroxychloroquine

Slow the disease process, preventing joint destruction

4. Biologic Therapies

TNF inhibitors include Etanercept and Adalimumab.

IL-6 inhibitors, resistant cases on JAK inhibitors

Target specific immune pathways

5. Surgery

Joint replacement or repair in badly damaged joints

Lifestyle & Supportive Care

1. Physical Therapy

Improves the flexibility of joints and muscle strength

Prevents deformities

2. Occupational Therapy

Helps maintain daily function and adapt to joint limitations.

3. Exercise

Low-impact exercises such as swimming, walking, and yoga

Reduces stiffness and maintains mobility

4. Diet

An anti-inflammatory diet rich in omega-3 fatty acids, fruits, and vegetables

Avoid having excess processed foods and sugars.

5. Stress Management

Meditation, mindfulness, and yoga reduce inflammation and improve coping

6. Integrative Approaches

Homoeopathy, Ayurveda, and herbal therapies may support symptom relief, fatigue, and joint health as complementary care, not as a replacement for conventional treatment. Prognosis: RA is chronic and yet manageable. Early diagnosis and treatment prevent joint damage and improve quality of life. Most patients can maintain daily activities with medication, physical therapy, and lifestyle management. Regular monitoring is highly essential for avoiding systemic complications.