Rheumatoid Arthritis: Causes, Signs, Symptoms, Diagnosis, Natural Ayurvedic Management (Amavata)

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Autoimmune diseases are illnesses that occur when the body’s tissues are mistakenly attacked by their own immune system.

Rheumatoid Arthritis Causes

The cause of rheumatoid arthritis is unknown. Even though infectious agents such as viruses, bacteria, and fungi have long been suspected, none has been proven as the cause. Certain genes have been identified though that increase the risk for rheumatoid arthritis.

Signs And Symptoms Of RA

• Fatigue
• Loss of energy
• Lack of appetite
• Low grade fever
• Muscle and joint aches
• Stiffness of joints, especially during morning hours (morning stiffness)

Also, during flares joints becomes warm, red and swollen. The small joints of both hands and wrists are usually involved.

How Is RA Diagnosed?

There is no singular test for diagnosing rheumatoid arthritis. The diagnosis is based on the clinical presentation. Ultimately, rheumatoid arthritis is diagnosed based on a combination of the presentation of the joints involved, characteristic joint swelling and stiffness in the morning, the presence of blood rheumatoid factor and citrulline antibody, as well as findings of rheumatoid nodules and radiographic changes (X-ray testing).

The American College of Rheumatology has developed a system for classifying rheumatoid arthritis that is primarily based upon the X-ray appearance of the joints. This system helps medical professionals classify the severity of your rheumatoid arthritis with respect to cartilage, ligaments, and bone.

Stage I

• No damage seen on X-rays, although there may be signs of bone thinning

Stage II

• On X-ray, evidence of bone thinning around a joint with or without slight bone damage
• Slight cartilage damage possible
• Joint mobility may be limited; no joint deformities observed
• Atrophy of adjacent muscle
• Abnormalities of soft tissue around joint are possible

Stage III

• On X-ray, evidence of cartilage and bone damage and bone thinning around the joint
• Joint deformity without permanent stiffening or fixation of the joint
• Extensive muscle atrophy
• Abnormalities of soft tissue around joint possible

Stage IV

• On X-ray, evidence of cartilage and bone damage and osteoporosis around joint
• Joint deformity with permanent fixation of the joint (referred to as ankylosis)
• Extensive muscle atrophy
• Abnormalities of soft tissue around joint possible

Rheumatologists also classify the functional status of people with rheumatoid arthritis as follows:

• Class I: completely able to perform usual activities of daily living
• Class II: able to perform usual self-care and work activities but limited in activities outside of work (such as playing sports, household chores)
• Class III: able to perform usual self-care activities but limited in work and other activities
• Class IV: limited in ability to perform usual self-care, work, and other activities

Management Of RA With Ayurveda

Modern science has no known cure for rheumatoid arthritis. The role of treatment in RA is to reduce joint inflammation and pain, maximize joint function and prevent joint destruction and deformity.

Physical therapy has no curative effect for arthritis nor does it alter the course of the disease process. The objectives of physical therapy are analgesia, maintenance of normal ranges of motion in involved joints, maintenance of normal power in muscles involved, protection of joints against additional trauma that might result in further structural deterioration / deformity.

Amavata: The Ayurvedic Correlation To Rheumatoid Arthritis

In Ayurveda, the clinical correlation of RA is Amavata. The following line of treatment is explained in the classical Ayurvedic texts for Amavata.

1. Langhana (Fasting)
2. Shodhana chikitsa (purification of the body)
3. Shamana chikitsa (treatment to reduce symptoms)

What treatments and therapies will an Ayurvedic practitioner advise? Hot fomentation can be done for the affected joints. Medicines for promoting the digestive fire, ama pachana, can be used. These include Amrithothoram kashayam, Rasna erandadi kashayam, Amritarishtam, Amritadi choornam and Amavatari rasa. Again, the medicines must be given after assessing the rogi and roga bala only.

Mridu virechana (mild purgation) can be given. Kshara vasti or Vaitarana vasti can be given. This is medicated, self-administered enema therapy. Upanaha can be done on affected joints.

RA Diet And Lifestyle Regimen

• Avoid curd, fish, milk, urad dal and jaggery
• Consume horse gram, ginger, bitter gourd and drumsticks
• Intake of garlic is advised
• Avoid day time sleep
• Evacuate bowels regularly
• Always use warm water to drink and for taking a bath
• Reduce stress by practicing yoga and meditation
• Weight should be controlled, avoid a high fat diet

Ideally, consult with a qualified Ayurvedic practitioner to get proper treatment for the management of Amavata.