Rheumatoid arthritis (RA) is a progressive systemic autoimmune disease characterized by inflammation of the joints and surrounding tissues.The most common presentation of RA is a symmetrical inflammatory polyarthritis, particularly of the hands and feet, although any synovial joint is at risk.

Risk Factors 

Idiopathic

Positive family history

Inherited tissue t6ype major histocompatibility complex (MHC)antigen

Smoking 

Bacterial and fungal infection 

Herpes simplex virus infections 

Epstein-Barr virus (EBV)

Vitamin D deficiency 

Signs and Symptoms  of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is characterised by various signs and symptoms that affect the joints and, in some cases, other body parts. It’s important to note that the severity and pattern of symptoms can vary among individuals. Here are common signs and symptoms associated with rheumatoid arthritis:

1. Joint Pain and Swelling: Persistent joint pain, often affecting smaller joints first (e.g., wrists, fingers).Swelling and tenderness around the affected joints.
2. Morning Stiffness:Prolonged morning stiffness that lasts for at least 30 minutes or longer, making it difficult to move joints upon waking.
3. Symmetrical Joint Involvement:Joint symptoms typically occur in a symmetrical pattern, affecting the same joints on both sides of the body (e.g., both wrists both knees).
4. Fatigue: Generalised fatigue and overall weakness or malaise.
5. Systemic Symptoms:Fever and a general sense of not feeling well, especially during increased disease activity.
6. Decreased Range of Motion:Gradual loss of joint function and a reduced range of motion due to inflammation and joint damage.
7. Joint Deformities:Over time, joint deformities may develop, leading to changes in the shape and alignment of affected joints.
8. Rheumatoid Nodules:Small, firm lumps under the skin near joints often seen in more advanced cases of RA.
9. Joint Warmth:Warmth and redness around affected joints due to increased blood flow and inflammation.
10. Flare-ups and Remissions:Periods of increased disease activity (flare-ups) may alternate with periods of reduced symptoms (remissions).

 Diagnostic tests, including blood tests and imaging studies, may be used to confirm the presence of RA and assess its severity.

What Causes  Rheumatoid Arthritis According To  Ayurveda?

Rheumatoid Arthritis (RA), according to modern medicine, and Aamavata, according to Ayurveda, has an etiological and clinical relationship. The main pathogenic event in RA or Aamavata is the formation and deposition of Aama (explained later) at all levels of body physiology, including gastrointestinal and macro and microchannels of the inner transport system of the body.

1. Tridoshik disequilibrium: There is a parallel between modern medicine and Ayurveda. According to modern medicine, a person with a particular genotype is more likely to develop RA. According to Ayurveda each person is born with a unique “Prakriti” or body-mind type. This is based upon unique combination of three bio-principles called Doshas viz. Vata, Pitta, and Kapha. People with predominant Vata or Kapha Prakriti and/or their disequilibrium are more likely to suffer from Aamavata/RA. Vata and Kapha Prakriti person is more likely to have decreased digestive-metabolic fire or Agni in the body (explanation of Agni is described later), resulting in impaired digestion and absorption of food. This leads to formation of an immunogenic and toxic substance called Aama, which is the causative factor for inflammation. Pitta Prakriti individuals have stronger Agni, but in some of them Agni may be very high and erratic or Vishama and therefore is not able to digest food well. Restoration of Agni and correction of imbalanced state is an important component of treatment strategy in Ayurveda.
2. Decreased Agni or metabolic fire: Agni corresponds to enzymes, chemicals, hormones, neurotransmitters and cytokines known to modern science. There are 13 Agnis responsible for the entire process of digestion of food and all aspects of metabolism, including elemental/molecular metabolism.Jatharaagni works at the gastrointestinal tract for digestion and assimilation of food. It is the strongest of all Agnis and is most important in the pathogenesis of RA/Aamavata.When these Agnis are depleted due to continued lifestyle errors and faulty eating, the body begins producing a range of unwanted and unfinished byproducts. These abnormal byproducts tend to accumulate in the body. Such digestive and metabolic products are called Aama, which is believed to block the micro channels or Strotas of the inner transport system of the body in varying degrees. Because Aama is a toxic, biologically unwanted and antigenic product, the body tends to react to it and reject it. Such a blockade effect and antigenic reactive process may give rise to a variety of diseases. RA is one of those diseases.
3. Alteration of bacterial flora of the gut or dysbiosis:Intestinal mucosa is able to selectively absorb the digested food and prevent the absorption of undigested, partially digested food or toxic substances in the body. Intestinal mucosal permeability and peristalsis is impaired in Aamavata.

Inflammation is a common denominator in Aamavata or RA, various autoimmune diseases, heart disease, obesity, diabetes, Alzheimer disease, and cancer, etc. Alteration of bacterial flora of the gut occurs because of lack of Agni and indiscriminate use of antibiotics. Impaired permeability and motility of the gut results in absorption of not fully digested and partially detoxified food. It starts the chain reaction described earlier to cause inflammation.

Predisposing and contributing factors

• Heavy and large meals in relation to digestive fire or Agni.
• Strenuous exercise or physical activity after a heavy meal.
• Consumption of food with allergens, e.g., animal products, nuts, wheat products, and seafood.
• Imbalanced physical activity based upon the body type, trauma on the one hand and sedentary life-style on the other.
• Inflammatory bowel disease.
• Stress, emotional disturbances, suppression of natural urges, and lack of sleep.

Why choose Ayurveda for Rheumatoid Arthritis?

In Ayurveda, the progression of a disease is often described in terms of the “Six Stages of Disease” (Shat Kriyakala). These stages provide a framework to understand how imbalances in the doshas (Vata, Pitta, and Kapha) manifest and evolve. In the first four stages, accumulation, aggravation, dissemination and localisation of Doshas occur. There are no clinical manifestations and symptoms are vague. Characteristic symptoms appear during the fifth and sixth stages of manifestation and disruption of the disease. Identifying Vikrti, or disequilibrium of Doshas in the body, can reestablish equilibrium and prevent disease manifestations in the first four stages of the disease. When symptoms appear in the last two stages, manifestation and disruption, the offence and defence strategies will be employed appropriately.

Rheumatoid arthritis treatment can be mainly done through : 

• Balancing the Doshas.
• Increasing the digestive and metabolic fires, or Agni.
• Stopping the formation of Aama at different levels.
• Increasing digestion and excretion of Aama.
• Restoring the damaged intestinal mucosa and absorption.

Recommended Yoga Poses for Rheumatoid Arthritis

Arthritis is a common condition that  cause pain, stiffness, and inflammation in the joints. Along with internal medication , incorporating yoga into your routine can provide additional benefits. Gentle yoga poses can help improve flexibility, reduce joint pain, and enhance overall well-being.

Tadasana (Mountain Pose):

This pose helps improve posture balance and strengthens the legs without putting excessive strain on the joints.

Child’s Pose (Balasana):

Child’s Pose promotes relaxation and gently stretches the hips, thighs, and lower back.

Cat-Cow Stretch (Marjaryasana-Bitilasana):

This fluid motion helps to warm up the spine, improve flexibility, and reduce stiffness.

Downward-Facing Dog (Adho Mukha Svanasana):

Downward Dog stretches the entire body, including the shoulders, hamstrings, and calves, while also promoting joint mobility.

Seated Forward Bend (Paschimottanasana):

This pose stretches the spine, hamstrings, and lower back, providing relief to stiff joints.

Bridge Pose (Setu Bandhasana):

Bridge Pose strengthens the core, hips, and thighs, supporting the lower back and alleviating discomfort.

Supine Hand-To-Big-Toe Pose (Supta Padangusthasana):

This pose enhances flexibility in the hips, thighs, and hamstrings.

Ayurvedic Rheumatoid Arthritis Treatment

Amavata, a term in Ayurveda, refers to a condition where the vitiation of doshas, mainly Vata and Ama, leads to inflammatory joint disorders, resembling rheumatoid arthritis in modern medical terms. The Ayurvedic approach to treating Amavata involves a combination of Shamana Chikitsa (conservative treatment) and Shodhana Chikitsa (biological purification).

Shamana Chikitsa (Conservative Treatment):

1. Langhana (Depletion or Fasting):

Purpose: To reduce excess body tissues and stimulate the elimination of accumulated ama.

Method: Controlled fasting or dietary restrictions to improve digestion and metabolism.

2. Deepana (Digestive Fire Enhancement):

Purpose: To kindle and strengthen the digestive fire (agni).

Method: Use of herbs and formulations that stimulate digestive enzymes, improving digestion and preventing further ama formation.

3. Pachana (Digestive Therapy):

Purpose: To enhance the digestion of food and promote the digestion of undigested material (ama).

Method: Utilization of herbs and therapies to improve digestive capacity.

Shodhana Chikitsa (Biological Purification):

1. Snehapana (Oleation Therapy):

Purpose: Lubrication of internal tissues, facilitating the movement of doshas and ama towards the digestive tract for elimination.

Method: Consumption of medicated oils or ghee in increasing quantities over a specific duration.

2. Swedana (Fomentation or Sweating Therapy):

Purpose: To open the body’s channels, liquefy ama, and facilitate its elimination through sweating.

Method: Steam treatments, hot baths, or warm compresses to induce sweating.

3. Virechana (Purgation Therapy):

Purpose: Cleansing the digestive tract, expelling doshas and ama.

Method: Administration of natural laxatives or purgatives to induce controlled bowel movements.

4. Basti (Enema Therapy):

Purpose: A comprehensive purification method to eliminate doshas and toxins from the colon.

Method: Introduction of medicated substances (oil, herbal decoctions) into the rectum to induce bowel evacuation.

Integration of Shamana and Shodhana:

In treating Amavata, the selection of Shamana or Shodhana therapies depends on factors such as the stage of the condition (acute or chronic), the dominance of doshas, and the overall constitution of the individual. Shamana therapies aim to alleviate and balance doshas, whereas Shodhana therapies focus on eliminating accumulated toxins and restoring equilibrium.

Rheumatoid Arthritis  Ayurvedic Treatment: Prevention

Preventing rheumatoid arthritis (RA) involves a combination of lifestyle choices, early detection, and managing risk factors.Here are some preventive measures:

Regular Exercise:

Engage in regular physical activity to maintain joint health and flexibility.

Exercise helps strengthen the muscles around the joints, reducing stress on the joints themselves.

Maintain a Healthy Weight:

Maintain a healthy body weight to reduce the load on joints, especially in weight-bearing areas.Obesity is a known risk factor for rheumatoid arthritis, so achieving and maintaining a healthy weight is crucial.

Balanced Diet:

Consume a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins.Consider including foods with anti-inflammatory properties, such as fatty fish (omega-3 fatty acids), nuts, seeds, and colorful vegetables.

Omega-3 Fatty Acids:

Incorporate foods rich in omega-3 fatty acids, such as salmon, flaxseeds, chia seeds, and walnuts, which have anti-inflammatory properties.

Quit Smoking:

Smoking is a significant risk factor for developing rheumatoid arthritis. Quitting smoking can reduce this risk.

Smoking also negatively affects the effectiveness of RA treatments.

Limit Alcohol Consumption:

Excessive alcohol intake may increase the risk of developing RA. If you consume alcohol, do so in moderation.

Regular Health Check-ups:

Early detection and intervention can significantly impact the progression of RA. Regular health check-ups and prompt consultation with a healthcare professional for joint symptoms are essential.

Manage Stress:

Chronic stress may contribute to the development of autoimmune conditions. Incorporate stress management techniques such as yoga, meditation, or relaxation exercises into your routine.

Diet and Lifestyle Changes for Rheumatoid Arthritis Ayurvedic Treatment

 Ayurveda recommends a diet that balances vata for rheumatoid arthritis. These are some of the foods that can be included or avoided in your diet for Rheumatoid Arthritis Management  

Foods to include : 

Grains that are easy to digest, like cooked oats, rice, and cream of wheat

legumes, such as lentils, dal, mung beans, miso, and tofu

lukewarm water, or water boiled with ginger root, to help with digestion and remove toxins

Include more Green, leafy vegetables, berries

Spices including ginger, turmeric, and garlic, which are anti-inflammatory and aid with digestion.

 foods to avoid : 

Avoid Heating spices, like chili powder and cayenne pepper

AvoidHard-to-digest fruits and vegetables, like raw radishes, turnips, onions, apples, broccoli, and Brussels sprouts

AvoidSour and fermented foods, like hard cheeses, sour cream, green grapes, pineapple, grapefruit, and alcohol

Avoid Salt in your diet 

Rheumatoid Arthritis Ayurvedic Treatment at Dheemahi Ayurveda

Dheemahi Ayurveda is dedicated to providing authentic and effective Ayurvedic treatments while considering the unique needs of each patient.By combining the knowledge of the past five generations with contemporary healthcare practices, Dheemahi Ayurveda offers a comprehensive and personalised approach to patient care. With daily consultations follow-up check-up,  we provide more reliability as by doing physical examinations, doctors can get more findings about the condition of the patient.The documentation of treatment schedules further ensures transparency and accountability in the healthcare process