How To Manage Rheumatoid Arthritis Symptoms Effectively?

ABSTRACT

Bone and joint health is necessary for the well-being of the bones and joints in your body. Bones provide structure and support, while joints allow movement. Keeping them healthy is important for staying active and pain-free as you age. This involves staying active, eating nutritious foods, and protecting our body from injuries to maintain strong bones and flexible joints. If bone and joint health are not properly maintained, it can lead to various problems, including Arthritis. Arthritis is a condition that involves inflammation of the joints, leading to pain, stiffness, and reduced movement. Over time, if joints are not cared for, they can undergo changes that result in arthritis. With age, the risk of arthritis also increases and if there are underlying comorbidities like diabetes mellitus, the risk gets higher. In today’s article, we will talk about herbal remedies of rheumatoid arthritis in detail.

INTRODUCTION

Rheumatoid Arthritis is a symmetrical arthritis which is chronic, inflammatory and an auto-immune condition affecting various joints in the body. Normally our immune system helps us in protecting our body from disease and infection. But when our immune system mistakenly attacks our own body’s cells and tissues, auto-immune conditions like Rheumatoid Arthritis develop. It begins with discomfort and swelling in your joints. The swelling will be painful and will eventually lead to bone erosion and joint deformity. Initially RA will affect smaller joints in the body, especially interphalangeal joints and as the disease progresses, it will spread to wrists, elbow, and shoulders or from ankles, knees to hips. There are periods of remission and periods of flare which are very painful. Mostly if your one joint is involved then the same one in the other limb will also be involved. Sometimes inflammation in Rheumatoid Arthritis can damage other organs as well. Rheumatoid Arthritis can involve not only your joints but also can damage skin, eyes, kidneys, bone marrow, blood vessels, heart, lungs etc. in later stages. Around 40% of patients of rheumatoid arthritis will develop systems which don’t involve joints.

CAUSES

Rheumatoid arthritis (RA) is an autoimmune disease where the immune system mistakenly attacks the body’s own joints, causing inflammation. While the exact cause is not completely understood, several factors are believed to contribute to the development of RA

1. Genetic Factors: Some people may inherit genes that make them more susceptible to RA. Certain genes, especially those related to the immune system (like the HLA-DR4 gene), have been linked to an increased risk.
2. Immune System Dysfunction: RA is an autoimmune disorder, meaning the body’s immune system attacks its own healthy tissues. In the case of RA, it targets the synovial (lining of the joints), causing inflammation.
3. Sex: RA is more common in women than in men, suggesting that hormones may play a role. The disease often develops in women during their childbearing years, which indicates that estrogen may be a contributing factor.
4. Environmental Triggers: Exposure to certain environmental factors, such as infections, smoking, or air pollution, socio-economic status, may trigger RA in individuals who are genetically predisposed.
5. Infections: Some viral or bacterial infections might trigger RA in people who are already genetically predisposed.
6. Age: RA can develop at any age, but it is more commonly diagnosed in people between the ages of 30 and 60.
7. Obesity: Being overweight or obese may increase the risk of developing RA and can worsen the disease’s progression once it develops. BMI of >30 keeps you at a greater risk of RA.

SYMPTOMS

The symptoms of rheumatoid arthritis (RA) include

• Joint pain:  Common in small joints (hands, wrists, feet).
• Morning stiffness: Joints feel stiff, especially after rest or sleep.
• Swelling: Joints become swollen and puffy.
• Fever: Low-grade fever during flare-ups.
• Redness and warmth: Inflamed joints may appear red and feel warm.
• Decreased range of motion: Difficulty moving affected joints.
• Fatigue: Feeling extremely tired or low in energy.
• Rheumatoid nodules : Firm lumps under the skin, often near elbow
• Symmetrical joint involvement: Often affects joints on both sides of the body.

SIGNS

In rheumatoid arthritis (RA), signs and deformities can develop as the disease progresses. These deformities are a result of prolonged inflammation and damage to the joints and surrounding tissues. These include

• Ulnar Deviation: The fingers may bend toward the pinky side of the hand.
• Boutonnière Deformity: The middle joint of a finger becomes bent, and the tip of the finger extends.
• Swan Neck Deformity: The middle joint of the finger bends backward, while the tip bends downward.
• Hammer Toe: Toes become bent in a claw-like position.
• Joint Instability: The ligaments and tendons around affected joints weaken, leading to joint instability.
• Subcutaneous Nodules: Firm lumps under the skin, typically near elbows, but also on other joints.
• Carpal Tunnel Syndrome: Nerve compression in the wrist, causing numbness, tingling, or weakness in the hand.
• Joint Deformity: In severe cases, joints may lose their normal shape and function, making it difficult to move them.

DIAGNOSIS

PHYSICAL EXAMINATION

According to the American Rheumatism Association, there is a 7-point diagnostic criteria for Rheumatoid Arthritis (RA) diagnosis. If 4 or >4 are present, it is considered a confirmatory diagnosis of RA. These include

1. Morning stiffness lasting at least 1 hour
2. Arthritis in three or more joint areas
3. Hand joint involvement (wrist, MCPs, PIPs)
4. Symmetric arthritis
5. Presence of rheumatoid nodules
6. Positive rheumatoid factor
7. Radiographic changes like erosions & periarticular osteopenia in the hands, wrists, etc.

BLOOD EXAMINATION

1. Rheumatoid factor: to look for antibodies related to RA
2. ESR, CRP: measures inflammation in the body
3. Anti-CCP: to look for any antibodies related to RA
4. CBC, LFT, KFT are also done.
5. X-Rays, MRI can be done to assess joint damage and inflammation.

TREATMENT / LIFESTYLE ADJUSTMENTS

• DMARDs: like methotrexate, leflunomide etc., are used to slow down the progression of RA.
• NSAIDs for reducing pain and inflammation.
• Corticosteroids: for pain and inflammation.
• Topical pain relieving medications are used.
• Physical Therapy is also recommended to patients in periods of their remission.
• Surgery: procedures like joint replacement, osteotomy, synovectomy, etc. are done but it should be considered a last resort.

AYURVEDIC OVERVIEW

In Ayurveda, Rheumatoid Arthritis is compared with “Aama-vata”. As the name suggests, it has involvement of both Vata Dosha and Ama (toxins). Due to consumption of Virudh-aahar (mutually incompatible foods), Mandagni (slow digestive fire), Nischala (sedentary life-styles), Snigdha bhojana (oily, fried, fatty food); the digestive fire in stomach slows down leading to formation of undigested nutritional essence / toxins called as “Ama” in Ayurveda. Along with this the Vata dosha also gets vitiated. The vitiated vata then circulates along with “Ama” in the body. When this vitiated Vata & Ama reaches sites of kapha mainly joints and muscles, it gets accumulated there and develops as “Ama-vata”. This involves all your tridoshas, as the vata and kapha dosha gets vitiated and pitta dosha gets decreased.

Initially, symptoms develop as Angamarda (body ache), Alasya (lethargy), Gaurava (heaviness in body), Shunata (swelling in body), and Jwara (fever). In advance conditions, it presents as Saruja shopha (painful swelling in joints of hands, feet, ankles, etc.), Vrischika damshavat peeda (sharp stinging pain), Nidra viparyaya (sleep disturbances), Agni dourbalya (sluggish digestion), Gauravam (heaviness in body).

Basic principle of treatment followed in Ayurveda for Ama-vata is Langhan (fasting) for the digestion of “Ama” and to increase the Agni (digestive fire). Use of Katu (bitter) rasa, tikta (pungent) rasa is done for increasing Agni (digestive fire). For inflamed joints, use of Dashang Lepa (a paste prepared with Vata pacifying herbs) is recommended. Since Kapha dosha is involved, Rooksha Swedana (dry fomentation) is done. Udhwartana (massage with dry herbs powders on inflamed area) and Baluka Swedana (fomentation with sand) is done locally to reduce inflammation. Use of Eranda Tailam (Castor Oil) is done for pacifying vitiated Vata dosha. For relieving severe pain, Rasnadi kwath is used as it pacifies Vata dosha.

AYURVEDIC HERBS BENEFICIAL IN RHEUMATOID ARTHRITIS

1. Shallaki / Boswellia Serrata – Its essential oil is called “Frankenstein oil”. Shallaki is rich in Glucosamines. These are amino-acids that have anti-inflammatory action that help in relieving joint pain and increase joint mobility and flexibility. It balances Kapha and Pitta dosha as it has Laghu (light), Rooksha (dry) properties. Externally Upanaha swedana (application of hot paste) with Shallaki is recommended to use in joint pains
2. Ashwagandha / Withania Somnifera – Ashwagandha is enriched with Katu (bitter), Tikta (pungent), Kashaya (astringent) rasa; is Snighda (oily) yet Laghu (light) and of Ushna veerya (hot potency). Ashwagandha is Kapha & Vata hara (pacifies vitiated kapha and vata dosha). It is also a Rasayana (improves life expectancy), Balya (improves strength), anti-inflammatory and anti-bacterial.
3. Guggul / Commiphora Mukul – Acharya Charaka has said guggul to be “medo-anilaharm” i.e., it balances vata dosha and is also helpful in reducing cholesterol levels, thus helpful in obesity. It is also tridosha shamak i.e., balances all the three doshas. It’s Madhur (sweet) rasa balances Vata Dosha, Kashaya (astringent) rasa balances Pitta Dosha and Tikta (bitter) rasa balances Kapha Dosha. It also has “Vran-ropan” (wound healing) properties, thus it helps in relieving joint inflammation.
4. Nirgundi / Vitex Negundo – It consists of various alkaloids like phenol, vitricine, dulcitol etc. It is a potent Vata and Kapha dosha shamak as it is Laghu (lightness), Rooksha (dry) qualities and Katu (pungent), Tikta (bitter). It is also “Rujapaha” i.e., it relieves pain and thus is useful in arthritic pain.
5. Asthi-shrinkhala / Cissus Quadrangularis – An ancient ayurvedic saying states “यत्र आकृति तत्र गुणा वसन्ति” meaning when something is similar to any body organ or structure, its functioning will be beneficial for that particular body organ. So in this case, Asthi-shrinkhala has a similar appearance to structure of bone and joints, & it is indeed very efficient for strengthening of bones and joints. It is also called “had-jod”. It balances Vata dosha as it is of Madhur (sweet) rasa and Kapha dosha as it has Laghu (light), Rooksha (dry) qualities and Ushna veerya (hot potency).The extract from this plant is rich in calcium ions. Had-jod is also “Bhagna Sandhankara” (helpful in healing broken joints or bones) and “Balya” (helpful in strengthening bones).
6. Mandukparni / Centella Asiatica – It is commonly called as “Gotu-kola”. This herb is mentioned under 4 Medhya Rasayana by Acharya Charaka (Father of Medicine in Ayurveda). This herb is rich in Tikta rasa (bitter) thus, pacifies aggravated Kapha and Pitta dosha and also improves Agni (digestive fire) by “Ama-pachana” (digestion of toxins).  This herb’s dry powder is used for “Udhwartana” i.e., dry powder massage which is helpful in treating obesity, improves muscle tone and complexion and also improves blood circulation. This herb is said to be “Shothhar” (anti-inflammatory), “Balya” (strengthening) and “Rasayana” (rejuvenates our immune system). It is also helpful in relieving venous insufficiency to improve blood circulation.
7. Suranjana / Colchicum Luteum – The root of this herb is rich in an active alkaloid called “Colchicine”. Suranjana is Kapha and Vata shamak i.e., reduces vitiated kapha and vata dosha. It is rich in Katu (pungent) and Tikta rasa (bitter). The root powder of Suranjana is used with other Vata pacifying herbs decoction in arthritic pains. Suranjana root powder mixed with egg yolk is applied on joints to relieve arthritic pain. It acts as a blood purifier, thus indicated in Rheumatoid Arthritis.

HERBAL REMEDIES FOR RHEUMATOID ARTHRITIS BY PLANET AYURVEDA

Planet Ayurveda provides a combination of ayurvedic herbs for the management of rheumatoid arthritis. With the use of above-mentioned herbs, Planet Ayurveda has compiled the “RA Care Pack”. This pack includes Boswellia Curcumin, Aamvatantak Churna, Ashwagandha Capsules, Joint Aid Plus, RumoGin5 Capsules and Yograj Guggul. All the Planet Ayurveda medicines are 100 % natural, vegetarian, additive free, chemical & preservative free and without any side effects. With ayurvedic intervention, Rheumatoid Arthritis can be managed efficiently and thus, increasing the quality of life.

1. Boswellia Curcumin
2. Aamvatantak Churna
3. Ashwagandha Capsules
4. Joint Aid Plus
5. RumoGin 5 Capsules
6. Yograj Guggul

Product Description

1. Boswellia Curcumin

These capsules are prepared from the standardized extract of Shallaki (Boswellia serrata) and Haridra (Curcuma longa). The “Frankenstein oil” in Shallaki and the major alkaloid Curcumin presentin Haridra are both potent anti-inflammatory, therefore, helpful in reducing joint pain and increasing joint mobility.

Dosage: 2 capsules twice daily with warm water, after meals.

2. Aamvatantak Churna

This preparation is available in “Churna” form which is prepared from the standardized extract of herbs like Ashwagandha (Withania Somnifera), Methi (Trigonella Foencum Graecum), Suranjaan (Colchicum Autumnale), Gorakhmundi (Sphaeranthus Indicus), Haridra (Curcuma Longa) and Sunthi (Zingiber Officinalis). This churna acts on the accumulated “ama” in the body and pacifies it. It is also helpful in reducing the inflammation of joints.

Dosage: 1 teaspoonful twice daily with warm water, before meals.

3. Ashwagandha Capsules

These capsules are prepared from the standardized extract derived from the root of Ashwagandha (Withania Somnifera). Ashwagandha has a great effect on the immune system, thus helping in this auto-immune condition. It also purifies blood and reduces edema. Ashwagandha is “Balya” thus helps in strengthening of joints and relieves pain.

Dosage:  2 capsules twice daily with warm water, after meals.

4. Joint Aid Plus

These capsules are prepared from the standardized extract from the herbs like, Shallaki (Boswellia Serrata), Guggul (Commiphora Mukul), Nirgundi (Vitex Negundo), Shunthi (Zingiber Officinale), and Ashwagandha (Withania Somnifera). These herbs are helpful in reducing inflammation and strengthening of joint and bones. Guggul and Shallaki are helpful in reducing characteristic pricking pain which is increased on movement by pacifying the aggravated Vata dosha. Moreover, the presence of Shunthi in it aids digestion and Ashwagandha provides strength to the muscles and ligaments. This formulation has given effective results in almost all types of joint related conditions.

Dosage: 2 capsules twice daily with warm water after meals.

5. RumoGin 5 Capsules

These capsules are prepared from the standardized extract of various ayurvedic herbs like Haridra (Curcuma Longa), Sunthi (Zingiber Officinalis), Shallaki (Boswellia Serrata), Pippali (Piper Longum) and Maricha (Piper Nigrum). These herbs have anti-inflammatory, anti-arthritic, antibacterial properties which help in maintaining healthy joints and improves joint flexion & extension

Dosage:  1 capsule twice daily with warm water, after meals

6. Yograj Guggul

Yograj Guggul is an herbal formulation available in form of tablets which are prepared from the standardized extract of ayurvedic herbs like Guggul (Commiphora Mukul), Amla (Emblica Officinalis), Haritaki (Terminalia Chebula), and Vibhitaki (Terminalia Bellirica), which together help balance the all the body’s tridoshas but mainly pacifies Vata dosha. These tablets are known for its anti-inflammatory, antioxidant, and detoxifying effects. It supports joint health, promotes healthy metabolism, alleviates digestive issues, and helps manage conditions like arthritis, obesity, and respiratory problems. Regular use of Yograj Guggul can improve overall vitality and enhance the immune system.

Dosage: 2 tablets twice daily with warm water, after meals.

CONCLUSION

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects the smaller joints causing pain, stiffness, and swelling. Conventional treatments often focus on managing symptoms, but they may not address the root causes of the disease. Ayurveda, with its holistic approach, offers a more comprehensive treatment by focusing on balancing the body’s Tridoshas and promoting overall wellness. Ayurvedic treatments like herbal remedies, dietary changes, Panchkarma (detoxification therapies), and lifestyle modifications help reduce inflammation, improve joint mobility, and strengthen the immune system. Key herbs such as Ashwagandha, Turmeric, and Guggul are known for their anti-inflammatory properties and are often used in managing Rheumatoid Arthritis symptoms. Panchkarma therapies, which detoxify the body, also play a significant role in addressing the underlying imbalances contributing to RA. Incorporating Ayurveda into the management of rheumatoid arthritis can offer a more natural, sustainable approach to long-term health and disease prevention. With early diagnosis and treatment we can help prevent or minimize the joint damage.