Arthritis Series- Rheumatoid Arthritis

1. Osteoarthritis 2. Rheumatoid arthritis 3. Fibromyalgia 4. Gout
   5. Cervical Spondylosis or Arthritis of the Neck

How does it happen?

Rheumatoid arthritis is an autoimmune disease. The immune system protects the body by attacking foreign elements as bacteria and viruses. However, in Rheumatoid arthritis, the immune system starts attacking the joints instead. This inflammation causes the synovium- the tissue inside of joints to thicken. Synovium creates a fluid that helps the joints to move freely. This further causes swelling and pain around the joints.

Who all can get affected?

As per Arthritis-India about 0.92% of Indians get affected by Rheumatoid Arthritis. Women are more prone to RA by 3% than men. It occurs mostly between the age group of 30 to 60 in women and later in men. Pregnant women, are prone. Reasons as oral contraceptive pills, coffee, and cigarette smoking are the main cause of RA.

What all it affects?

1. Bones and Joints: Inflammation that is not checked can hamper the following:
2. Cartilage
3. Elastic Tissue Covering the Bone Ends In Joints
4. Bones

The joint spacing may become smaller as the loss of cartilage continues. This may cause the joints to become lose, painful, and unstable. They might even lose mobility or deformity may occur. It is a non-reversible process. “Prevention is better than cure” as states Dr. Mathur at Sanjeevani Kaya Shodhan Sansthan.  He says early diagnosis and concerted treatment could help.

The rheumatoid arthritis symmetrically affects the joints of:

• Hands
• Elbows
• Knees
• Ankles
• Feet
• “It is a systemic disease which means it can affect the entire body” adds Dr.Vashishtha and most commonly, systems as:
• Cardiovascular
• respiratory systems

• Systemic Inflammation can also Affect Your Teeth:

The bacteria in the stomach and periodontal disease may be responsible for starting Rheumatoid arthritis.
Peridontal disease is severe gum inflammation in the gums and bone- periodontal tissues around the teeth.

You could consult your doctor for a bite plane.

The gum diseases can start long-lasting inflammatory gum infections that cause Rheumatoid arthritis as per John Hopkins study. The chronic disease can create citrullinated proteins that begin a series of issues ending in Rheumatoid arthritis.

• Dry Mouth: Some patients can experience dry mouth due to excess medication or Sjögren’s syndrome which often happen with RA. A person suffering from Sjögren’s syndrome experiences a dry mouth and dry eyes problem. Saliva kills bacteria in the mouth and also neutralizes acid. Without saliva, there are more chances of getting periodontal diseases and cavities.
• RA in JAW: RA in jaw might not allow the jaw to open fully.
• Gingival overgrowth: Due to accumulation of plaque, gingival enlargement may happen. This state occurs due to certain medications as immunosuppressant. If it happens due to medications, the gums will turn pink though not bleed easily. The discontinuation of the medicines will lead the condition to subside.

Tips for Patient’s with RA for Teeth Care

• Avoid Tooth Implants: If you suffer from RA avoid getting tooth implant. A screw is drilled into the bony jaw. Being an autoimmune disease, the body may not comply and the effort would be a waste.
• How to Eat? Eat softer foods. Take small bites so that it is easier to chew.
• Chewing Selectively: You may chew from your front teeth than using the molars and put less pressure on your jaws.
• Get a Bite Plane: Consult your doctor to get a bite plane. A bite plane secures the teeth and prevents pain hurting your teeth at night.
• Keep your Mouth healthy: You must brush and floss your teeth daily. Maybe you are unable to reach your teeth due to pain in the jaw or the arm. You could use electric toothbrush. Get your mouth cleaned from a dentist regularly.

How Naturopathy at Sanjeevani can Help You?

You must continue with your prescribed medication. The naturopathy treatment goes hand in hand to help you manage the stiffness and pain in Rheumatoid Arthritis.

Massage

This is a natural therapy practiced for thousands of years. The modern sciences have proven that massages help relieve pain. At Sanjeevani, the patients get a full body massage daily, and also a half body massage in the afternoon session. You must consult the doctor before taking massages and notify the massage therapist about your sore spots that must be avoided. At Sanjeevani, we only use natural herbs in special oils. We don’t use scented oils as they can irritate the skin.

Heat and Cold

Heat and cold treatments are prescribed to ease Rheumatoid arthritis symptoms. They offer different types of benefits:

Cold Treatment:

Cold Treatment helps the inflammation and swelling in the joints. You must apply icepack to affected area when RA flares up. Do not apply for more than 15 minutes at a time. It is recommended to give at least 30 minute interval before the next application.

Heat Treatment:

Heat relaxes the muscles and helps the blood flow. We have many heat related treatments- sauna, Jacuzzi, Steam, Local steam, etc. that help you heal and relax.

Deep Breathing

In the meditation sessions in the evening, patients are taught how to breathe deeply. It calms a person down. It further helps to turn off the stress receptors that make the muscles tighter and make the pain worse. Also it takes your mind away from pain.

Meditation

Meditation helps to focus on your breath while inhaling and exhaling. Meditation is for an everyday person and helps you release your stress. It is performed with deep breathing. It will help you to focus your mind better, which naturally wanders.

Physiotherapy

Dr. Lakshmi Narayan recommends Progressive Muscle Relaxation at the physiotherapy center. Tighten and relax muscles in different parts of the body. You are helped with a series of exercises that help you work your way down the body. Starting from the face muscles to neck, arms chest, back, belly, legs, and feet. Or it is worked the way up.

There are Heat Cold Treatments and Electrical Stimulation solutions that help you deal much better from the Rheumatoid.

Being a chronic and progressive disease there is loss of physical functionality and disability attached with Rheumatoid Arthritis RA. The Physiotherapy Center at Sanjeevani Gohana is dedicated to give physical treatment to Prevent Disability in patients. 

Dr. Lakshmi Narayan says that “before beginning the treatment we study and understand the condition, requirement, and ability of the patient. We work on all areas to give the best treatment and conditioning to the patients. A suitable program is devised taking into account and to assist the disability, incapacity, and handicap of a patient.”

Following points are taken into account:

• Functional Assessment- analysis of gait, daily life activities, transfer status.
• ROM Range of Motion of the joints
• Postural Assessment
• Muscle Strength Test: This is performed manually or by aid of isokinetic equipment
• Respiratory function is also Evaluated

Being a chronic and progressive disease there is loss of physical functionality and disability attached with Rheumatoid Arthritis RA. The Physiotherapy Center at Sanjeevani Gohana is dedicated to give physical treatment to Prevent Disability in patients. 

Dr. Lakshmi Narayan says that “before beginning the treatment we understand the condition, requirement, and ability of the patient. We work on all areas to give the best treatment and conditioning to the patients. A suitable program is devised taking into account and to assist the disability, incapacity, and handicap of a patient.”

Following points are taken into account:

• Functional Assessment- analysis of gait, daily life activities, transfer status.
• ROM Range of Motion of the joints
• Postural Assessment
• Muscle Strength Test: This is performed manually or by aid of isokinetic equipment
• Respiratory function is also Evaluated

Methods used in treatment of Rheumatoid Arthritis

Physiotherapy Modalities help in coping with RA. Many factors affect the process of the disease therefore there is no general treatment plan that may be used for all. But the following practices are used as per the requirement of the patient:

• Electrical stimulation
• Cold and hot applications
• Hydrotherapy

Electro-stimulation is used to relieve the patient from pain.

Transcutaneous electrical nerve stimulation (TENS) is one of the most common methods used in the treatment of RA. The highest frequency is 10 in TENS, used only in extreme cases with pain persisting over 3/4^th of a day.

The patient feels considerable relief with daily application of TENS for15 minutes. It can then be reduces to once a week at least for three weeks. TEMS gives a short term relief from pain up to a day.

TENS is helpful in pain relief, ROM and reduction in swelling.

In physiotherapy, Cold treatment is given in acute stages and hot in chronic stages. It is best to take the heat treatment before exercising. Thermotherapy may be given for hot-pack:

• Infrared Radiation
• Fluidotherapy
• Paraffin
• Hydrotherapy

These applications may be give once or even twice a day. The duration between 10 to 20 minutes is adequate.

NOTE: People suffering from vascular circulation and sensational deficits as chances of getting a burn is risked.

Cold application is given in joints where heat within the joint (intra-articular) is not wanted.Cold treatments include:

• Cold-Pack
• Ice
• Nitrogen Spray
• Cryotherapy

The RA patients suffer from inflamed joints that produce enzymes that destroy the cartilage. The destructive enzymes become activated as the joint temperature increases. These enzymes are dormant at 30° C and become very active between 33° C and 36° C temperature. These destructive enzymes include:

• Collagenase
• Protease
• Elastase
• Hyaluronidase

The heat therapy improves circulation and deliver the nutrients to joint and muscles. Its great before exercising as it removes stiffness. Cold therapy is best after exercise as the increased joints temperature can be put down. Cold therapy is best during acute pain. It slows circulation and restricts the blood vessels and swelling also.  It dulls pain by numbing the nerve endings.

Foods that help:

Turmeric: The member of the ginger family, Tyrmeric is lavishly used in the Indian cooking and is a natural anti-inflammatory. Research has revealed that it blocks proteins, responsible for causing inflammation and helps to ease pain. Of-course patients continue to use their nonsteroidal anti-inflammatory drugs (NSAIDs).

Visualization

While your program at Sanjeevani- Gohana, You are taught many powerful visualization techniques by Dr. Ved with great ease that help you deal with it even after you leave Sanjeevani-Gohana.

Biofeedback

Many patients are enrolled in Biofeedback programs in areas where they live. You are taught how to control automatic responses as heart rate and blood pressure. The therapists teach you how to control your reaction to stresses. After taking your treatment at SanjeevaniKaya Shodhan Sanstahan, you would realize that your control on automatic responses are enhanced. This is because your mind and body begin to work together after the detoxification, therapies, positive attitude and knowledge informally dispensed during yoga and meditation sessions.

Above all, stepping into the unprecedented positive environment with caring doctors and staff members, and the scenic environment in the green lush with nature in full bloom all year round, itself marks the beginning of healing.