Rheumatoid arthritis is an autoimmune condition. It starts when the immune system, which is supposed to protect, goes awry and begins to attack the body’s own tissues. It causes inflammation in the lining of joints (the synovium). Rheumatoid arthritis is a progressive disease that initially causes signs and symptoms like joint pain and swelling in the feet and hands. As a result, joints may get red, warm, swollen, and painful. Rheumatoid arthritis most commonly affects the joints of the hands, feet, wrists, elbows, knees and ankles. Chronic inflammation can cause permanent joint destruction and deformity. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well.

Types Of Rheumatoid Arthritis

1.Seropositive -Rheumatoid arthritis patients who are classified as seropositive have anti-cyclic citrullinated peptides (anti-CCPs) in their blood test results. These are also referred to as anti-citrullinated protein antibodies (ACPAs). These are the antibodies that attack the body and produce the symptoms of rheumatoid arthritis.
Between 60% and 80%of rheumatoid arthritis patients test positive for the presence of anti-CCPs. The presence of these antibodies can be detected as early as 5 to 10 years before clinical rheumatoid arthritis symptoms appear.

2.Seronegative- It’s still possible for patients to develop rheumatoid arthritis without the presence of antibodies in their blood. This is referred to as seronegative type rheumatoid arthritis. Seronegative patients are those who do not test positive for the anti-CCPs.
Though seronegative patients lack the antibodies that help diagnose the condition, they can still be diagnosed with rheumatoid arthritis in a number of ways. These include the demonstration of clinical rheumatoid arthritis symptoms, as well as X-ray results indicating patterns of cartilage and bone deterioration. It’s possible for seronegative patients to have milder rheumatoid arthritis symptoms than seropositive patients, this isn’t always the case. It can still depend on a number of factors, including genetics and other conditions as well.

3. Juvenile Rheumatoid Arthritis-Juvenile rheumatoid arthritis is another type that affects patients under the age of 17 years. It is also known as juvenile idiopathic arthritis. It is the most common type of arthritis for this age group and symptoms can be persistent swelling, stiffness and joint pain which can last for months. Some patients may experience rheumatoid arthritis symptoms for the rest of their lives.
The effects of juvenile rheumatoid arthritis differ from those seen in adult patients because children and youth can experience growth issues as a result of the disease. Eye and lymph node inflammation is also a concern.
Like adult patients, juvenile rheumatoid arthritis is diagnosed from a series of different blood tests including testing for rheumatoid factor and the presence of anti-CCPs. In some cases, may not be able to detect abnormalities in the blood tests of children and youth who have clinical symptoms.

4.Rheumatoid Factor -Another type of arthritis is called the Rheumatoid Factor. However, the rheumatoid factor can also appear in patients who have other conditions. This is why the presence of rheumatoid factor isn’t always a firm confirmation of whether or not a patient will develop rheumatoid arthritis. Rheumatoid factor is another antibody that is used to determine the presence of the autoimmune disorder that causes rheumatoid arthritis. This is in addition to testing positive for anti-CCPs.

Causes of Rheumatoid Arthritis
Rheumatoid Arthritis may be genetically inherited. It is also suggested that a few environmental factors trigger the immune system in risky individuals. It is said that smoking, obesity and chemical exposures like pollution, insecticide and some cosmetics may increase the risk for rheumatoid arthritis.
Rheumatoid arthritis occurs when the immune system attacks the synovium – the lining of the membranes that surround joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.
Joints possess a synovial membrane (it covers the joint from inside) and cartilage which covers the articulating surface of the bone and merges at its free edges with the internal synovial membrane lining of the joint cavity. The joint cavity contains a small amount of synovial fluid. The cartilage derives nutrition from the synovial fluid like a sponge. Synovial fluid acts as a shock absorber as it avoids friction between bones and also responsible for the nutrition of the joint. Pain, inflammation (swelling), fever, loss of function, and morning stiffness are cardinal features of arthritis.

Signs and symptoms of rheumatoid arthritis may include:
Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite
Early rheumatoid arthritis tends to affect smaller joints first — particularly the joints that attach fingers to hands and toes to feet.
As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of body.
About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. Rheumatoid arthritis can affect many non-joint structures, including eyes, skin, lungs, heart, kidney, salivary glands, nerve tissue, bone marrow and blood vessel.

Ayurvedic prospective
According to Ayurveda Rheumatoid arthritis (RA) called as Ama Vata. Ama is defined as the toxins produced in the body due to an imbalance in body metabolism. These toxins circulate in the whole body and accumulate in the weaker joints, triggering the immune system and leading to joint inflammation. The disease is more prevalent in cold and damp conditions.

As per Ayurveda various steps to manage Rheumatoid Arthritis –
Agni Deepana and Ama Pachana – Correction of body metabolism by activating the digestive fire.
Ama Shodhana – Removal of Ama(Toxin)
Pathya – Following diet regimens and lifestyle changes to prevent Ama formation.
Shamana Chikitsa – Internal herbs to reduce pain and joint inflammation.
Rasayana – Herbs to improve immunity and joint stability.

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