Arthritis: Ankylosing spondylitis and Rheumatoid arthritis

Arthritis means inflammation (it includes warmth, pain, and pain on pressure) of a joint, it is also responsible for limitation of joint movement which is affected, the cause of arthritis is may be due to pyogenic or septic arthritis or due to rheumatoid arthritis.

Types of arthritis:

1. Monoarthritis (which involves one joint at a time, also known as monoarticular arthritis), it includes Gout, tubercular arthritis, hemophilic arthritis, pyogenic arthritis, and tubercular arthritis.
2. Polyarthritis (which involves four or more joints at the same time), it includes seronegative spond-arthritis, juvenile chronic polyarthritis, rheumatic fever, rheumatoid arthritis, primary osteoarthritis.

Ankylosing Spondylitis:

It is also known as Marie-Strumpell Disease, it is a chronic ailment that is identified by the inflammatory stiffening of the joint which is progressive in nature. The hips joint is the most affected joint in this disease.

Symptoms of ankylosing spondylitis:

1. It is more commonly found in young males of the age between 15 to 30 years of age, they complain of the pain which has a gradual onset with the stiffness of the lower portion of the back, at the starting stage this stiffness occurred after the period of rest and this stiffness improved after the movement.
2. The pain becomes severe in the night or some time in the early morning which compels the patient to awake from sleep, the patient gets relief from this pain when he does some exercise or tries to walk.
3. Sometimes patient complains about pain in the heel area, above external genitalia, in between chest wall.
4. In the late stages of ankylosing spondylitis, there is a deformity of hips occurs along with kyphotic deformity of the spine.
5. Often, Shoulders and knees are involved.
6. The patient may present with Inflammatory bowel disease.

Some other symptoms of ankylosing spondylitis which are not joint-related but related to other organs of the body:

1. Generalized osteoporosis is a common feature.
2. Patients who are suffering from ankylosing spondylitis for a long time, they may develop complaints related to heart, nervous system-related problems like spinal cord compression, complaint related to the respiratory system like fibrosis of apical lobe of the lung, complaints related to eyes like acute iritis.

Investigations for ankylosing spondylitis:

1. Xray of pelvic region and back.
2. Complete Blood count, high ESR, and mild anemia is a common finding.
3. Positive HLA B27.

Treatment of ankylosing spondylitis:

1. Physiotherapy under the guidance of a qualified physiotherapist
2. Homeopathic medicines give prompt relief from pain, without affecting the kidney as most of the painkillers have a toxic effect on the kidney.

Rheumatoid arthritis:

It is an inflammation of synovial joints that is chronic in nature and nonsuppurative (nonpus forming). It is an autoimmune disease (a disease in which the defense of our body fights with its own defense mechanism). Most commonly found in females than males. The majority of patients belong to the age group between 20 to 50 years.

Cause of Rheumatoid arthritis:

The exact cause of rheumatoid arthritis is still unknown.

Symptoms of rheumatoid arthritis:

1. Stiffness of joints most particularly in the morning.
2. Positive rheumatoid factor.
3. Swelling is most commonly symmetrical in the presentation.
4. Three or more joints are swollen.
5. Swelling in hands and wrist joints.
6. Presence of rheumatoid nodule.

The course of rheumatoid arthritis varies in different individuals, in some, it is just like arthritis of milder level which recovers completely, but in some individual, the same disease presents with severe debilitating diseases of chronic nature, there is a period of remission and exacerbation of the symptom of the disease.

Stages of rheumatoid arthritis:

1. Reversible soft tissue damage, as the disease is limited to the synovium, and no destructive sign is seen on a radiograph.
2. Irreversible destruction of soft tissue and early cartilage erosion but this stage is controllable.
3. Irreversible bony changes and soft tissue changes.

Investigations for rheumatoid arthritis:

1. Xray of both hands and joints affected.
2. complete blood count which shows an increase in ESR, and low hemoglobin.
3. Rheumatoid factor and anti-CCP test.

Treatment:

1. The main aim of treatment of both types of arthritis stated above is to, control the disease activity by drugs called Disease-Modifying Anti rheumatic drugs(DMARDs) some times steroids.
2. Preservation of joint’s function and its prevention from any deformities.
3. Physiotherapy like wax bath hot water fomentation may give symptomatic relief, joint mobilization and muscle building exercises are beneficial and must be done under the guidance of an expert physiotherapist.

Some food to be taken for ankylosing spondylitis and rheumatoid arthritis :

1. Omega 3 fatty acids: Soybeans, chia seeds, walnuts, flax seeds, anchovies, caviar, oysters, fish like trout, sardines, herring, mackerel, seabass cod liver oil, Seaweed, and algae, like, nori, spirulina, and chlorella.
2. Brown rice, corn, quinoa, buckwheat, and oats, lean meat, to be promoted in arthritis.
3. Calcium-rich food: must be promoted like low-fat dairy products, poppy, sesame, celery and chia seeds, Parmesan cheese, yogurt, sardines (a fish), almonds, milk, whey proteins, collard greens, spinach, and kale, Figs, amaranth, etc, canned sardines with bones.
4. Vitamin D rich food: Fish like salmon, herring, egg yolk, cod liver oil, mushrooms, soy milk, etc
5. Antiinflammatory herbs: Garlic, ginger, turmeric, are beneficial in all types of arthritis.
6. To avoid is Sugar and refined foods, high-fat food, red meat, MSG, saturated fat foods, like pizza, processed foods, excess salt, the three “wheat, rye, and barley” as they contain gluten may trigger symptoms, omega 6 fatty acids, like vegetable oils like safflower and sunflower oil.
7. Low Starch diet to be avoided, like potatoes, pasta, bread, etc, in arthritis.

Essential oils beneficial in ankylosing spondylitis and rheumatoid arthritis: To be used as the local application only, to be mixed with olive oil or coconut oil, etc.

1. Basil oil.
2. Lemongrass essential oil.
3. Turmeric Oil.
4. Ginger oil + Orange oil.
5. Lavender oil.
6. Eucalyptus oil.
7. Frankincense oil +Myrrh oil.
8. Evening primrose oil.
9. Peppermint oil.