Peer reviewed research paper - A pilot study to see the effectiveness in the cases of rheumatoid arthritis

Peer reviewed research paper – A pilot study to see the effectiveness in the cases of rheumatoid arthritis

Peer reviewed research paper – A pilot study to see the effectiveness of homoeopathic medicines in the cases of rheumatoid arthritis

ABSTRACT:

Rheumatoid arthritis (RA) is an inflammatory illness characterised by chronic joint inflammation. Rheumatoid arthritis is characterised by inflammation of the tissue surrounding the joints and inflammatory arthritis.  Rheumatoid arthritis is a degenerative joint condition characterised by inflammation in the tissue that creates joint lubricating fluid. When this tissue is irritated, it causes deformity and joint damage by loosening joint ligaments and degrading cartilage and bones. This article examines the efficacy of homoeopathy in the treatment of RA.

KEYWORDS: rheumatoid arthritis, inflammation, joints, homoeopathic medicine

Abbreviations: Rheumatoid arthritis (RA)

INTRODUCTION

Rheumatoid arthritis is a degenerative polyarthropathy with a symmetrical distribution. It’s also an autoimmune illness with a variety of extra articular symptoms that can affect a variety of body organs.[1]

INITIAL SIGNS AND SYMPTOMS:

RA strikes many people (70 percent) without warning. Non-specific symptoms may exist prior to a RA diagnosis. These symptoms might occur in the absence of joint symptoms, leading to a misdiagnosis as a viral infection.[1]

ARTICULAR MANIFESTATIONS

Rheumatoid arthritis (RA) often affects the tiny joints of the hands and feet in a symmetrical pattern. The disease may start in one big joint, such as the knee or shoulder, or it may come and go, moving from one joint to another. Most people will acquire inflammation in their small joints in their extremities as the illness progresses, with 20-50 percent of persons developing inflammation in their large central joints.[1]

DIAGNOSIS

Rheumatoid arthritis (RA) may be a difficult disease to diagnose. Instead, the diagnosis is based upon characteristic signs and symptoms, the result of laboratory tests and x- ray. RA symptoms may develop gradually, and it can be difficult to precisely date the beginning of the disease.

The 1987 revised criteria for the classification of RA is as follows:

1]GUIDELINES FOR THE CLASSIFICATION:

A] Four out of seven criteria are required to classify a patient as having RA.

B] Patients with two or more clinical diagnoses are not excluded.

2] CRITERIA

  1. Morning stiffness of >1 hour most mornings.
  2. Arthritis and soft tissue swelling of > 3 of 14 joints/ joint groups.
  3. Arthritis of hand joints.
  4. Symmetric arthritis.
  5. Rheumatoid nodules in specific places.
  6. Serum rheumatoid factor: demonstration of abnormal amounts of serum factor by any method for which the result has been positive in less than 5 percent of normal subjects.
  7. Radiological changes suggestive of joint erosion.2

PHYSICAL EXAMINATION-

The joints are examined to check for damage (mal- alignment, range of motion) and inflammation (redness, warmth and swelling). Swelling can be sign of an effusion or synovitis. The muscles are examined for atrophy or weakness. Other systems are examined for signs of RA, and to rule out other causes of the symptoms, such as infection and malignancy.

Objectives of the study:

1. To study in detail about rheumatoid arthritis (RA)

2. To see the effectiveness of homoeopathic medicines in the treatment of rheumatoid arthritis (RA)

Materials and methods:

• This study was conducted on the patients who were suffering from  rheumatoid arthritis (RA) to assess the effectiveness of homoeopathic medicines in the treatment of rheumatoid arthritis (RA).

Research design:

Non-controlled experimental study design.

Sample design:

Total 30 cases were selected by purposive sampling method.

All cases were selected according to inclusion criteria and excluded according to exclusion criteria.

Inclusion criteria:

1) People between 30-60 age group, of both genders.

2) Patient who fit in 4 out of 7 the criteria of rheumatoid arthritis according to Revised criteria for the classification of rheumatoid arthritis. i.e.

  1. Morning stiffness of >1 hour most mornings.
  2. Arthritis and soft tissue swelling of > 3 of 14 joints/ joint groups.
  3. Arthritis of hand joints.
  4. Symmetric arthritis.
  5. Rheumatoid nodules in specific places.
  6. Serum rheumatoid factor: demonstration of abnormal amounts of serum factor by any method for which the result has been positive in less than 5 percent of normal subjects.
  7. Radiological changes suggestive of joint erosion.

Exclusion criteria:

  1. Cases without regular follow up.
  2. Cases with complications.
  3. Patients who were suffering from systemic disease such as high blood pressure, diabetes mellitus, pregnancy, etc.

Source of data:

• The data was collected from patients reported to the outpatient department, of Kulsum clinic, Akola, Maharashtra.

• Data was collected from patients or their attenders, by interviewing the patient’s history in detail and thorough physical examination.

Analysis of data:

All the collected symptoms of each patient were analysed and totality of symptoms was obtained in each case by taking into consideration the homoeopathic principles.

The potency selection was done based on the demand of the case, taking into consideration the criteria of susceptibility, vitality, changes in the structural and functional level as per need of the case. These cases were followed for a period of 3 months duration.

During the follow up each case was evaluated keenly including the intensity of symptoms before during and after treatment. No controls were considered during the study. All cases were treated after taking case in which the complete symptomatology of patients (clinical presentation and individual symptoms) was recorded. Selection of remedy in each case was based on the totality of symptoms.

Follow ups:

Cases were reviewed for every 7 days, 15 days basis to assess the subjective and objective changes. Each case was followed for a period of 3 months from the commencement of treatment.

Assessment of effectiveness:

Effectiveness of the medicines was assessed on the basis of clinical improvement of the general condition of the patient and the disappearance or relief of symptoms.

After completion of  3 months of treatment, the post – treatment disease intensity was compared taking into consideration the general well-being of the patient and symptoms of rheumatoid arthritis (RA).

Results:

Table showing age group of patients:

30-40 years 40-50years 50-60years
8 12 10

Table showing gender of patients:

Male Female
8 22

Table showing gender in different age group:

Gender 30-40 years 40-50years 50-60years Total
Male 0 3 5 8
Female 5 8 9 22

Table showing chief complaints of patient before treatment:

Chief complaints Present in patients
Pain 30
Stiffness in morning 30
Stiffness as day increased 12
Tenderness to palpitation 23
Swelling 21
Cracking sound in knee joints 22

Table showing medicine given to patient:

Medicine No. of patients
Apis mellifica 4
Bryonia alba 6
Caulophyllum thallictroides 2
Ledum palustre 3
Kalmia latifolia 6
Rhus toxicodendron 6
Ruta graveolens 3
Total :7 30

Table showing complaints of patient after treatment:

Chief complaints Present in patients
Pain 10
Stiffness in morning 12
Stiffness as day increases 8
Tenderness to palpitation 12
Swelling 8
Cracking sound in knee joints 9

Discussion:

Out of 30 patients, all 30 patients suffered from pain, after administration of  homoeopathic medicine 20 patient got  amelioration in the complaint, 18 from 30 were got relief  from stiffness in morning, stiffness as day increases was seen in 12  but after treatment 4 patient felt easiness in the complaint, tenderness on palpitation was observed in 23 patient and after treatment it got reduced to 12 patient,  swelling was seen in 21 patient and  got 13 patient felt relief  from it,  22 patients were suffering from cracking in joints and 9 still suffered from it. After administration of homoeopathic medicine, the intensity and frequency of the above symptoms got reduced. Females are more affected by RA than male. RA was commonly seen in farmers. Thus, the study showed that homoeopathic medicines are effective in the cases of rheumatoid arthritis.

Apis mellifica: Swollen knee, stiffness of feet, bruised feeling.[3] oedema of hands, palms hot,[4] stinging pains like sting of honey bees.[5]

Bryonia alba: Rheumatic swelling of the right shoulder and upper arms with stiffness, swelling, pain in whole arm and ends of fingers, aggravated in morning on waking up, open air.[6] tension rheumatic type drawing tearing mostly in limbs when moving the parts, swelling increases during day and reduces at night.[5]

Caulophyllum thallictroides: Severe pains in joints of wrist and fingers, severe pain on closing and swelling seen.[5] Severe pain and stiffness in small joints fingers toes ankles, pain changes position every few minutes.[3]

Ledum palustre: Pain all through the foot and the limbs, throbbing in right shoulder, cracking in joints, worse warmth of bed, ankles swollen soles painful.[3] Rheumatic pain in hips, knee foot joints hard and tight swelling of knee with shooting and tearing pains and hardness of whole leg. Swelling of leg below and above knee.[6]

Kalmia latifolia: Pain come and go with the sun, they begin in the morning at the rising of the sun and increases till noon, pain decline and disappear at sunset, motion will bring on the pain or aggravate it, pain sometimes shoot like lightning.[7]

 Rhus toxicodendron: Hot, painful swelling of joints. Pains tearing in tendons, rheumatic pains spread over a large surface of nape of neck and extremities. Tenderness at knee joint.[3] Aching pain in legs, must change position, painful swelling in knee joints, shooting and tingling pain in ankle bones.[6]

Ruta graveolens: contraction of fingers thighs pain when stretching the limbs, pain in bones of feet and ankle.[3] all parts of the body on which he lies are painful as if bruised.[6]

Conclusion:

Females suffered more with the complaints of rheumatoid arthritis and the age group between 50-60 was affected more with the disease. After administration of homoeopathic medicine, there was reduction in the intensity and episodes of the symptoms of rheumatoid arthritis.

Refernces

1] Syngles A. Deodhar SD. RHEUMATOLOGY Principles and Practice,,Published by Jitendar P Vij (Jaypee brothers medical publishers (p) Ltd.) New Delhi, 2010 (first edition), pg.70-80.   

2] Harrison. Principles of internal medicine, Vol 2,14 edition, united states of America, McGraw hill companies,1885pg

3] Boericke W, Pocket manual of homoeopathic Materia Medica with Indian Medicine and Repertory, Indian Books and Periodicals. New Delhi, reprint edition. July 2004 

4] Pathak SR, Materia medica of homoeopathic medicines   

5]Nash EB, Regional Leaders

6] Clarke JH, A Dictionary of Practical Materia Medica

7] Kent J.T., Lectures on Homoeopathic Philosophy, 2002, B. Jain Publishers, New Delhi

About the author:

Dr Kulsum Sameen

BHMS, M.D (Repertory), PhD( Organon)

Working as Associate Professor in Department of Physiology, PHMC KHAMGAON, MAHARASHTRA

Posted By

Homeopathy360 Team