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Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease primarily characterized by symmetrical inflammation of multiple joints. It occurs when the immune system mistakenly attacks the body’s own joints. RA mainly affects small joints such as the hands, wrists, and feet, causing pain, swelling, warmth, and morning stiffness.

More than 90% of patients experience involvement of the proximal interphalangeal joints (middle joints of the fingers). If left untreated, RA can lead to joint destruction and deformity. It may also affect multiple organs and systems, including the heart, lungs, and kidneys.

Causes

The exact cause of RA is not yet fully understood. It is classified as an autoimmune disorder. Current research suggests that RA may be related to factors such as:

  • Infections
  • Hormonal influences
  • Environmental triggers

Symptoms and Characteristics

  • Women are affected 2–3 times more often than men
  • Most common between ages 35–60
  • Chronic joint pain and swelling
  • Morning stiffness lasting more than 30 minutes
  • Symmetrical joint involvement
  • Progressive joint damage if untreated

RA is considered a highly disabling condition. However, early diagnosis and early treatment can significantly improve and control symptoms.

Diagnostic Criteria

Doctors may diagnose RA based on:

  • Medical history and clinical symptoms
  • X-ray imaging (to detect joint damage)
  • Blood tests such as:
    – Erythrocyte Sedimentation Rate (ESR)
    – Rheumatoid Factor (RF)
    – Anti-CCP antibodies

Western Medical Treatment

Treatment aims to relieve pain and control disease progression:

  • Steroids (to reduce inflammation and pain)
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
  • Disease-Modifying Anti-Rheumatic Drugs (DMARDs), such as Hydroxychloroquine and Methotrexate

Traditional Chinese Medicine (TCM) Perspective

According to TCM theory, RA is related to deficiency of the body’s vital energy (Qi) and invasion of external pathogenic factors such as wind, cold, dampness, and heat. These factors obstruct the meridians, impair circulation of Qi and blood, and lead to joint pain and inflammation.

Dampness, heat, and blood stasis are considered key pathological factors. Over time, prolonged illness may affect internal organs, leading to liver and kidney deficiency and further imbalance.

TCM Classification and Treatment

In Traditional Chinese Medicine, RA is categorized into eight syndrome types:

Wind-Damp Obstruction

Cold-Damp Obstruction

Damp-Heat Obstruction

Phlegm and Blood Stasis Obstruction

Blood Stasis Blocking the Channels

Deficiency of Qi and Blood

Liver and Kidney Deficiency

Deficiency of Qi and Yin

Different herbal formulas are prescribed based on the specific syndrome type. TCM treatment focuses on restoring balance and addressing the root cause according to individual patterns.

Prevention and Joint Protection

During flare-ups:

  • Rest adequately
  • Protect painful joints
  • Follow prescribed medication treatment

During remission:

  • Engage in appropriate rehabilitation exercises
  • Maintain joint mobility
  • Stop smoking and limit alcohol
  • Follow a nutritious, low-salt diet
  • Maintain a healthy body weight

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