Rheumatoid arthritis (RA) symptoms come and go in the human body depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive or in remission. Remissions can occur spontaneously or with the period of treatment and can last for weeks, months, or even years. During remissions, symptoms of the disease disappear, and people generally feel well. But when the disease becomes active again or relapse, the symptoms can return. Return of disease activity and symptoms is called a flare. The course of rheumatoid arthritis varies among affected individuals, and periods of flares and remissions are typical.
When the disease is active, RA symptoms can include fatigue, loss of energy, lack of appetite, low-grade fever, muscle and joint aches, and stiffness. Muscle and joint stiffness are usually most notable during the morning and after periods of inactivity. This is referred to as morning stiffness and post-sedentary stiffness. Arthritis is common during disease flares. Also during flares, joints frequently become warm, red, swollen, painful, and tender. This occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). The synovium also thickens with inflammation (synovitis).
RA inflames multiple joints and affects both sides of the body. In its most common form, therefore, it is referred to as a symmetric polyarthritis. Early RA symptoms may be subtle. The small joints of both the hands and wrists are often involved. Early RA symptoms can be pain and prolonged stiffness of joints, particularly in the morning. Symptoms in the hands with RA include difficulty with simple tasks of daily living, such as turning door knobs and opening jars. The small joints of the feet are also commonly involved, which can lead to painful walking, especially in the morning after arising from bed.
Occasionally, only one joint is inflamed. When only one joint is involved, arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection. Chronic inflammation can cause damage to body tissues, including cartilage and bone. This leads to a loss of cartilage and erosion and weakness of the bones as well as the muscles, resulting in joint deformity, destruction, and loss of function.
Rarely, RA can even affect the joint that is responsible for the tightening of our vocal cords to change the tone of our voice, the cricoarytenoid joint. When this joint is inflamed, it can cause hoarseness of the voice. Symptoms in children with RA include limping, irritability, crying, and poor appetite.
However, RA can be treated with acupuncture. Very thin disposable acupuncture needles are inserted on specific acupuncture points on the body and ear along with moxibustion. The response of a patient to acupuncture depends on the severity of the illness and the length of time the patient has suffered from it. Other important factors are general health, constitutional type, emotional balance, diet, lifestyle. Acupuncture’s effectiveness depends on its ability to improve the flow of Qi (the life-force, vitality, or energy that makes us alive) in the body.
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi