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Of all forms of joint inflammation, rheumatoid arthritis is the most disastrous, destructive, and disabling. It may strike suddenly, then progress rapidly to an acute and seriously damaging stage. Although seven out of ten cases of rheumatoid arthritis occur between the age of 20 and 60, its onset could come at any time during life. Frequently, it advances subtly and deceptively. The initial symptoms appear for a few days and go away, then come back later slightly worse. There may be weeks or months between goings and comings. Gradually the disease reappears at shorter intervals, until it is a daily problem, which cannot be ignored. No two patients are quite the same. No one can say how any given instance is going to heal, except there will for certain be ups and downs.

Physicians use the term remission to describe times when a disease seems to go away by itself. The pain, stiffness, and swelling of rheumatoid arthritis even in severe cases may suddenly subside and disappear for months or even years. For about 25% of these fortunate individuals, it never comes back. Damage already done, though, does not miraculously disappear, even if the victim cannot tell by pain or other symptoms that the disease is still there. Moreover, his or her arthritis is likely to flare up again in the same insidious way that it first appeared.

People with rheumatoid arthritis can feel sick all over. The main targets of rheumatic disease are the joints of both hands, the arms, the hips, the knees, and the feet. People may be affected generally with fever, fatigue, and poor appetite. They may lose weight and develop anemia. Occasionally the lymph glands or spleen may become enlarged. It is quite common for the arthritis patient to be troubled by coldness, trembling of the hands and feet, or excessive sweating.

Rheumatoid arthritis usually affects more than one joint. The joint first stiffens, then swells and becomes tender, eventually making its entire motion difficult and painful. These symptoms are typically at their worst when the patient first arises in the morning. Pain and stiffness tend to get better after he or she has been up and moving for a while. Some patients develop small lumps under the skin, called rheumatoid nodules. These are usually at the elbows, knees, or ankles, and may be quite tender.

Progressive damage may occur inside the joint. Here is what happens. The area where two bones meet is enclosed, usually in a capsule that contains fluid. This joint capsule has an inner lining called the synovial membrane. The inflammation of rheumatoid arthritis starts here, swelling this membrane and spreading to other parts of the joint. An outgrowth of inflamed tissue invades the cartilage surrounding the bone ends, eventually eating it away. Finally scar tissue forms between the bones. Sometimes a scar transforms itself into actual
bone, permanently fusing and rendering it immovable.

While a joint is undergoing this destruction, muscle contraction can cause contracture and severe deformity. This is most apparent when the disease attacks the hands; the fingers can become so distorted that they are virtually useless. Even though the cause of rheumatoid arthritis is not completely known, scientists believe it is due to some type of a germ, possibly a bacterium or virus. The immune system is involved also, and harmful antibodies frequently form, attacking our own body tissues, in this case the joints. The key to success in combating the long-term complications of rheumatoid arthritis is a treatment program begun early and carried out faithfully for a lifetime.

The diet of the patient with rheumatoid arthritis is exceptionally important. Refined sugars, all sweets and excessive fats in the diet should studiously be avoided. Meat intake should be curtailed and ultimately eliminated, as well as spices, condiments, and unnecessary food additives. It is worth trying to eliminate nightshade plants from the menu. These include tomatoes, potatoes, eggplant, and peppers. At least 20% of our patients have benefited from this restriction, especially with relief of joint pain. The diet should be simple, of good quality, with a variety of natural foods, eaten at regular intervals. Adequate water intake is important to insure good hydration of joint tissues, as well as maintaining a vigorous circulation.

As part of the treatment program, one should also find the ideal personal balance between rest and exercise. This may vary from person to person depending upon how severely the disease process is raging. The acute stages of arthritis require more rest, while with improvement, exercise is most essential. Inflammation usually subsides with bed rest, but prolonged immobility can rapidly lead to stiffening and contracture of diseased joints.

Incorrect posture in standing, walking, sitting, or lying down puts unnecessary strain on inflamed joints. This is why guidelines for correct posture are part of the treatment. Rarely, an inflamed joint might be splinted to protect it from the abnormal pull of muscle spasm, yielding contractures that cause painful deformities. Particularly is this important in the hands and fingers, to keep them functioning smoothly.

Much of the crippling of rheumatoid arthritis develops because the painful joints are kept for long periods in what feels like a comfortable position. They then become frozen or stiffened, while muscles around the joint are weak from inactivity. The way to keep your joints mobile is to move them. In rheumatoid arthritis an exercise prescription does not mean athletics, lifting heavy things, jogging, or any strenuous activity. Quiet exercises tailor-made for the problem must be performed every day, putting the joints through their full range of motion.

The muscles must be kept strong, so that the joints can function as they are meant to. The key word is balance. Too much rest can result in stiff joints and muscles. Too much exercise may damage joints. Physical therapists, as well as physicians may be helpful in outlining a program for rehabilitation.

Moist heat is relaxing and soothing to the inflamed joints. Various types and forms of heat are used to treat rheumatoid arthritis. They all help joints to move better with less pain. Hot baths are useful for the larger joints, such as the hips, knees, or elbows. They may be given in the bathtub or kitchen sink, and usually will last 15-30 minutes at a time. Hydrotherapy is the science of treating disease with water. Many clinics and hospitals have departments devoted to this medical specialty. Some physicians specialize in it. Hot packs, fomentations, heat lamps, and paraffin wax applications can all be used with success to treat specific joints for the relief of pain, spasm, and inflammation.

Healthful method of lifting. Bend the knees and get close to the object. Grasp it firmly and hold it close to you. Rise from the squatting position, using the leg muscles and keeping the back erect. When carrying large parcels, always look where you are going; maintain an
erect posture at all times.

Also important is our disposition in preventing flare-ups of rheumatoid arthritis. Emotional upsets, tension states, depression, and sudden traumatic shock frequently aggravate the symptoms. Patients who already have this
disease may actually get worse during periods of upset, then better when such stresses are relieved.

This is not to say that these psychological factors cause rheumatoid arthritis, but only that they may contribute to the problem in some way. Achieving peace of mind through trust in our all wise Creator, helps remove all causes for bitterness and grief. Cultivating a life of prayer and Bible study will greatly help the arthritis sufferer to regain health right at home.

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