Reactive Arthritis- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body, most often intestines, genitals or urinary tract. Reactive arthritis usually targets knees, ankles and the joints of the feet. Inflammation also can affect eyes, skin and urethra.

The infection usually occurs days to weeks before the onset of joint pain. In some cases, a preceding infection may only be identified with laboratory testing. Previously, reactive arthritis was sometimes called Reiter’s syndrome, which was characterized by eye, urethra and joint inflammation.

Signs and symptoms

  • Pain and stiffness in joints, especially knees, ankles and feet
  • Eye inflammation like conjunctivitis
  • Urinary problems like increased frequency and discomfort during urination
  • Inflammation of soft tissues like muscles, tendons and ligaments
  • Swollen toes or fingers
  • Skin problems including a rash on the soles and palms and mouth sores
  • Low back pain

Cause

Infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia).

Fisiopatologia

The bacteria induce (cause) arthritis by distorting body’s defence against infections, as well as the individual’s genetic environment

Reactive arthritis is an immune-mediated syndrome triggered by a recent infection. It is hypothesized that T lymphocytes are induced by bacterial fragments such as lipopolysaccharide and nucleic acids when invasive bacteria reach the systemic circulation. These activated cytotoxic-T cells then attack the synovium and other self-antigens through molecular mimicry. This is supported by the evidence of Chlamydia trachomatis and C pneumoniae ribosomal RNA transcripts, enteric bacterial DNA, and bacterial degradation products in the synovial tissue and fluid. It is believed that anti-bacterial cytokine response is also impaired in reactive arthritis, resulting in the decreased elimination of the bacteria. It is, however, unclear why such localization of inflammation occurs.

The prevalence of HLA-B27 in reactive arthritis is estimated at 30% to 50% in patients with reactive arthritis, although values range widely. In hospital-based studies with more severely affected patients, frequencies as high as 60% to 80% have been reported. HLA-B27 should not be used as a diagnostic tool for a diagnosis of acute reactive arthritis. The presence of HLA-B27 is believed to potentiate reactive arthritis by presenting bacterial antigens to T cells, altering self-tolerance of the host immune system, increased TNF-alpha production, promoting the invasion of microbes in the gut, and delayed clearance of causative organisms.

Initially, the dermal histopathological features of reactive arthritis are similar to psoriasis. Examination of the synovial fluid reveals large macrophages, Reiter cells with phagocytosed neutrophils, lymphocytes, and plasma cells. Extensive pannus formation is very rare.

Diagnosi

 

Diagnosis is largely based on symptoms of the inducing infections and appearance of typical musculoskeletal (joint and muscle) involvement.

Blood tests are done for any infection and all types of arthritic conditions.

If indicated, doctors might order a test for Chlamydia infection or test for the HLA-B27 gene

 

Trattamenti

Treatment for the infection consists mainly of antibiotics. Other medications used to treat reactive arthritis include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Corticosteroids
  • Topical steroids
  • Rheumatoid arthritis medications such as sulfasalazine (Azulfidine), methotrexate (Trexall) or etanercept (Enbrel)

Physical therapy is found beneficial in the management of reactive arthritis to improve the flexibility of joints & to reduce stiffness.

Prognosi

Follows a typically self-limited course, with resolution of symptoms by 3-12 months.

 

Complicazioni

  • Recurrent arthritis (15-50%)
  • Chronic arthritis or sacroiliitis (15-30%)
  • Ankylosing spondylitis (30-50% of HLA-B27–positive patients)
  • Urethral stricture
  • Aortic root necrosis
  • Secondary glaucoma
  • Cataratta
  • Cystoid macular edema
  • Posterior and anterior synechiae
  • Cyclitic membrane
  • Vitreous opacification
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Sacroiliitis
  • Erythroderma (rare)

 

 

Malattie e Ayurveda

Considering the clinical features & presentation, the disease reactive arthritis can be compared with aamavata described in Ayurveda classic texts.

Nidana

Incompetent and unwholesome diet with opposite potency

Improper body postures & movements

Loss of appetite & digestive power

Exercise immediately after highly unctuous & oily food

Sedentary lifestyle

Purvaaroopa

Dourballya      – Tiredness/Fatigue

Hrudayasya gauravam – Heaviness of chest

Samprapti

The ama produced due to defective digestion & sedentary lifestyle, gets lodged in the site of sleshma (Kapha) like joints with the help of Vaata and produce symptoms of Aamavaata.

Lakshana

Angamarda    – bodyache

Aruchi            – Loss of taste sensation

Thrishna        – Excessive thirst

Alasyam         – Lethargy/laziness

Gauravam      – Heaviness of the body

Jwara             – Fever

Apaaka           – Indigestion

Soonata          – Oedema

Divisioni

It can develop by the vitiation of Vaata, Pitta, Kapha individually (ekadoshaja), or any two of them together(dwidoshaja) or all the three doshas vitiated together(tridoshaja).

Prognosi

Saadhya          – only one dosha vitiated

Yaapya           – two doshas involved

Asadhya         – All doshas involved & the disease affected all over the body.

Chikithsa

Ayurveda treatment for Aamavaata is completely different from other joint diseases. Use of any snehadravya like oils/ghee will aggravate all the symptoms in this disease. So, only langhana(weight reducing therapy like fasting)and Rookshana(drying up therapies with medicines & treatment procedures) are recommended.

Samana

            Lepana with rookshadravyas like kolakulathadi choorna

Parisheka with soolaharakwatha        like dasmoolakwatha

Aamapachanam with shaddharanam choornam etc

Agnideepanam with gandharvahastadi kwatham etc

Vyadhivipareeta chikithsa

Sodhana

        Langhana

Swedana

Virechana

Snehapanam

Vasti especially kshaaravasti

       

Farmaci di uso comune

        Amruthotharam kashayam

Rasnasaptakam kashayam

Rasnasunthyadi kashayam

Yogarajaguggulu

Balarishtam

Shaddharanam choornam

Guggulutiktakam ghrutam

 Marche disponibili

AVS Kottakal

AVP Coimbatore

SNA oushadhasala

Rimedi casalinghi

No home remedies are proven to cure reactive arthritis. But a healthy diet and lifestyle will be helpful to improve the quality of life.

Dieta

  • Da evitare

I pasti pesanti e gli alimenti difficili da digerire causano indigestione.

Cibi spazzatura: causano disturbi della digestione e riducono la biodisponibilità del farmaco.

Bevande gassate: rendono lo stomaco più acido e disturbano la digestione.

Cibi refrigerati e congelati - causano una digestione debole e lenta indebolendo Agni (fuoco digestivo).

Milk and milk products – increase kapha and cause respiratory problems

Cagliata - causa vidaaha e quindi molte altre malattie

  • Da aggiungere

Pasti leggeri e alimenti facilmente digeribili

Green gram, soups, honey

Cibo fresco e caldo trattato con semi di cumino, zenzero, pepe nero, ajwain, ecc.

 Comportamento:

Proteggersi dal clima freddo.

È meglio evitare l'esposizione a luce solare eccessiva, pioggia o polvere.

Mantenere un programma alimentare e di sonno regolare.

Evitare di trattenere o forzare gli stimoli come urina, feci, tosse, starnuti ecc.

Evitare la sedentarietà.

 lo yoga

Pavanamuktasana

Nadisudhi pranayama

Bhujangasana

Semplici esercizi per la salute dei polmoni e del cuore

 

Tutti gli esercizi e gli sforzi fisici devono essere decisi ed eseguiti esclusivamente sotto la supervisione di un medico esperto.

 

Articoli di ricerca

https://www.ncbi.nlm.nih.gov/books/NBK499831/#_article-28255_s5_

 

The objectives of this study were to investigate and validate individual variables and to develop a composite score for disease activity measurement in patients with reactive arthritis (REA). In the first cross‐sectional part, the clinical and laboratory evaluation of 45 patients was used to elaborate the most important individual disease activity measures. In the second prospective part, these variables as well as a composite score for disease activity measurement of REA were prospectively validated in 23 patients at two points in time.The following variables emerged as the most useful for the composite measure: number of swollen and tender joints, patient’s pain and global assessment, and C‐reactive protein. The score was calculated by simple addition of the individual figures.

It was concluded that DAREA constitutes a reliable score which can easily be assessed on a day‐to‐day office work basis.

Queste dichiarazioni non sono state valutate dalla Food and Drug Administration degli Stati Uniti. Questo prodotto non è destinato a diagnosticare, trattare, curare o prevenire alcuna malattia. Consultare il proprio medico di famiglia prima dell'assunzione.

Scrittore:
Il dottor Rajesh Nair, cofondatore e consulente capo di Ayurvedaforall.com, si è laureato presso il prestigioso Vaidyaratnam Ayurveda College (affiliato all'Università di Calicut), in Kerala, India. Inoltre, ha conseguito un diploma post-laurea in Yoga Terapia presso l'Università di Annamalai.

Il Dr. Nair offre consulenze in due cliniche molto frequentate a Haripad e dintorni, Alleppey, Kerala, lo stato meridionale famoso in tutto il mondo per gli autentici trattamenti ayurvedici e per i medici. Oltre a offrire consulenze su tutti gli aspetti dei trattamenti ayurvedici, il Dr. Nair ha un interesse particolare per il Panchkarma, lo Yoga e il Massaggio.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

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