Rheumatoid arthritis is a chronic disorder for which there is no known cure. Fortunately in the last few years, a shift in strategy toward the earlier institution of disease modifying drugs and the availability of new classes of medications have greatly improved the outcomes that can be expected by most patients.  The goal of treatment now aims toward achieving the lowest possible level of arthritis disease activity and remission if possible, the minimization of joint damage, and enhancing physical function and quality of life. The optimal treatment of RA requires a comprehensive program that combines medical, social, and emotional support for the patient. It is essential that the patient and the patient’s family be educated about the nature and course of the disease. Strategies are all aimed at reducing pain and discomfort, preventing deformities and loss of joint function, and maintaining a productive and active life. Inflammation must be suppressed and mechanical and structural abnormalities corrected or compensated by assistive devices. Treatment options include medications, reduction of joint stress, physical and occupational therapy, and surgical intervention.

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What causes joint swelling in Rheumatoid Arthritis?
To understand the cause of joint swelling in Rheumatoid Arthritis, let us first understand the structure of a synovial joint. A joint is made up of two bones. It is lined on the inner side by a protective lining called the synovium. This synovium is the target of immune attack & gets swollen. To begin with the swelling is mild. Hence it is not very obvious from outside. HOwever, it does cause pain & stiffness of the joint. Later, as the swelling increases, it becomes clearly visible externally as well.

What causes deformities in Rheumatoid Arthritis?
The swollen synovium in Rheumatoid Arthritis has destructive potential. If not teated, it begins damaging the underlying bones. This damage involving the bones and surrounding muscles leads to deformities.

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What are the symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis commonly affects the joints of the hands (knuckles and the first joint of the fingers). It also affects the small joints of the feet. The wrist, elbow, shoulder, knee and ankle can also be affected.

Initially, a person may not experience obvious swelling in the said joints. However, there is pain & stiffness of these joints early in the morning. The stiffness settles after a hot water bath or as the joints are used. Later, as the arthritis progresses, the swelling becomes obvious.

Non-pharmacological methods of treatment that are popular and in fact recommended by many health care practitioners would include physical therapy and occupational therapy. In addition lifestyle changes will also be necessary. Natural methods may not always work as an alternative treatment, but they are very effective as a supplement to conventional treatment.
Your diet and physical therapy shall form the most important aspects of treatment:

Diet:
1.    Avoid consuming meats as far as possible, as well as other foods high in protein. A high carb diet would be more advisable.
2.    Milk and milk products should also be eliminated from the diet.
3.    Avoid using hydrogenated oils or polyunsaturated vegetable oils, margarine, as well as products made with these ingredients.
4.    Try and consume freshly ground flaxseeds, walnuts, and cold water fish, as they are good sources of omega 3 fatty acids.

Exercise:
1.    Exercise here is not aimed solely at physical fitness. It should be directed towards maintaining the range of motion, enhancing strength and mobility, improving your over all health and feelings of well being.
2.    Light aerobic exercise, or swimming can be very beneficial.
3.    Yoga is possibly the best fitness discipline as it will not just focus on physical fitness. In the context of physical fitness too however it trumps other methods because of the emphasis on gradual gentle movements that focus on strength, endurance, and flexibility.

Lifestyle:
1.    It’s important that you relax and do not get overcome with stress. Here again yoga comes in very handy. Other relaxation techniques and meditation can also be used.
2.    Try to follow a disciplined and organized routine.