Rheumatoid Arthritis (RA) is chronic inflammatory condition that affects entire body, but especially the joints. The joints typically involved are the hands, feet, wrists, knees, ankles, Usual age of onset is 20-40 years although it may begin at any age.

The onset of RA is usually gradual, occasionally quite abrupt. Fatigue, Low grade fever weakness, weight loss, joint stiffness and vague joint pain may precede the appearance of painful  swollen joints by several weeks. Several joints are usually involved in the onset, typically in symmetrical  fashion. In about of 1/3 of persons with RA, initial  involvements is confined to one or a few joints.

Involved joints will characteristically be quite warm, tender and swollen. The skin over the joint will take on purplish hue. As the disease progresses, deformities develop in the joints of hands and feet. The common deformities include; Swan neck, button whole etc.,

Causes :
Evidences reveal that RA is an autoimmune reaction, in which antibodies develop against components of joint tissues. The mechanism for this auto immune reaction remains largely unknown. But certain factors are found to predispose the disease such as:

• Genetic Factors
• Life Style
• Nutritional Factors

Auto Immune Reaction
Anti Bodies formed to microbial antigens are thought to cross react with the antigens in the joint tissues. In other words the anti bodies formed to attack the body abundant evidences support this concept.
The presence of circulating immune complexes is one of the major factors thought to contribute to the joint destruction that accompanies RA.
Dietary Factors
Studies revealed RA has not been found in areas where people eat a more primitive diet. It is found at a relatively high rate in places where people consume a so called western Diet. A diet rich in whole foods, vegetables, appears to offer some prevention against developing RA. The increased consumption of meat, refined foods, saturated fat are found to provoke RA
Diagnostic  Criteria :

• The following are the features observed physically to conclude RA
• Morning stiffness
• Pain on movements
• Tenderness in a joint
• Swelling
• Nodules under the skin over body prominence on joints

The serum test should contain the rheumatoid factor (RF) the level of RF in the blood co-relates with the RA symptoms.
Therapeutic Criteria
Modern medical therapy has a limited value. It fails to treat the complex underlying causes of the disease.
Naturopathy and yogic systems have given good results in RA since times.
Naturopathy:  This includes Diet Therapy, Physical Therapies (Hydro Therapy, Massage)
Diet Therapy : Patients with RA were benefitted from fasting, but fasting should be done strictly under medical super vision.
Fasting was found to have reduced levels of inflammatory mediators. Even the acute, worsened condition of RA was relieved with short term fast.
Fasting can be under taken  - with water, fruit juice, vegetable juice etc., as prescribed by the naturopathy physician.
Short term fast followed by a Satwik diet resulted in a substantial reduction in the disease, in many patients.
Bromelain :
It is a mixture of an enzyme found in pineapple. It has been reported to exert a wide variety of beneficial effects, including reducing inflammation in cases of RA.
Ginger
The inclusion of Ginger in the diet as a spice possesses numerous therapeutic properties. Fresh ginger is more effective than the dried one. The presence of protease in Ginger shows inhibition of formation  of inflammatory compounds.
Apart from the above foods all the other vegetables, fruits are to be included in the diet of the patient as per the advice. Eg., Carrot Juice, Bottle guard juice given in required proportions for the systemic effects.
The non spicy vegetarian diet helps in lowering the gastrointestinal disturbaces.
Root vegetables like Potato, Colocasia, etc., are to be strictly avoided.
Physical Therapies

• Hot and cold fomentation to the joints for about 10-15 minutes, helps to relive pain.
• Cold packs, hot applications-implemented for symptomatic relief
• Massage-as prescribed by the physician.

Yoga and Pranayama
Prescribed Yogic exercises help for improving and maintaining the joint function, as well as for general health.