It is a universally acknowledged truth that "A healthy mind stays in a healthy body". But, unfortunately, for one reason or another, people of different age groups experience a diseased state. One of the many serious diseases affecting about 1% of the population worldwide is rheumatoid arthritis. The factors that drive the pathogenesis of this autoimmune disorder are still unknown and women being three times more afflicted than men. Many-a-times, I see the disability of people suffering from arthritis, then a thought strikes my mind that "when they were in their youth age, everything seems possible to them; but at a point in the middle years of progress they realized that they are never going to accomplish all the shining goals they had set for themselves sometime back; just because of a gift from the god in the form of arthritis that has made their lives dependent, dependent and only dependent on others". So, through this article I want to spread awareness among those people who are depressed with the awkward symptoms of this disease and not finding any way despite the current advancements in medicine.

Rheumatoid arthritis (RA)
Rheumatoid arthritis is characterized by marked inflammation of the joints and surrounding tissues and associated failure of the repair process. The wrists, fingers, knees, feet, and ankles are most commonly affected. Autoimmunity to type II collagen (CII) is one of the pathogenic mechanisms of RA. In recent years, the increasing experimental and clinical data have provided compelling evidences for the involvement of free radicals in the pathophysiology of RA. The excessive production of reactive oxygen species (ROS) can damage protein, lipids, nucleic acids, and matrix components.

Treatment of rheumatoid arthritis

There is no known cure for RA. Till date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and patient occupation.

Current anti-arthritic drug regimen with its possible side-effects

With the belief that medicine heals doubts as well as diseases; medications have become the cornerstone of treatment for active rheumatoid arthritis. Therapy for RA rests on two principal approaches: symptomatic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and treatment with disease-modifying anti-rheumatic drugs (DMARDs). NSAIDs do not slow the progression of the disease. Furthermore, NSAIDs are relatively old and conservative treatments for RA. By contrast, DMARDs, immunosuppressive agents, retard or halt disease progression or delay disease onset but have multiple effects, some of which are undesirable, and toxic also over the long term; and they do not suppress the progression of clinical disability. Pain killers are the most frequently used drugs which may cause many untoward effects such as kidney damage, gastritis and liver dysfunction.

Recently, a case report has been published by the Canadian press stating "Rheumatoid arthritis drug 'actemra' carries risk of potentially fatal allergic reaction". In addition to this, a popular non-steroidal anti-inflammatory drug (NSAID) rofecoxib was banned by the Government of India for its serious side effects such as heart attacks, strokes and other cardiovascular diseases.

A number of immunosuppressive drugs are also used to treat RA. They include methotrexate, azathioprine, cyclophosphamide, and cyclosporine. Because of potentially serious side effects, immunosuppressive medicines are generally reserved for patients with very aggressive disease.

However, despite optimal use of currently available anti-rheumatic agents, most RA patients live with chronic pain and severe functional decline because the currently prescribed drug regimen is symptomatic and focus primarily on reducing joint inflammation and soft tissue swelling, but are not effective in preventing cartilage breakdown and the joint destruction associated with RA.

A new light of hope: Complementary and alternative medicine
Research has indicated that people suffering from chronic pain, as in RA, and those dissatisfied with current treatment are very likely to seek alternative treatments, and an estimated 60-90% of persons with arthritis use complementary and alternative medicine (CAM) which usually involves incorporation of botanical and herbal supplements. So, research has now focused for the search of novel therapeutic approaches especially CAM for preventing the inflammatory and autoimmune components of the disease, promoting restoration of immune tolerance, inhibiting cartilage destruction, and for satisfactory prolonged treatment of RA. The reason for choosing CAM is that natural products have been the source of the most active ingredients of medicines. From ancient times, a large number of plants are used in homeopathy, ayurveda and traditional Chinese medicine for treating several ailments including RA but the rationale behind the use of most of them is not known. Another reason for the use of CAM lies in the fact that the strong synergism of several constituents in the crude drug may prove more potent and effective than any single targeted compound. There are innumerable evidences in literature, which shows that herbal medicines are safe and effective not only in the treatment of a single disorder rather have multiple beneficiary effects. As example, curcumin, the component of turmeric is popular worldwide for its numerous advantages in improving the quality of life including arthritis and at present, is under clinical trials for the treatment of cancer.

In conclusion, the CAM movement started as a grass root movement and has since gathered a lot of awareness with consumers, the medical community and the government. The growth of CAM has given evidence regarding the new ways of thinking about what is optimal healthcare. In spite of the fact that CAM use lacks scientific support, widespread use of CAM is still common. Despite the considerable amount of work ahead, CAM ultimately has the potential to elevate and improve mainstream healthcare, both in conjunction with conventional medicine and separately.

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