Table of Contents
Definition
Rheumatoid arthritis (RA) is a chronic autoimmune disorder in which the immune system mistakenly attacks the joints’ lining, causing persistent inflammation. This leads to joint pain, swelling, stiffness, and deformities. RA often affects joints symmetrically and can also impact other organs and systems in the body.
ANF Therapy ®️ is an evolving technique designed to help with this chronic inflammatory condition.
What is rheumatoid arthritis?
The immune system is the defence system of the human body. It destroys foreign particles entering the body. Rheumatoid arthritis (RA) is an autoimmune disorder in which the body’s immune system starts attacking its own tissues, causing joint inflammation and damage. It can also affect other parts of the body, including various organs such as skin, eyes, lungs, heart, and blood vessels.
Rheumatoid arthritis typically manifests symmetrical distribution, meaning that if one joint is affected on one side of the body, the corresponding joint on the other side is likely to be affected. The most commonly involved joints in rheumatoid arthritis include:
What are the Global Statistics for Rheumatoid Arthritis?
Rheumatoid arthritis affects approximately 0.46% of the world population— around 18 million individuals were estimated to be living with the condition in 2019. Among them, over 1.5 million people are Americans, making its prevalence 0.5 to 1% in the United States and Europe.
According to Dr Mikel H-G Hoff, Like other autoimmune diseases, rheumatoid arthritis also affects women more than it affects men— 75% of individuals with rheumatoid arthritis are women. In addition, even though the typical onset of the disease is between 25 and 50, 55% of the people currently living with rheumatoid arthritis are over 55 years of age.
How Does Rheumatoid Arthritis Develop? Pathophysiology:
Multiple factors can cause rheumatoid arthritis. Dr Mikel H-G Hoff states that the bursa and synovium are the fluids of the joints that provide frictionless movement and act as cushions. If there is an infection in the bursa, it causes inflammation of the joint, which can be due to trauma or autoimmune diseases.
He also states that the lymphatic system is the body’s main system. It creates an immune response and protects the joints. When the lymphatic system is compromised, it causes inflammation of the joints, resulting in pain and joint damage.
Rheumatoid arthritis usually develops when an environmental or genetic factor “triggers” a person’s immune system to attack their joint tissues. The role of different cells and inflammatory mediators in rheumatoid arthritis is summarised below:
Cells and Inflammatory Mediators | Role in Rheumatoid Arthritis |
CD4 T Cells |
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Mononuclear Phagocytes |
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Fibroblasts |
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Osteoclasts |
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Neutrophils |
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B Cells |
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Tumor Necrosis Factor Alpha |
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Interleukin-1 |
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Interleukin-6 |
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Interleukin-8 |
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Transforming Growth Factor Beta |
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Fibroblast Growth Factor |
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Platelet-Derived Growth Factor |
|
What are the Types of Rheumatoid Arthritis?
Rheumatoid arthritis has been classified into several types.
Seropositive Rheumatoid Arthritis
Rheumatoid arthritis is associated with antibodies in the blood due to underlying pathophysiology and is known as seropositive rheumatoid arthritis. Around 60-80% of cases of rheumatoid arthritis are seropositive and are often associated with a higher risk of complications. Seropositivity can refer to testing positive for the rheumatoid factor or anti-citrullinated protein antibodies.
Seronegative Rheumatoid Arthritis
Seronegative rheumatoid arthritis is associated with the absence of very low levels of rheumatoid factor and anti-citrullinated protein antibodies. Although it is associated with less severe disease, it usually takes healthcare professionals more time to diagnose seronegative rheumatoid arthritis.
Juvenile Idiopathic Rheumatoid Arthritis
Juvenile idiopathic rheumatoid arthritis occurs in populations under 16 years of age. It affects one or more joints for at least six weeks. It is often not a chronic disease— most children outgrow their symptoms. However, it can affect their bone growth.
Elderly-Onset Rheumatoid Arthritis
Elderly or late-onset rheumatoid arthritis refers to rheumatoid arthritis that manifests after 60 years of age. It often involves larger joints, such as the shoulder joint, and has symptoms that overlap with many other systemic and rheumatologic conditions.
Felty’s Syndrome
Felty’s syndrome is a rare form of seropositive rheumatoid arthritis. It is associated with neutropenia—abnormally low neutrophils, a subtype of white blood cells—and splenomegaly—spleen enlargement. Due to the low immunity caused by the reduced neutrophil count, patients are often prone to severe infections.
Rheumatoid Arthritis Associated with Other Conditions
Rheumatoid arthritis is often comorbid with other autoimmune and inflammatory medical conditions, such as:
- Sjogren’s syndrome
- Lupus
- Scleroderma
- Psoriatic arthritis
- Ankylosing spondylitis
What are the 4 Stages of Rheumatoid Arthritis?
Rheumatoid arthritis is a condition that causes progressive changes in an individual’s joints. These changes occur in distinct phases, each with its own set of symptoms and implications for the patient’s quality of life.
Synovitis
The synovial membrane is the lining of a synovial joint. Synovitis is the initial stage of rheumatoid arthritis in which this membrane gets swollen and filled with inflammatory cells. Inflammatory changes cause it to thicken. The patient starts to feel discomfort, pain, and stiffness in their joint, which may or may not be accompanied by early damage to the cartilage and bone.
Pannus Formation
The pannus is an abnormal fibrovascular layer that covers the cartilage. As a result, there is extension erosion and loss of the cartilage, which may expose and damage the underlying bone. The joint progressively becomes more inflamed.
Fibrous Ankylosis
The pannus layer becomes fibrous connective tissue. It invades and dramatically reduces the joint space, deforming its typical tissue architecture. Consequently, the joint becomes much less flexible as the disease reduces its range of motion.
Bony Ankylosis
The fibrous connective tissue undergoes ossification, and the joint bones fuse together. There is a complete loss of joint function, and the joint becomes immobile. This is the advanced stage of rheumatoid arthritis.
What are the Risk Factors for Rheumatoid Arthritis?
Many risk factors or triggers have been associated with rheumatoid arthritis. They can either be environmental or arise from within the individual’s body.
Genetic Predisposition
Having a susceptible genetic makeup is the strongest etiologic factor for rheumatoid arthritis. Over 30 genes have been linked with rheumatoid arthritis development, such as:
- HLA-DRB1
- PTPN22
- STAT4
- PRKCQ
Medical History
An individual’s personal and family history when it comes to different disorders is an important risk factor for rheumatoid arthritis. These conditions include:
- Nonmelanoma skin cancer
- Solid cancers
- Other autoimmune conditions
- Chronic kidney disease
- Thyroid disease
- Asthma
- Reactive lung disease
A person’s chances of developing rheumatoid arthritis also increase if they have a family member who has rheumatoid arthritis or any other autoimmune disease.
Stress
Both physical and mental stress contribute to the development of rheumatoid arthritis. Stress is a known trigger of the body’s immune response and has been implicated in various autoimmune disorders.
Infections
Rheumatoid arthritis has been specifically linked with a prior history of infections, especially gum infections. Examples of these infectious agents include:
- Porphyromonas
- EBV
- Parvovirus B19
- Proteus
- Mycoplasma
Lifestyle
The conditions under which a person spends their life can often trigger diseases like rheumatoid arthritis. Such factors include:
- Air pollution
- Smoking
- Occupational stress
- A diet consisting of red meat, sugar, and sodium
- Blue collar jobs
- Health inequity
Clinical Presentation of Rheumatoid Arthritis
The typical rheumatoid arthritis patient is likely a middle-aged woman who complains of symmetrical joint pain, swollen joints, and stiffness in the morning, which lasts for over an hour. Patients often have a family history of autoimmune diseases. Signs and symptoms of rheumatoid arthritis include:
Joint-Related Symptoms
Joint abnormalities are the classic presentation of rheumatoid arthritis as they are the most commonly affected body part implicated in the disorder. These symptoms include:
- Persistent throbbing arthralgia
- Stiffness in the joints that lasts more than 30 minutes, especially after waking up or during periods of inactivity
- Different forms of visible joint deformities
- Ulnar deviation
- Swan-neck deformity
- Hitchhiker’s thumb
- Boutonnière deformity
- Tenderness and redness of joints
- Symmetrical involvement of joints
- Instability in joints
- Reduced range of motion of joints
- Joint immobility
Systemic Symptoms
| Organs Involved | Clinical Manifestations |
|---|---|
| Skin |
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| Heart |
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| Blood Vessels |
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| Lungs |
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| Kidneys |
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| Gut |
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| Blood |
|
| Nervous System and Eyes |
|
What is the Differential Diagnosis for Rheumatoid Arthritis?
Rheumatoid arthritis has symptoms similar to those of many inflammatory diseases and joint disorders. Sometimes, rheumatoid arthritis and these conditions are co-morbid, which further leads to difficulties in their diagnosis. These differential diagnoses include but are not limited to:
- Osteoarthritis
- Polymyalgia rheumatica
- Septic arthritis
- Ankylosing spondylitis
- Dermatomyositis
- Psoriasis and psoriatic arthritis
- Systemic lupus erythematosus
- Sjogren’s syndrome
- Reactive arthritis
What are the Major Complications of Rheumatoid Arthritis?
Rheumatoid arthritis has been associated with a number of complications, which are often the cause of death in patients who have rheumatoid arthritis:
- Interstitial pneumonia
- Myocardial infarction
- Cerebrovascular accident
- Serious infection
- Bleeding peptic ulcer
These complications are often reduced with timely diagnosis and proper disease management. However, the treatment can often damage various organs, e.g., kidneys, liver, and mucosal linings.
Management of rheumatoid arthritis with ANF Therapy®️:
Management of rheumatoid arthritis with ANF Therapy®️ begins with a thorough clinical diagnosis. An ANF Therapist conducts a detailed examination of the patient’s joints to differentiate rheumatoid arthritis from other potential conditions.
History:
ANF Therapists take a detailed history of the patients to make a diagnosis because past medical and family history is very important to confirm the diagnosis. History includes:
Onset and Duration of the Disease:
The therapist inquires about when the symptoms first appeared and how long they have been present. Understanding the onset helps in distinguishing between acute and chronic conditions, which is vital for diagnosis and treatment planning.
Progression of the Disease:
Information is collected on how the disease has evolved over time. The therapist looks for patterns in symptom escalation or remission, which can indicate the severity and aggressiveness of the condition.
Presenting Complaints:
Patients are asked to describe their primary symptoms, such as pain, swelling, and limited joint movement. This helps identify the specific nature of the disease and its impact on daily activities.
Morning Stiffness:
A hallmark of rheumatoid arthritis is prolonged morning stiffness lasting more than 30 minutes. The therapist assesses the duration and severity of morning stiffness to help confirm the diagnosis.
Affected Joints:
Detailed information is gathered on which joints are affected, noting if the involvement is symmetrical (a common feature in rheumatoid arthritis). This helps map the disease pattern and understand its progression.
History of Fever
The presence of fever can indicate an underlying systemic inflammatory response. The therapist checks for episodes of fever, which can support the diagnosis of an autoimmune condition like rheumatoid arthritis.
Family History:
Genetic predisposition plays a role in rheumatoid arthritis. The therapist asks about any family history of autoimmune diseases or rheumatoid arthritis, as this information can help confirm a hereditary link.
Medical History:
A comprehensive review of the patient’s past medical history is conducted, including previous diagnoses, treatments, and responses to those treatments. This helps in identifying any co-existing conditions or potential causes of the current symptoms.
Physical examination:
A thorough physical examination is essential for diagnosing rheumatoid arthritis and assessing its severity. The ANF Therapist conducts a detailed examination to identify clinical signs of the disease. The key components of the physical examination include:
1-Inspection:
During inspection, an ANF Therapist inspects the joints for visible signs of swelling, redness, and deformity. Rheumatoid arthritis commonly affects the small joints of the hands and feet, but larger joints can also be involved. They will examine the skin around the joints for any changes, such as thinning or bruising, and check nails for any abnormalities that may indicate systemic involvement.
2-Palpation:
The ANF Therapist palpates each joint to assess for tenderness and swelling. Tender joints often indicate active inflammation. Palpation helps detect synovial thickening, a characteristic feature of rheumatoid arthritis due to inflammation of the synovium. The presence of rheumatoid nodules, which are firm, non-tender lumps under the skin, typically around pressure points such as elbows.
3-Range of Motion:
The therapist evaluates the range of motion in affected joints. Limitations in movement can indicate joint damage or severe inflammation.
4-Muscle Strength:
Muscle strength around the affected joints is tested to identify any weakness resulting from disuse or inflammation. Specific tests for grip strength in the hands, as rheumatoid arthritis often affects the small joints of the hands.
5-Joint Deformities:
The ANF Therapists check for joint deformities such as ulnar deviation, swan-neck deformities, and boutonniere deformities, which are common in advanced rheumatoid arthritis. They will also assess the stability of the joints to detect any laxity or instability that may result from chronic inflammation and joint damage.
6-Systemic Examination:
Examination of lymph nodes for enlargement can indicate systemic involvement. Check for signs of extra-articular manifestations, such as lung involvement (e.g., interstitial lung disease) or cardiovascular symptoms, which can occur in rheumatoid arthritis.
Neurological examination:
The ANF Therapist will also do some neurological examination to check the nerve involvement. It includes:
- Checking the reflexes
- Muscle tone
- Muscle strength
Application of devices:
Dr Mikel H-G Hoff states that inflammation is the main cause of pain in rheumatoid arthritis. The main aim of ANF Devices is to remove inflammation and make the patients pain-free. It includes the application of devices. These are
Anti-inflammatory devices:
Anti-inflammatory devices are applied to the affected areas of the body to address inflammation and support the lymphatic system.
Antioxidant devices:
These antioxidant biochemical devices are also allied with anti-inflammatory devices, which aim to remove harmful free radicals from the body and exacerbate the inflammatory response.
Other Devices:
An ANF Therapist creates a personalised protocol for each patient according to the condition and its severity. The protocol is a combination of several ANF Devices to initiate the body’s natural healing process and support the immune system.
Expected outcomes:
ANF Therapy®️ has treated multiple patients with rheumatoid arthritis. This frequency therapy aims to provide swift relief from pain within minutes without causing complications. Most patients experience improved symptoms in a few minutes of the first session.
However, some may require a longer time to heal.
ANF Devices are changed every 72 hours. ANF Therapists guide patients and determine the number of sessions required to resolve inflammation completely.
Benefits of ANF Therapy®️ on other conventional medicines:
ANF Therapy®️ offers several advantages compared to traditional medical treatments that rely on medications and invasive procedures. Here are the key benefits:
1-Non-Invasive Treatment:
ANF Therapy®️ does not involve any surgical procedures or injections, thus reducing the risk of complications associated with invasive treatments.
2-Medications free:
Unlike conventional therapies that often involve painkillers and anti-inflammatory drugs, which can cause gastrointestinal issues and liver damage, ANF Therapy ®️ does not cause harmful effects.
3-Holistic Approach:
ANF Therapy®️ aims to focus on optimizing the body’s own healing mechanisms by improving neural oscillation and biochemical functions, promoting overall wellness. By accurately identifying and addressing the root causes of pain and inflammation, ANF Therapy®️ aims to provide more precise and effective relief.
4-Rapid and Long-Term Results:
Many patients experience significant improvements from the first session, making ANF Therapy®️ an effective option for those seeking immediate relief.
This Therapy aims to address acute symptoms and promote long-term health benefits by correcting underlying dysfunctions.
5-Safe for All Ages:
ANF Therapy ®️is safe for individuals of all ages, from children to the elderly, and can be used without concerns about age-specific contraindications.
6-Customized Treatment Plans:
Each treatment plan is tailored to the individual’s specific condition and needs, ensuring optimal results without unnecessary interventions.
Join ANF Therapy®️ as a healthcare professional:
ANF Academy provides comprehensive training for medical professionals in the field of frequency medicine, with a focus on neurological oscillations, neurochemical processes, and advanced palpation skills. The ANF Clinical Training Program is designed to equip practitioners with the necessary expertise to effectively manage injuries and inflammation, ensuring optimal patient outcomes.
Training highlight:
- Master advanced techniques in neurological examination.
- Distinguish between healthy and inflamed nerves.
- Analyze the physical effects of disrupted neurological oscillations.
- Identify and address the root causes of pain and pathology.
For more information, please visit www.anfacademy.com
References:
About Authors
Writer:
Dr. Shahzaib Nasir
Dr. Shazaib Nasir, MBBS, RMP, is a medical writer at ANF Academy. He graduated from Multan Medical and Dental College, Pakistan. He works as a medical officer in the Oethpaedics department at Ibn-e-sina Hospital and Research Institute, Multan. He deals with patients suffering from chronic orthopaedic problems and pain. He is passionate about healthy eating and exercising. Moreover, he believes that frequency medicine can be the future of Orthopaedics.
Editor:
Dr. Shama Nosheen
Dr. Shama Nosheen, MBBS, RMP, is a skilled medical editor and writer at ANF Academy, specializing in medical communications. For 5 years, she has been working with renowned international healthcare companies as a medical writer, aiming to bridge the gap between patients and doctors. She is a graduate of Nishtar Medical University Multan. She grabbed American Board certification (ABAMS) in Aesthetic Medicine after graduation. Working with ANF Academy, she has developed a thorough understanding of ANF Therapy® that works on the principles of frequency medicine.
Reviewer:
PT. Irina Heinisuo Berná
Her background includes a Degree in Physiotherapy and a Master’s in Innovation and Research in Health Sciences, enriching her expertise in holistic health care. At ANF Academy, she seamlessly integrates clinical practice, academic teaching, and research into her daily activities to shape the future of ANF Therapy®. Irina’s work symbolizes integrating education and compassionate care to improve global health outcomes.
Final Reviewer:
Dr. Mikel H-G Hoff
Dr. Mikel H-G Hoff, Founder of ANF Therapy®, holds a bachelor’s degree in medicine and a Ph.D. in biochemistry, specializing in the bio function of the human body, specifically the neurological system. He is a manual therapist and sports psychologist. He is committed to revolutionizing healthcare by educating medical professionals and directly treating patients to enhance their quality of life. His extensive background in sports injury therapy, manual therapy, and various medical specializations, including biochemistry and nerve system signalization, empowers him to deliver pain-free solutions and lasting patient outcomes.
