Rheumatoid arthritis (RA) is an autoimmune disease with unclear etiology. It falls under the category of chronic rheumatic diseases, a significant concern in both contemporary and Traditional Chinese Medicine (TCM). In TCM, it is categorized as a type of "Bi Syndrome," and acupuncture has shown significant efficacy in its treatment, backed by extensive experience.
RA can potentially affect various joints throughout the body, necessitating different acupuncture points and methods depending on the affected joints. Acupuncture plays a vital role in managing RA for several reasons. Firstly, early stages of the disease can be effectively controlled by acupuncture, which is crucial for preventing the destruction of bones and cartilage in the affected joints. Secondly, as RA is often chronic and prone to relapses, long-term use of anti-inflammatory medications or steroids can have significant side effects. In contrast, acupuncture can be administered long-term without any side effects. Thirdly, acupuncture shows considerable rehabilitation effects in later stages of RA, characterized by joint ankylosis and muscle contractures. However, it is challenging to reverse joint bone damage or softening solely through acupuncture.
Apart from affecting larger joints, RA frequently involves smaller joints as well. Similar to treating larger joint arthritis, direct acupuncture on small joint areas is key to achieving rapid effectiveness in treating small joint arthritis.
Joint ankylosis deformity is often a severe consequence in the later stages of RA. Acupuncture, especially when combined with massage therapy, can be effective in such cases. The treatment approach varies across different stages. In the initial stages, when the patient experiences intense pain and general weakness, the focus is on pain relief and strengthening the body through acupuncture. Once the pain is under control, the therapy aims to gradually release the ankylosed joints, starting with the knees to restore walking function and subsequently addressing the neck, shoulders, and other joints.
It's important to note that joint ankylosis is not irreversible. Sometimes, it resembles a situation where hinges are rusted and lack flexibility. With appropriate passive traction, the "rusted" joints can gradually be loosened. However, the force applied should not be too strong; it should be tolerable for the patient and yet effective, avoiding the risk of tearing contracted tendons or causing fractures.
Engaging the patient's active participation and encouraging regular exercise in conjunction with treatment significantly enhance therapeutic outcomes. As RA is prone to recurrence, measures to consolidate the therapeutic effects are crucial. Therefore, patients nearing recovery should persist with the treatment until local tenderness points have largely disappeared, ensuring more stable and lasting effects. Additionally, patients should be advised to keep the joints warm, avoid exposure to cold or the use of ice packs, and eliminate factors that might trigger a relapse.
The mechanism of acupuncture in treating RA includes enhancing the body's immune function and improving hemodynamics. Acupuncture promotes blood circulation to remove stasis, thereby achieving therapeutic goals.
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