Rheumatoid arthritis is a chronic inflammatory disease that causes inflammation in multiple joints, including those in the hands, wrists, feet, and ankles. The exact cause is still unknown, but autoimmune mechanisms are considered a primary factor. An autoimmune response occurs when the immune system, which usually protects the body from external threats, mistakenly attacks the body itself.
The main issue in chronic rheumatoid arthritis is systemic joint involvement, with synovial and vascular proliferation and the absorption of cartilage and bone. This chronic systemic inflammatory condition, with no known cause, is marked by these characteristics. Although joint inflammation may naturally subside in some cases, persistent inflammation leads to progressive joint destruction, deformity, and functional impairment. Extra-articular symptoms, such as rheumatoid nodules, arteritis, neuritis, scleritis, pericarditis, lymphadenopathy, and splenomegaly, are also common. These symptoms are not considered complications but are now understood to be intrinsic to the nature of chronic rheumatoid arthritis.
Epidemiologically, it affects an estimated 0.3–1.5% of the population, with female prevalence rates 2–3 times higher than males. The peak incidence for females occurs between the ages of 30–50, while males experience a secondary peak incidence after age 50. The occurrence within families is relatively high, and monozygotic twins also show higher than expected incidence rates, suggesting that a combination of genetic predisposition (e.g., HLA-DR4 antigen) and environmental factors likely contribute to the condition.
Since the cause is unknown, Western medicine currently lacks causative or definitive treatments. NSAIDs are used as symptomatic treatment for polyarthritis pain. Immunosuppressants such as D-penicillamine, Carfenil, Bucillamine, Salazopyrine, and Methotrexate, along with corticosteroids, are also commonly used in various combinations to manage immune abnormalities.
In traditional Korean medicine, herbal prescriptions are tailored to each case to provide pain relief, improve overall health, and reduce side effects from Western medications. Acupuncture is used to alleviate joint pain and treat surrounding ligaments, tendons, and fascia affected by excessive strain. Acupuncture can enhance local circulation in the affected areas, helping to reduce inflammation and providing analgesic effects.
Treatment Case: 54 year old female
The patient was a 54-year-old woman with a medication allergy to cold remedies, making it difficult for her to use Western medicines. She developed joint pain in her right hand in March, followed by morning stiffness and swelling in the proximal interphalangeal joints of both hands. She was prescribed NSAIDs and Bucillamine at a nearby clinic but developed a rash a week later, leading to discontinuation of the medications. Seeking herbal treatment, she visited a traditional medicine clinic. At stage 3 chronic rheumatoid arthritis, her ESR was 85 mm/hr, CRP was 6.35 mg/dl, and her rheumatoid factor was 228 IU/ml, indicating high disease activity. The patient had facial flushing, frequent dry mouth, and a floating pulse, with warmth in the swollen joints, so she was given Wolbigachangbu-tang. After five months, her joint pain significantly improved, although there was no improvement in lab results, so the prescription was changed to Doheakseunggi-tang. Subsequent tests gradually showed improvement, and after three years, her ESR was 7 mm/hr, CRP was negative, and disease activity had subsided. She continues to experience stable progress to this day.
Korean Acupuncture & Wellness Clinic
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