[Kim Jaeho's Life Story]<173> The Nature of Rheumatoid Arthritis

Among numerous arthritis patients, rheumatoid arthritis is the third most common after osteoarthritis and gout, the most common among inflammatory arthritis types, and a uniquely distinct form of arthritis in many aspects. It is estimated that about 1% of the global population suffers from this arthritis. In 2018, the number of rheumatoid arthritis patients receiving treatment in South Korea was 240,000, accounting for 5% of the total 4.86 million arthritis patients, with female patients being about three times more numerous than male patients.

Unlike osteoarthritis, which mostly affects older patients, rheumatoid arthritis can occur at any age regardless of age, and many patients are under 50 years old. Osteoarthritis commonly occurs in the hip, knee joints, and finger joints, progresses slowly, causes mild pain, and little swelling. In contrast, rheumatoid arthritis frequently affects the small joints of the hands and feet symmetrically, progresses relatively quickly, causes severe pain, and significant swelling.

The unique characteristics of rheumatoid arthritis stem from its distinctive cause. Autoimmune diseases are conditions in which immune cells, designed to attack various bacteria and cancer cells entering from outside, mistakenly attack normal cells. Rheumatoid arthritis is one such autoimmune disease that attacks the joints.

The medical community continuously researches the cause of the alteration in immune cells of rheumatoid arthritis patients, which leads them to attack normal cells instead of bacteria or cancer cells, but so far, the cause of this alteration remains largely unknown. Agencies like the U.S. Centers for Disease Control and Prevention (CDC) only point to risk factors that increase the likelihood of onset, such as age, female gender (especially those who have not given birth), genetics, smoking, early childhood risk exposures, and obesity.

Rheumatoid arthritis is treated with various medications without knowing the exact cause of onset, and no drug has yet been developed to restore the altered immune cells to normal. Medications generally aim to suppress joint inflammation, relieve pain, reduce functional loss, and slow or prevent joint damage. However, their effects are often limited, so complementary treatments such as nutritional support, rest, and physical therapy are used together.

Medications include various types such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (steroids), and disease-modifying antirheumatic drugs (DMARDs), but none are curative. Using steroids, which are immunosuppressants, can kill immune cells and temporarily reduce joint attacks, appearing effective. However, prolonged use can lead to fatal consequences when infected by bacteria, so their use should be limited.

To supplement the limitations of drug treatment and improve quality of life, various methods such as regular exercise, smoking cessation, maintaining a healthy weight, rest, healthy diet, cold and heat therapy, meditation, and acupuncture are utilized.

Despite drug treatments and these various therapies, treatment outcomes for rheumatoid arthritis remain unsatisfactory. As acknowledged by the medical community, rheumatoid arthritis does not heal with current treatments, so cure is not the goal of therapy. Even when symptoms are alleviated and quality of life is somewhat maintained, rheumatoid arthritis often continues to progress.

Although the medical community admits to limited understanding, what is the cause of the altered, or more bluntly, "crazy," immune cells that cause rheumatoid arthritis? How about considering this from the perspectives of psychoneuroimmunology and the World Health Organization (WHO)’s definition of health?

Psychoneuroimmunology focuses on the fact that the central nervous system, composed of brain cells and the spinal cord, communicates with the immune system, studying the interactions between these two systems. Research has revealed that physical and mental stress substantially affect the immune system in many cases. The WHO emphasizes the interdependence of physical, mental, social, and spiritual health in its definition of health.

From the research results of psychoneuroimmunology and the WHO’s perspective on health, it is advisable to consider that problems arising in mental, social, and spiritual aspects significantly influence the cause of the immune cells’ dysfunction. Therefore, for the prevention and healing of rheumatoid arthritis, rather than relying solely on the limited effectiveness of drug treatments, lifestyle changes should be made to improve the physical, mental, and spiritual environment of immune cells (see Life Story episodes 78 and 171).

Kim Jae-ho, Independent Researcher

This content was produced with the assistance of AI translation services.