Rheumatoid Arthritis

Author: K. Zbinden

Definition 

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic inflammatory joint disease and is one of the most common rheumatic diseases. It is also referred to as chronic polyarthritis, as several joints are usually affected at the same time or one after another. The clinical picture of arthritis is primarily characterized by persistent joint inflammation, which, if left untreated, can lead to pain, swelling, restricted movement, and, in the long term, joint damage.

Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks the body’s own structures. In chronic rheumatoid arthritis, this misguided immune response is directed primarily against the synovial membrane. The synovial membrane lines the joint from the inside and produces synovial fluid, which is important for nourishing the cartilage and ensuring smooth gliding of the joint surfaces. Due to the immune system’s misdirection, inflammatory substances migrate into the synovial membrane and trigger chronic inflammation there. The synovial membrane swells, thickens, and produces more synovial fluid. At the same time, additional immune cells and inflammatory messengers are attracted, which sustains the inflammation itself. Over time, the thickened synovial membrane can attack the joint cartilage, adjacent bones, and surrounding structures such as ligaments and tendons. This leads to progressive joint damage and can cause pain, restricted movement, loss of strength, and joint deformities. The disease often occurs symmetrically, for example in both hands, both wrists, or both feet. For this reason, it is often associated in everyday language with rheumatism, joint rheumatism, or polyarthritis.

Healthy joint / Rheumatoid arthritis

1. Synovial membrane
2. Synovial fluid
3. Cartilage
4. Joint capsule
5. Joint bone
6. Inflamed synovial membrane
7. Inflammatory substances
8. Immune cells
9. Destroyed cartilage and bone

Rheumatoid arthritis can occur at any age, but it often begins in middle adulthood. Women are affected more often than men. Early rheumatoid arthritis is not always recognized immediately because the first symptoms are often nonspecific. A characteristic feature is that the disease can progress in flare-ups. Such a rheumatic flare-up can be accompanied by increased pain, inflammation, and a significant restriction of mobility. The course of rheumatoid arthritis varies greatly from person to person. Some people experience long stable phases, while others have recurring flare-ups and progressive symptoms. The stages of rheumatoid arthritis can also differ depending on inflammatory activity, joint involvement, and treatment success.

The diagnosis of rheumatoid arthritis is made through medical assessment. Symptoms, physical examination, blood values, and imaging procedures are taken into account. Early evaluation is important, as appropriate rheumatoid arthritis treatment can positively influence the course of the disease and prevent joint damage as much as possible. The disease is generally not life-threatening. Nevertheless, it can become chronic and significantly affect quality of life. Thanks to modern medicine and targeted rheumatoid arthritis therapy, life expectancy with rheumatoid arthritis is usually much better today than it used to be. Crucial factors are an early rheumatoid arthritis diagnosis, consistent medical care, and a holistic treatment approach. In addition to drug therapy, this includes exercise, physiotherapy, joint-friendly everyday strategies, and supportive measures to maintain mobility.

Causes of rheumatoid arthritis 

The exact causes of rheumatoid arthritis have not yet been fully clarified. However, researchers assume that it is a multifactorial disease. This means that various genetic, immunological, hormonal, and environmental factors can contribute to the development of the disease. There is usually no single cause of rheumatoid arthritis. Rather, the disease develops through a complex interaction of several influences. A central role is played by a misdirection of the immune system. Why the immune system suddenly recognizes the body’s own structures as foreign and attacks them has not yet been conclusively clarified. Experts assume that a genetic predisposition together with various external influences can contribute to triggering the disease.

Genetic factors can also play a role in the development of rheumatoid arthritis. People with certain hereditary predispositions have an increased risk of developing chronic polyarthritis. Nevertheless, a genetic predisposition does not automatically mean that the disease will actually break out. Often, additional triggers are required for the condition to develop. The most important risk factors for rheumatoid arthritis include smoking, chronic inflammatory processes, certain infections, hormonal influences, and a family history of the disease. Obesity, stress, and changes in the immune system are also discussed as possible contributing factors. These influences can increase the risk of the disease developing in predisposed individuals.

Overall, the causes of rheumatoid arthritis show that it is a complex interaction of various factors. Reliable prevention of rheumatoid arthritis in the sense of complete prevention is therefore not possible. Nevertheless, a smoke-free lifestyle, regular exercise, a healthy body weight, a balanced diet, and early medical evaluation can help reduce the risk or positively influence the course of rheumatoid arthritis.

Symptoms of rheumatoid arthritis 

The symptoms of rheumatoid arthritis are varied and can differ significantly from person to person. They depend, among other things, on inflammatory activity, the affected joint area, general health, possible accompanying conditions, and the previous course of rheumatoid arthritis.
The symptoms of rheumatoid arthritis primarily affect joints, tendons, and joint-adjacent structures. Since it is a chronic joint inflammation, pain, swelling, morning stiffness, and restricted movement can persist for a long time. A diagnosis of rheumatoid arthritis is usually made through a medical examination, blood values, imaging procedures, and an assessment of the typical symptoms. Early rheumatoid arthritis in particular should be taken seriously, as timely treatment can positively influence the further course.
The most common symptoms of rheumatoid arthritis are listed below. However, it is important to note that atypical symptoms can also occur and that the list is not exhaustive.

• ◉ Joint pain: Inflammatory pain often occurs in several joints. The hands, fingers, wrists, feet, toes, or knees are particularly often affected. This rheumatic pain can become worse at rest, during movement, or during a rheumatic flare-up.
• ◉ Swollen joints: A typical joint inflammation is shown by swelling, warmth, and tenderness. Swollen joints can feel tight and significantly restrict mobility.
• ◉ Morning stiffness: Many affected people feel stiff and immobile after waking up. This morning stiffness often lasts longer than 30 minutes in chronic rheumatoid arthritis and usually improves only with gentle movement.
• ◉ Symmetrical symptoms: A characteristic feature of joint rheumatism is that symptoms often occur on both sides of the body. For example, both hands, both wrists, or both feet can be affected at the same time.
• ◉ Symptoms in fingers and hands: In the early stages, pain, swelling, or stiffness often appears in the metacarpophalangeal and proximal interphalangeal joints. Everyday activities such as gripping, writing, opening bottles, or fastening buttons can become difficult as a result.
• ◉ Restricted mobility: Pain, swelling, and inflammation can make joints less mobile. As polyarthritis progresses, deformities or permanent functional limitations can also develop.
• ◉ Fatigue and exhaustion: Rheumatoid arthritis is not only a joint disease. Many affected people also experience pronounced fatigue, exhaustion, and a general feeling of illness. These symptoms can be particularly severe during a rheumatic flare-up.
• ◉ Feeling of warmth and tenderness: Inflamed joints can feel warm and be sensitive to touch. These symptoms of rheumatoid arthritis are caused by active inflammation in the joint.
• ◉ Rheumatoid nodules: Some people develop so-called rheumatoid nodules, often at pressure points such as the elbows, fingers, or forearms. They occur especially in long-standing or more severe chronic polyarthritis.
• ◉ Tendon and muscle complaints: Inflammation can also affect tendon sheaths, bursae, and surrounding soft tissues. This can lead to pain, loss of strength, or a feeling of instability in the affected area.
• ◉ General feeling of illness: Some affected people report loss of appetite, mild fever, fatigue, or flu-like symptoms. These symptoms can indicate that the inflammation is active not only locally in the joint but throughout the body.
• ◉ Skin changes: A rheumatoid arthritis rash is not among the most common symptoms, but it can occur in connection with inflammatory accompanying reactions, vasculitis, or certain medications.
• ◉ Flare-up pattern: Symptoms can vary in severity. During a rheumatic flare-up, pain, swelling, stiffness, and exhaustion often increase significantly. Afterwards, calmer phases may follow again.
• ◉ Long-term joint changes: If the inflammation is not sufficiently controlled, it can damage cartilage, bone, and ligaments. That is why early rheumatoid arthritis treatment is important in order to influence the course of the disease as favorably as possible.

The symptoms of polyarthritis can vary greatly depending on the cause. In rheumatoid arthritis, however, inflammatory joint complaints, morning stiffness, swelling, and possible involvement of several joints are the main focus. A careful diagnosis of rheumatoid arthritis is therefore crucial in order to classify the symptoms correctly and initiate appropriate rheumatoid arthritis therapy.

Conventional therapies - What helps with rheumatoid arthritis 

Various conventional therapy approaches are available to treat rheumatoid arthritis. The goal of rheumatoid arthritis therapy is to control inflammation, relieve pain, maintain mobility, and prevent long-term joint damage as much as possible. Early rheumatoid arthritis diagnosis is particularly important, as treatment started in time can positively influence the further course and prognosis of rheumatoid arthritis.

The treatment of rheumatoid arthritis depends on inflammatory activity, the affected joints, the stage of the disease, possible accompanying conditions, and the individual needs of the person affected. Since chronic polyarthritis can progress very differently, therapy is usually adapted individually. A combination of medication, exercise, physiotherapy, everyday aids, and regular medical monitoring is often recommended. Medical consultation is essential in order to find the appropriate treatment for the individual case.
The following presents some proven measures of polyarthritis therapy. The list is not exhaustive, as different therapies may be useful depending on the severity of symptoms, the stage of rheumatoid arthritis, and the personal situation.

• ◉ Drug therapy: Rheumatoid arthritis medications often form the basis of treatment. These include anti-inflammatory drugs, painkillers, cortisone preparations, and so-called disease-modifying drugs. These are intended not only to relieve symptoms but also to slow inflammation and prevent joint damage as much as possible.
• ◉ Biologics and modern immunotherapies: If conventional medications do not work sufficiently, biologics or other targeted immunotherapies may be used. They intervene specifically in certain inflammatory mechanisms and can help reduce disease activity in active chronic rheumatoid arthritis.
• ◉ Pain therapy: In the case of severe rheumatic pain, pain-relieving medications, local applications, or complementary therapeutic procedures can be used. The goal is to reduce pain and improve mobility in everyday life.
• ◉ Physiotherapy: Targeted exercises help maintain joint mobility, strengthen muscles, and reduce incorrect loading. Physiotherapy is an important part of chronic polyarthritis therapy, especially when mobility, strength, or coordination are limited.
• ◉ Exercise therapy: Regular, joint-friendly exercise can help reduce stiffness, promote circulation, and improve general resilience. Suitable options include walks, water aerobics, light strength training, cycling, or individually adapted exercises.
• ◉ Occupational therapy: Occupational therapy helps affected people manage everyday activities better despite their symptoms. This includes joint-friendly movement patterns, aids, ergonomic adjustments, and strategies to protect the joints.
• ◉ Patient education: Good information about rheumatism, joint rheumatism, and the polyarthritis clinical picture strengthens self-management skills. Affected people learn to better recognize warning signs of a rheumatic flare-up, use medication correctly, and shape everyday life consciously.
• ◉ Cold or heat therapy: In acute inflammation, cold can help relieve swelling and pain. Heat is more often used for muscle tension or chronic stiffness.
• ◉ Nutritional counseling: A balanced, anti-inflammatory diet can support arthritis treatment. Foods often recommended include plenty of vegetables, high-quality plant oils, omega-3 fatty acids, sufficient protein, and as little highly processed food as possible.
• ◉ Weight management: A healthy body weight can relieve pressure on the joints and promote overall health. Especially with complaints in the feet, knees, or hips, weight reduction can reduce strain in everyday life.
• ◉ Regular medical check-ups: Since chronic polyarthritis can progress in flare-ups, regular follow-up examinations are important. Symptoms, joint status, blood values, inflammatory activity, and the effect of the medication are monitored.
• ◉ Treatment of accompanying conditions: People with rheumatic diseases may also develop other health problems, such as cardiovascular disease, osteoporosis, or exhaustion. Holistic care therefore considers not only the joints but the whole person.
• ◉ Orthopedic aids: Splints, insoles, supports, or specially adapted shoes can help relieve pressure on affected joints and prevent deformities. Such aids can make everyday life easier, especially with complaints in the feet, toes, or hands.
• ◉ Operations: If joints are severely damaged or conservative measures are no longer sufficient, surgical procedures may be necessary. These include, for example, joint replacement, tendon surgery, or correction of deformities.
• ◉ Lifestyle and self-management: Enough sleep, stress reduction, not smoking, regular exercise, and conscious handling of strain can support medical treatment. Even if complete prevention of rheumatoid arthritis is not always possible, such measures can help manage everyday life with the disease better.

Modern polyarthritis therapy has developed significantly in recent years. As a result, many affected people can now lead active lives despite chronic polyarthritis. What is crucial is that the diagnosis of rheumatoid arthritis is made early and that therapy is followed consistently, individually, and over the long term.

kybun mode of action - What helps with rheumatoid arthritis 

kybun products address the areas where many people with rheumatoid arthritis, chronic polyarthritis, or joint rheumatism are particularly burdened in everyday life: pain, restricted mobility, swollen joints, morning stiffness, and reduced resilience. Thanks to the elastic springy sole, kybun shoes can gently relieve the musculoskeletal system while simultaneously promoting natural, active movement. This special combination can help people with rheumatism stay active despite symptoms, mobilize the joints gently, and activate the muscles.

In rheumatoid arthritis, the medical focus is on controlling inflammation. kybun products therefore do not replace medical evaluation, rheumatoid arthritis medications, or individually adapted rheumatoid arthritis therapy. However, they can be used as a complementary measure in everyday life to make movement more comfortable, reduce pressure peaks, and relieve the joints when walking and standing. Especially in chronic rheumatoid arthritis, this can help positively influence the vicious cycle of pain, protective posture, and lack of exercise.
The following shows the most important effects of kybun products in rheumatoid arthritis, polyarthritis, and other rheumatic diseases.

• ◉ Promoting movement and reducing sedentary behavior

  Regular, joint-friendly movement is an important part of arthritis treatment and polyarthritis therapy. Movement can help maintain joint function, strengthen muscles, reduce stiffness, and improve general resilience. Inactivity, on the other hand, can lead to muscle loss, increasing stiffness, uncertainty when walking, and greater limitations in everyday life. The elastic springy kybun products encourage enjoyment of movement because they enable pleasant, dynamic standing and walking. The elastic springy material gently activates the musculoskeletal system without placing unnecessarily hard stress on the joints. For people with rheumatoid arthritis symptoms such as morning stiffness, joint pain, or restricted mobility, this can be valuable support.
  
  Especially in everyday life, it is important to interrupt prolonged sitting again and again with short periods of movement. kybun products can help reduce sitting time and bring more natural movement into the day. This activates muscles, circulation, and metabolism. This can usefully complement chronic polyarthritis therapy and improve quality of life in everyday life.

• ◉ Activation and strengthening of muscles through elastic springiness

  An elastic springy surface such as that of kybun products can gently activate the muscles. When standing and walking on the elastic springy material, small compensatory movements occur that prompt the body to continuously stabilize balance. This particularly engages the foot, leg, pelvic, and trunk muscles.
  In rheumatoid arthritis, well-functioning muscles are especially important. They support the joints, improve stability, and can help reduce incorrect loading. Especially with swollen joints, pain, or uncertainty when walking, many affected people adopt protective postures. These can promote additional discomfort in the feet, knees, hips, or back.
  Through the gentle muscle activation of kybun products, active stabilization of the body is promoted. The feet play a central role here, as they form the basis of posture. Better activation of the foot muscles can have a positive effect on the leg axis, posture, and movement pattern. In joint rheumatism and chronic joint diseases, this can help support the musculoskeletal system better in everyday life.

Balance and EMG

Balance ability was measured with a force plate by tracking the movement of the body’s centre of mass from front to back (ant-post) and side to side (med-lat) while standing. An electromyography (EMG) simultaneously recorded muscle activity.

With conventional shoes

1. Reduced muscular activity
2. Reduced range of movement of the body's centre of mass

With kybun shoes

1. Increased muscular activity
2. Increased range of movement of the body's centre of mass

• ◉ Reduction of impact forces from hard floors through cushioning effect

  Hard, flat floors transfer impact forces through the soles of the feet to the ankles, knees, hips, and spine with every step. For people with polyarthritis symptoms or rheumatic pain, these repeated loads can be unpleasant and make movement more difficult. Especially with inflamed or sensitive joints, a hard surface can make walking feel strenuous.
  
  The elastic springy sole of kybun shoes counteracts this effect. When the foot lands, the heel sinks gently into the elastic springy material, which reduces and slows the impact force. This cushioning provides noticeable relief, especially for complaints in the feet, knees, hips, or back. At the same time, the impact energy is absorbed by the elastic springy sole and released again for the rolling motion.
  
  The elastic springy effect also supports a more even distribution of force while walking. Overloaded structures such as joints, tendons, ligaments, and muscles can thus be spared. Especially in chronic polyarthritis, where several joints may be affected, comfortable and joint-friendly movement in everyday life is particularly valuable.

• ◉ Natural foot roll thanks to muscle activation and rolling function

  When walking in kybun shoes, the foot sinks slowly and in a controlled manner into the elastic springy material. This delayed sinking not only reduces the sudden load on impact, but also gives the muscles more time to respond actively to the movement. As a result, the movement can be controlled more precisely and the foot and leg muscles can contribute better, supporting a natural, controlled rolling motion.
  
  In rheumatoid arthritis, pain, swelling, or stiffness can cause affected people to roll the foot less naturally. Especially with complaints in the forefoot, toes, or metatarsal heads, the gait pattern can change. An unfavorable rolling motion can in turn lead to additional strain on the knees, hips, or back. kybun products can help promote a softer, more controlled, and more harmonious rolling motion. This makes the movement sequence smoother and distributes the load better across the entire foot. This can help people with polyarthritis symptoms move more safely and comfortably.

• ◉ Optimized pressure distribution

  The elastic springy kybun soles evenly envelop the sole of the foot, as the entire foot can sink into the unique material. This supports the longitudinal and transverse arches and ensures optimized pressure distribution when standing and walking. By increasing the foot’s contact surface, body weight is distributed more evenly and localized pressure peaks are reduced. This is especially important when the feet are sensitive, swollen, or painful under pressure due to rheumatoid arthritis, polyarthritis, or chronic joint inflammation in the heel, forefoot, metatarsal heads, or metatarsophalangeal joints.
  
  With rheumatoid arthritis symptoms such as pain, warmth, tenderness, or swollen joints, softer pressure distribution can make everyday life easier. It enables gentler standing and walking and can help reduce protective postures. This makes movement not only more possible, but often experienced more positively again.

with kybun

without kybun

Blue/Green areas: Low-pressure load. Foot soles are protected and put under less pressure.

Yellow areas: Average pressure load. To prevent calluses and pressure points, ensure relief.

Red areas: Excessive pressure. Leads inevitably to chronic strain reactions over longer periods.

• ◉ Care and protection of the fascia

  Fascia are connective tissue structures that connect muscles, joints, and other areas of the body. They play an important role in mobility, force transmission, and body awareness. With lack of exercise, protective postures, or one-sided strain, fascia can lose elasticity and further intensify discomfort in the musculoskeletal system.
  
  Walking on the elastic springy surface of kybun products creates gentle, rhythmic movement impulses. These can stimulate the fascial tissue, promote mobility, and support the gliding ability of the tissue layers. In people with rheumatism, joint rheumatism, or chronic rheumatoid arthritis, this can help keep the musculoskeletal system more supple. Especially when pain and stiffness lead to less movement, regular gentle activation is important. kybun products enable movement in everyday life without necessarily requiring additional training time. This means fascia, muscles, and joints can be continuously stimulated. This can complement rheumatoid arthritis treatment and positively influence the overall body feeling.

• ◉ Promotion of circulation through increased movement activity

  The deliberate instability of the elastic springy material leads to increased muscle activation in order to stabilize the body. This activity stimulates the muscle pump and can support circulation in the feet, legs, and the entire musculoskeletal system.
  
  Good circulation is important so that muscles, fascia, and joint-adjacent structures are supplied with oxygen and nutrients. At the same time, movement supports the removal of metabolic products. In chronic joint diseases and inflammatory complaints, regular, adapted activity can help reduce stiffness and improve well-being.

Application tips for rheumatoid arthritis 

Before wearing kybun shoes for the first time, you should consider a few application tips. Especially with rheumatoid arthritis, chronic polyarthritis, or joint rheumatism, it is important to gradually accustom the body to the elastic springy surface. Correct use can help gently relieve the joints, activate the muscles, and make movement in everyday life more comfortable. In the case of severe pain, pronounced swelling, acute inflammation, or a rheumatic flare-up, use should be cautious and, if necessary, discussed with a medical professional.

• ◉ Start with short wearing times and increase them gradually. At the beginning, wear the kybun shoes only as long as your body allows. With rheumatoid arthritis symptoms such as pain, morning stiffness, swollen joints, or rapid fatigue, the musculoskeletal system needs time to get used to the activating effect of kybun products. Take breaks from wearing them if symptoms increase or the joints feel overstrained. The elastic springy sole gently activates the muscles, which can lead to unfamiliar reactions, especially at the beginning.
• ◉ Make sure the joints are loaded comfortably. With arthritis, polyarthritis, and other chronic joint diseases, movement should always be dosed and joint-friendly. The kybun shoes are intended to help you move more naturally and comfortably. However, if significant pain, warmth, or swelling occurs, reduce the wearing time and give the affected joints rest.
• ◉ Gently press the heel into the elastic springy material when landing. Consciously feel how the foot sinks into the sole and how the cushioning of the kybun shoes is used. This can reduce hard impact forces and relieve structures such as muscles, tendons, ligaments, fascia, joints, and bones.
• ◉ Roll the foot slowly and in a controlled manner. Make sure that the foot does not tilt inward or outward during the rolling phase. Guide the movement from the heel over the midfoot to the forefoot as calmly as possible and avoid uncontrolled dropping of the foot. A smooth, controlled rolling motion can help distribute the load better and reduce protective postures. If you have complaints in the forefoot or sensitive toe joints, the rolling motion should only go as far as is comfortably possible.
• ◉ At the beginning, prefer shorter steps. Shorter steps promote stability, balance, and coordination. Especially with chronic rheumatoid arthritis, restricted mobility, or uncertainty when walking, this can help avoid overloading the feet, knees, hips, or back. As you become more accustomed, the step length can be gradually adjusted.
• ◉ Use movement consciously, but without overexertion. kybun products can help integrate more movement into everyday life. However, it is important that movement is not forced. With rheumatoid arthritis, better and worse days often alternate. On days with more symptoms or during a rheumatic flare-up, a shorter wearing time may be useful. On better days, activity can be increased slowly.
• ◉ Over time, try to roll more actively over the forefoot. An active rolling motion can promote the range of motion in the foot, knee, hip, and spinal joints. This gently mobilizes the entire musculoskeletal system. If active rolling is not possible due to pain, swelling, deformities, or other limitations, reduce the movement over the forefoot and stay within a comfortable range of motion.
• ◉ Observe your joints after wearing them. Pay attention to how your feet, knees, hips, and back respond to the kybun shoes. Mild muscular fatigue can be normal at the beginning. However, increasing joint pain, new swelling, or a clear worsening of symptoms should be taken seriously. In this case, it is advisable to pause use and seek medical advice.
• ◉ Combine kybun with your existing therapy. kybun products can complement rheumatoid arthritis therapy in everyday life, but they do not replace medical care, individually prescribed rheumatoid arthritis medications, or physiotherapeutic measures. Especially with a newly diagnosed rheumatoid arthritis or a changed symptom pattern, use should be coordinated with the treating professional.
• ◉ Be patient and listen to your body. The course of rheumatoid arthritis is individual. Some people get used to kybun shoes quickly, while others need more time. What matters is that use remains comfortable and is built up step by step. In this way, kybun products can help make movement feel more positive again and make everyday life with rheumatism, chronic polyarthritis, or joint rheumatism more active.

For kybun beginners

Wearing kybun shoes changes your gait from protective to natural. In 90% of cases this occurs without problems.

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