RA is the local expression of the general imbalance of the human body. Once the abnormal immune response has become established (which may take several years before any symptoms occur), plasma cells derived from B lymphocytes produce RF and ACPA in large quantities. Once the inflammatory reaction is established, the synovium thickens, the cartilage and the underlying bone begin to disintegrate and evidence of joint destruction accrues.

Typically in RA progression, the process of disease attack is often from small joints to large joints. Small joints of the hands and feet are most commonly involved (proximal interphalangeal joints, and metacarpophalangeal or metatarsophalangeal), followed by wrists and ankles, elbows, knees and shoulders, but almost any joint can be affected.

It is reported that 36 of 256 RA patients (14.1%) had self-limiting arthritis [1]. Within the process of improvement, the recovery process is often from large to small joints [1] [2] [3].

In recovery process, massage and exercise can induce diffusion of the immune complex, then increased antigen would cause the secondary immunity.

Meanwhile, we must pay attention to the same shape trauma which can cause secondary response to the whole body just like Koebner response or the isomorphic response which were found in Psoriasis, Juvenile idiopathic arthritis, vascular inflammatory