Osteoarthritis

 ost

Osteoarthritis

Osteoarthritis is the one most common type of arthritis. It is often called as degenerative joint disease because it will occur as a result of degeneration of the joint either by aging or by injury or some other reason like obesity etc.

Osteoarthritis mostly affects cartilage. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over each other. It also helps absorb shock of movement. In osteoarthritis, the top layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together. The rubbing causes pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, bone spurs may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space, which causes more pain and damage.

According to Ayurveda arthritis in included in vata roga i.e. this is a disease caused by the aggravation of vata dosha. Osteoarthritis is also called as Sandhivata or sandhigata vata. Sandhivata if formed by two words Sandhi means the joint and Vata stands for Vata Dosha. Vata is an Ayurvedic humor that symbolizes air or wind and governs all movements in the body as well as mind. The condition of Sandhivata is caused when the activities of Vata increase inside the Sandhis or joints. Because Vata is dry in nature, it absorbs the fluidity from any part of the body. The nature of vata is destructive or catabolic, due to which it causes destruction of the cartilages and reduction in the Synovial Fluid inside the joint capsule.

Osteoarthritis can range from very mild to very severe, and most commonly affects middle-aged and older people. It commonly affects hands and weight-bearing joints such as knees, hips, feet and the back.

Those over 60 years old about 10% of males and 18% of females are affected. Before 45 years of age it is more common in men, while after 45 years of age it is more common in women. It becomes more common in both sexes as people become older.

Causes

Osteoarthritis usually happens gradually over time, but some factors which predispose the condition are:

  • Being overweight
  • Getting older
  • Joint injury/ trauma
  • Joints that are not properly formed
  • A genetic defect in joint cartilage
  • Stresses on the joints from certain jobs and playing sports.
  • Excessive consumption of dry, cold or stale food
  • exposure to severe cold and dry weather
  • excessive use of joint
  • heredity
  • Skin infections and bacterial infections.
  • Physical stress on joints and other damages on joints
  • hormonal changes in the body leads hypocalcaemia ( low level of calcium)
  • Ecological or environmental factor may be the cause of arthritis
  • Metabolic and nervous tissue problems.

Sign and Symptoms

Osteoarthritis symptoms often develop slowly and worsen over time .Osteoarthritis is a disease of the joints. Unlike many other forms of arthritis, such as rheumatoid arthritis and systemic lupus, osteoarthritis does not affect other organs of the body.

The most common symptom of osteoarthritis is pain in the affected joints after repetitive use causing loss of ability. Pain is generally described as a sharp ache or a burning sensation in the associated muscles and tendons .Joint pain is usually worse later in the day. OA can cause a crackling noise (called “crepitus”) when the affected joint is moved or touched and there may occur muscle spasms and contractions in the tendons. Occasionally, the joints may also be filled with fluid. There can be swelling, warmth of the affected joints. Pain and stiffness of the joints can also occur after long periods of inactivity. In severe osteoarthritis, complete loss of cartilage causes friction between bones, causing pain at rest or pain with limited motion.

OA commonly affects the hands, feet, spine, and the large weight bearing joints, such as the hips and knees. As OA progresses, the affected joints appear larger, become stiff, painful and may swell, but usually feel better with gentle use but worse with excessive or prolonged use, thus distinguishing it from rheumatoid arthritis.

In smaller joints, such as at the fingers, hard bony enlargements, called Heberden’s nodes and/or Bouchard’s nodes later on complication, may form and though they are not necessarily painful, they do limit the movement of the joint significantly. Some people notice these physical changes before they experience any pain.

OA is the most common cause of a joint effusion of the knee.

So common symptoms of osteoarthritis may include:

  • Your joint may hurt during or after movement.
  • Your joint may feel tender when you apply light pressure to it.
  • Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
  • Loss of flexibility.You may not be able to move your joint through its full range of motion.
  • Grating sensation.You may hear or feel a grating sensation when you use the joint.
  • Bone spurs.These extra bits of bone, which feel like hard lumps, may form around the affected joint.

Diagnosis

No single test can diagnose osteoarthritis. Mostly the diagnose of osteoarthritis is made clinically by the doctor with the help of:

 

  • Medical history
  • Physical exam

But some time it become hard to make the diagnosis of the osteoarthritis of uncommon joint, in such cases following aid are of great valuable:-

X rays (The typical changes seen on X-ray include: joint space narrowing, subchondral sclerosis, increased bone formation around the joint ( osteophytes formation), subchondral cyst formation, etc.Other tests such as blood tests or examination of the fluid in the joints etc. 

Treatment (Ayurvedic View)

Ayurvedic treatment of Osteoarthritis not only prevents further deterioration in the joints but also rejuvenates damage . Ayurvedic treatment focus on the vata management as vata is the main causative factor for the osteoarthritis. Vata-alleviating treatments are suggested for lubrication and strengthening of joints.

Osteoarthritis treatment has four main goals:

  • Improve joint function
  • Keep a healthy body weight
  • Control pain
  • Achieve a healthy lifestyle.

Osteoarthritis treatment plans can involve:

  • Exercise
  • Weight control
  • Rest and joint care
  • Nondrug pain relief techniques to control pain
  • Medicines

Ayurvedic Line of Treatment

To cleanse the body using Panchakarma Procedures like Snehapana, Abhyanga & Sweda follwed by Virechana, basti , raktamokshana which detoxifies the body and prepares it for Further treatment.
Internal medication to subside the aggravated doshas.
Specific treatment of massahe and hot fomentation like Podikizhi (herbal powder), Elakizhi (Herbal Leaf Bag), Pizhichil etc whch is done for a course of 3-7 days as per requirement.
In case of osteoarthritis where the swelling or stiffness will be there along with pain and other symptoms, special procedures like Dhanyamladhara, Kaadi dhara is done for to reduce swelling then it is followed by a course of Dry procedures such as Valuka Sweda , Udwarthana & Sweda .Generally procedures using oil are contra indicated in this case.
In osteoarthritis the aging of the joint and bone will occur. To rejuvenate the system treatments like Kati Basti, Katipichu, janu basti , greeva basti etc will be done.

After panchakarma Treatment internal medicine and life style modifications will be recommend like:

  • Internal Medication; Tablets Like different Guggulus and kashayas for a course of 3-6 months
  • Special vat-pacifiing medicine
  • Mild excercises and meditation techniques
  • some individual changes in daily routine

Herbal medicines which cure the patient without any side effects

In our ayurvedic classics our Ancient Acharayas has mentioned several classical ayurvedic formulations for the cure of sandhivata.  Ayurvedic  herbal preparations  cures by establishing the equilibrium of Tridosha(Vata,pitta,kapha)and sapt dhatus (body tissues), by checking the formation, accumulation and elimination of the malas in the body. Certain medicines are:

v In Ayurveda, the main treatment is vata shamak chikitsa.

  • There are several herbs named
  • Rasona
  • Gandha prasarini
  • Sunthi
  • Erand
  • Pippali
  • Rasna
  • Guggulu
  • Karanj
  • Puti karanj

There are several Classical preparations named

  • Rasnadi guggulu
  • Maha vish garbh tailam
  • Ajmodadi churna
  • Mahavatvidhvansak ras
  • Erand tailam
  • yograj guggulu
  • Bhruatvata chintamani rasa
  • Vatakulantak rasa
  • Ekangveer rasa
  • Rasnasaptak kashaya
  • Gandharvahastya kada

In Ayurveda , each and every patient is an individual entity and the treatment also differs from patient to patient.

Roga Nidaan has its different parameters. It’s not as simple as in modern medicines that any person suffering from same problem will take same medicines. In ayurveda medicine for same disease vary from person to person depending upon, Prakruti pariksha, Saar, Sahanan(Compactness), Vyayam shakti(Exercise), Agni (Digestion) parikhsa or ama nirama assessment. All these parameters are  studied by an ayurvedic specialist . An ayurvedic specialist makes a clear picture of the individual by understanding a patient as a whole and also  decides what kind of preparation either medicine or panchakarma therapies to be used for the patient.

Panchvidha Kshaya Kalpana: SWARAS(Juice),CHURNA(powder),KALK,HIM,PHANT,)  is based on this principle.

  • So emphasis should be given that patient must take the ayurvedic medicine under the guidance of an Ayurvedic physician

Lifestyle changes

For overweight people, weight loss may be an important factor. Patient education is very helpful in the self-management of arthritis.  It decreases pain, improves function, reduces stiffness and fatigue, and reduces medical usage. Patient education can provide on average 20% more pain relief when compared to analgesics or painkiller alone in patients with hip OA.

Physical measures

Moderate exercise is beneficial with respect to pain and function in those with osteoarthritis of the knee and hip. These exercises should be done at least once in a day. There is lot of effectiveness of massage therapy. Functional, gait, and balance training have been recommended to address impairments of position sense, balance, and strength in individuals with lower extremity arthritis as these can contribute to a higher rate of falls in older individuals.

People with osteoarthritis find that self-management programs help them:

  • Understand the disease
  • Reduce pain while staying active
  • Cope with their body, mind, and emotions
  • Have more control over the disease
  • Live an active, independent life.

People with a good-health attitude:

  • Focus on what they can do, not what they can’t do
  • Focus on their strengths, not their weaknesses
  • Break down activities into small tasks that are easy to manage
  • Build fitness and healthy eating into their daily routines
  • Develop ways to lower and manage stress
  • Balance rest with activity
  • Develop a support system of family, friends, and health care providers.

 Risk factors

Factors that may increase your risk of osteoarthritis include:

  • Older age.The risk of osteoarthritis increases with age.
  • Women are more likely to develop osteoarthritis, though it isn’t clear why.
  • Carrying extra body weight contributes to osteoarthritis in several ways. It puts added stress on weight-bearing joints, such as your hips and knees. In addition, fat tissue produces proteins that may cause harmful inflammation in and around your joints.
  • Joint injuries.Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
  • Certain occupations.If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
  • Some people inherit a tendency to develop osteoarthritis.
  • Bone deformities.Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
  • Other diseases.Having diabetes or other rheumatic diseases such as gout and rheumatoid arthritis can increase your risk of osteoarthritis.

Complications

Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make daily tasks difficult. Some people are no longer able to work. When joint pain is severe, doctors may suggest joint replacement surgery.

Diet recommended for Arthritis patients:

  • Food rich in proteins, minerals, vitamins are good for arthritis patients.
  • Take fibrous fruits, green vegetables, sprouts, and raw vegetable juices.
  • Ginger juice is also very beneficial in arthritis treatments.
  • Drink water in copper glasses is good for curing arthritis.
  • Avoid junk foods.
  • Good balance between work and rest is necessary, so take proper rest.
  • Maintain a healthy physical environment that let arthritis patients feel comfortable and happy, It has positive affects in arthritis treatments.
  • Fish contains omega-3 fatty acids which is an effective diet for arthritis patients.
  • Living a stress-free and happy life will make the treatment easy and successful so take the life challenges happily. Diseases have its treatment stay stress free, cool, and face the health challenges boldly.

 

 

Yoga and different exercises benefits arthritis patients:

Regularly doing yoga improves your external as well as internal system. It gives you relief from arthritis pains, back pain, asthma, etc. Performing different yogic postures, exercises, stretches warms your muscle and relives pains.

Yogic exercises are beneficial for all age group, body types. Arthritis-affected area will gain its strength back. Exercises strengthens joint bones and various muscles, it makes immune system strong (which is very helpful in arthritis cure), reduces inflammation, and has various other benefits. There are number of yoga classes where you can avail these benefits.

By regular exercises rheumatoid patients gets their body flexibility back, and there is a reduce stiffness on knee-joints.

Exercises help arthritis patients in maintaining good body weight. Light body weight reduces pressure on joints.

All this help arthritis patients in gaining self-esteem and it relieves pain and inflammation.

Diet & Lifestyle Advice

  1. Avoid carbonated drinks, preserved and packaged foods, and dry or cold food items.
  2. Choose foods that are easy to digest .
  3. Excessive use of joints and underuse are both problematic, so get some exercise each day, but do not overexert.
  4. Try exercises that are easy on the joints such as walking, swimming and yoga.
  5. Keep your weight at an optimum level, neither too overweight nor too underweight.
  6. Do not withhold natural urges (such as sneezing, belching, urinating, releasing gas, etc.)

 Home Remedies

  1. Use warm sesame oil to massage stiff and painful joints in the morning. Massage improves blood circulation and reduces inflammation and stiffness.
  2. Put one teaspoon of fenugreek in a cup of water and set aside overnight. Then next morning, mix well and drink.
  3. Boil 10-12 slices of ginger in 8 cups of water for 5 minutes and let it steep for another 10-15 minutes. Drink this tea at a warm temperature throughout the day.
  4. Rose-hip provides a good herbal remedy for treating arthritis, as it relives pain and strengthens the body tissues, ligaments, etc.
  5. Applying garlic paste in the affected area or eating two to three garlic slices relieves joint pains and makes the bone strong.
  6. In taking raw potatoes juice benefits the arthritis sufferers.
  7. Mix one teaspoon honey and two teaspoon of lemon juice in warm water and drink it every morning.
  8. Drink cucumber and carrot juice.
  9. Drink chenopodium album (bathua) leaves juices.
  10. Drink warm water containing one teaspoon of turmeric every day. This relieves arthritis pain.
  11. Another goodremedy is to rub alovera paste or hot vinegar on affected area.

Eat coconut and walnut for strengthening bones.

Mix two teaspoon of honey and two teaspoon of apple cider vinegar in warm water and drink this mixture each day in the morning.

Conclusion                                 

Osteoarthritis (Sandhivata) can be successfully manageable through Ayurveda.