Osteoarthritis is one among several joint disorders. It is the most common form of arthritis usually affecting middle and old age people.
It is a progressive and degenerative disease involving cartilage, joint lining, ligaments and bone. Cartilages act as cushion in between the bones of a joint, in osteoarthritis this cartilage is damaged leading to friction between the bones. Joints of knees, hip, spine and hands are commonly affected.
In India each year over 15 million people are affected by osteoarthritis. About 20 years ago osteoarthritis was usually affecting elderly people of age group 65 years and above, but nowadays incidence is common among younger people in the age group of 35-50, due to sedentary lifestyle, unhealthy food habits, obesity, etc. India has the second largest knee-osteoarthritis patient base in the world.
Causes of Osteoarthritis
- Being overweight – Obesity is one among the major causes for osteoarthritis. Extra weight puts added stress on weight-bearing joints, such as your hips and knees.
- Nutritional deficiency – Lack of vitamin-D also contributes to osteoarthritis.
- Increased Joint stress – Prolonged use of high heels increases risk of developing osteoarthritis in women. Athletes and dancers who are involved in aggressive training are also at more risk.
- Age – As age progress joint cartilages wear off leading to osteoarthritis.
- Genetics – Some people inherit a tendency to develop osteoarthritis.
- Joint injuries – Injuries, such as those that occur when playing sports or from an accident, may increase the risk of 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.
- Gender- Usually females are more prone to osteoarthritis after 55 years of age.
Signs and Symptoms of Osteoarthritis
- Pain – You may experience sharp pain or burning sensation in the joints. Pain may be constant whole day or may occur during walking or any joint movements or while you sleep if arthritis is very worse.
- Tenderness – You may experience pain on applying pressure over the joint.
- Stiffness – You may feel your joints are stiff while getting up in the morning or after sitting for a long time or after certain period of inactivity.
- Muscle weakness – The muscles around the joint may get weaker, especially in arthritis of the knee.
- Swelling – Usually swelling does not occur in osteoarthritis. Occasionally you may notice mild swelling if there is inflammation.
- Joint deformity – When arthritis gets worse your joints lose their natural shape.
- Decreased mobility – The natural movements in the joint will be reduced gradually. As your arthritis gets worse, you may not be able to fully bend, flex, or extend your joints or you may not be able to use them at all. Decreased use of joints due to pain further reduces the range of mobility.
- Cracking or grating sensation – Your joints may make cracking or creaking or grating sounds on movement.
- Insomnia – The pain and stiffness of arthritis can disrupt your sleep. Deprivation of sleep worsens the pain in the morning.
- Spinal stenosis – Osteoarthritis of vertebra causes narrowing of space around spinal cord causing compression over spinal nerves. This pressure causes pain, weakness, numbness or abnormal sensation.
- Spur formation – There may be extra growth of bone around the affected joint, which will feel like a hard lump near the joint.
Diagnosis of Osteoarthritis
Physical examination of your joints by a physician, X-ray or MRI will confirm osteoarthritis.
Modern Management of Osteoarthritis
In modern medicine there is no cure for osteoarthritis, treatments are available to manage symptoms such as pain, stiffness and swelling, but they cannot prevent joint degeneration.
- Analgesics, NSAIDs (Nonsteroidal anti- inflammatory drugs), corticosteroids are prescribed to manage pain and inflammation.
- Cortisone shots – Injections of corticosteroid medications may relieve pain in your joint.
- Surgery – When conservative treatments fail, surgery is recommended. Joint replacement surgery is done to replace severely damaged joint.
Limitations of modern treatments
- Use of analgesics and NSAIDs can cause stomach upset, ringing in your ears, cardiovascular problems, bleeding problems, and liver and kidney damage.
- Use of corticosteroids will relieve the pain but worsen joint damage over time.
- Surgical risks include infections and blood clots. Artificial joints can wear out or come loose and may need to eventually be replaced. Repeat joint replacements are more challenging and less successful than the original surgery.
Osteoarthritis in Ayurveda
Osteoarthritis is explained in Ayurveda under sandhigata vata. Osteoarthritis is completely curable if it’s new onset and considerable amount of joint regeneration is possible through ayurveda. Osteoarthritis can be prevented by following few simple measures mentioned in Ayurveda.
Ayurvedic medicines, which are effective in osteoarthritis are:
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- Rasnairandadi kashayam, Maharasnadi kashayam, Rasnadi kashayam, Dashamoola kashayam, Dhanwantara kashayam,Sahacharadi Kashayam, Rasna saptaka kashayam, Punarnavadi kashayam- Reduces pain and other associated complaints of osteoarthritis.
- Yogaraja guggulu, Maha yogaraja guggulu, panchatikta ghrita guggulu, Simhanada guggulu, vatari guggulu and shallaki, Zeotone)- Reduces pain and inflammation.
- Ksheera bala taila, Narayana taila, Maha narayana taila, kottamchukkadi taila, Dhanvantara ghrita, Gandha taila – does lubrication to joints.
- Ashwagandha, Bala, Arjuna, Laksha, shatavari ksheera paka are given to reduce joint degeneration and also strengthen the joints.
Selection of medicines depends on each individual, whether the patient is obese or lean, chronic or acute arthritis and other associated complaints.
Panchakarma play an important role in the management of osteoarthritis. Following are the procedures which are very effective in osteoarthritis. Duration of procedure ranges from 7 days to 1 month.
- Abhyanga – It includes full body massage and local massage over the affected joints with specific medicated oils. Abhyanga improves circulation around the affected joints, pacifies vata thus reduces the pain and strengthens the muscles and joints.
- Janu basti – It is the procedure in which specific medicated oil with specific temperature is made to stand over the affected joint, inside masha pisti for 30 minutes. Janu basti restores the lubricating fluid in the joint and maintain integrity of the structures involved in the joint, Protects knee joints from age related changes, increases blood circulation; thus strengthens and nourishes the knee joints, and improves the mobility of the knee joints.
- Upanaha or Lepa – Application of medicated paste over the joint and wrapped with bandage. Paste is retained for 8-10 hours. Lepa helps to maintain warmness around the joint like a hot pack. It reduces joint stiffness, pain and relaxes muscle around the joint. Lepa should not be done when in acute pain.
- Sveda – It is nothing but fomentation by nadi sweda or patra pinda sweda or churna pinda sweda. The effect of sveda is similar to that of lepa.
- Virechana – Virechana helps in elimination of vitiated doshas and vata anulomana. Thus restores the equilibrium in the body.
- Basti – Basti has a commendable role in management of osteoarthritis. It includes Ksheera basti and anuvasana basti. In ksheera basti, milk is the main ingredient and oil in anuvasana basti along with other medicines. These nutrients are absorbed through the gut wall and nourishes the degenerated joints.
- Agnikarma- Medical cauterization is done to manage pain.
Importance of Exercise in Osteoarthritis
- Improving joint mobility and flexibility – One of the most beneficial ways to manage osteoarthritis is to get moving. Simple activities help to improve joint strength, reduce stiffness and manages pain. Even simple activities like walking, easy exercise can reduce pain and help maintain a healthy weight.
- Muscle strength – Strengthening the muscles around the affected joint by exercise helps to reduce the stress, stiffness and pain. Improves joint stability and flexibility.
- Weight Management – Excess weight adds additional stress to weight-bearing joints, such as the hips, knees, feet and back. Losing weight can help people with osteoarthritis to reduce pain and limit further joint damage. The basic rule for losing weight is to eat appropriately and increase physical activity.
- Stretching – Slow, gentle stretching of joints may improve flexibility, lessen stiffness and reduce pain. Exercises such as yoga are great ways to manage stiffness.
Yogasanas Which Are Beneficial in Osteoarthritis
1. Ardhakati chakrasana
2. Ardha chakrasana
3. Pada hastasana
9. Viparita karani
12. Vakrasana and all loosening exercises.
Prevention of Osteoarthritis
- Doing regular oil massage at home with medicated oil or sesame oil.
- Include 1 tsp of ghee daily in meals.
- Drink sufficient quantity of milk.
- Do regular exercise to maintain ideal weight and to strengthen the joints.
- Avoid joint injuries. If encountered with the injury seek medical attention immediately.
- If you are diagnosed with osteoarthritis, undergo prompt treatment without negligence to prevent further deterioration.
- If you have family history of osteoarthritis or are involved in sports, dancing or any other activities which impart more stress on the joints than normal, undergo Ayurvedic treatments and take proper natural supplements to prevent osteoarthritis.
Prevention is always better than cure.
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