Monday, July 2, 2012

OSTEOARTHRITIS AND AYURVEDA-FURTHER DETAILS

Osteoarthritis (OA) is one the most common painful ailment seen above the age 45 and is characterized by mild to severe pain in the joints. Osteoarthritis is also known as degenerative arthritis or degenerative joint disease.
Usually the pain is restricted to a single joint and is most commonly seen in the knee and Hip joints. It is one of the most common causes for decreased mobility and joint pain in the elderly population.

OA is described as Sandhigatha Vatha or Sandhivatha and is one of the eighty Vata related disorders.
Cause:

ü  Abnormal wearing of the cartilage that covers the bone ends and acts as a cushion inside joints

ü  Destruction or decrease of synovial fluid that lubricates the joints

ü  In Ayurveda, the specific cause for OA is aggravated vatha dosha

ü  Aggravated vatha dosha tends to dry up the synovial secretions and also destroys the cartilage since Vata dosha has got the tendency to dry(Rooksha guna in sanskrit). Cartilage is composed of 65 to 80 percent water

What are the changes that happen?
The contact areas of the bones are coated with a slip membrane, a 3-4 cm thick cartilaginous tissue. This is called articular cartilage and helps smoothen the bone ends.
  • This extremely smooth cartilage reduces friction within the joint and cushions hard impacts, e.g. when running.
  • Wear and tear of the cartilage,inflammatroy changes inside the joint leads to OA
Prevalence:
Osteoarthritis (OA) is the leading cause of disability in elderly people.
  • OA most often strikes the knee, particularly the inner aspect of the tibiofemoral joint
  • Women in the menopausal age are more likely to suffer from this condition
  • Prevalence is particularly high among overweight individuals and the elderly(Women more than men,Urban populace more than the rural)

Symptoms:
Pain and reduced mobility of the affected joint
  • Pain aggravates or shows up more during walking, climbing steps or running
  • The pain can vary based on the stage of the problem,from mild to severe
  • Inability to use Indian toilets, pain on getting up
  • Creaking or clicking sounds inside the joints
  • Loss of flexibility in the affected joint/s, pain on moving the joint
  • Swelling in the joint

Who is more prone to suffer from this problem?

ü  Sports persons with injuries to the joints

ü  People involved in military training involving lot of jogging or running

ü  People who are overweight or obese

ü  Persons suffering from osteoporosis

ü  Women above age 40 and men above age 45

ü  Prevalence is higher among women because they are more prone to osteoporosis due to hormonal imbalance

Diagnosis:

ü  An experienced physician will be able to detect the changes inside the joint by doing a thorough examination of the affected joint

ü  X-rays of the joint will show reduction in the joint space due to wearing out of the cartilage and other typical changes of OA

ü  MRI and CT scans

Prevention:

ü  Earlier detection and treatment is the most important aspect which determines whether the individual gets good relief.

ü  OA which is in the initial stages is treatable with Ayurveda and once the wear and tear becomes extreme, surgical intervention may become necessary.

ü  Once cartilage damage has begun, it is going to progress at increasing speed

ü  Resting of the affected joint is a very important part of prevention from further aggravation

ü  Exercise to strengthen the group of muscles supporting the affected  joint

ü  Avoid consuming green chillies and red chillies excessively

ü  Consume 1/4th to ½ tsp of Cow ghee in your diet

ü  Avoid legumes such as beans, Red beans, Indian pea or chickpea, green peas on a daily basis. According to Ayurveda, these food articles  have the tendency to aggravate Vatha dosha

Prevention in Ayurveda:

ü  Abhyanga or applying medicated oil such as Narayana taila or Ksheerabala taila should be started by people who are prone to OA or are in the age when OA incidence rises

ü  Intake of medicated tila taila which is rich in Vitamin D such as Ksheerabala 101 Avarthi or Gandha taila is advisable

Treatment in Ayurveda:

OA is one the commonest problem seen in an Ayurveda OPD and is addressed successfully when the patient comes for treatment in the initial stage of the problem. To do so there is an increased need for awareness creation regarding the problem among the public.

Medicines:

ü  In Ayurveda, we use different guggulu based preparations in the pill form to treat OA.e.g:Yogaraja guggulu,Trayodashanga guggulu

ü  Apart from that medicated Cow Ghee and til oil based preparations are used to improve lubrication in the joints. e.g:Ksheerabala and Dhanvatharam Avarthi

ü  The fat based medications used in Ayurveda are rich in Vitamin D and this helps enhance the absorption of calcium from the gut.

ü  This process helps strengthen the bones and joints by slowing down the demineralization process which is the basic cause of the problem.

Panchakarma:

ü  Use of medicated oils and liniments externally over the affected joint

ü  Local steam or hot fomentation

ü  Ayurveda advocates the use of medicated oil in the form of Ahyanga, Vasthi, pathra pinda sweda, Janu vasthi, localized dhara etc over the joints. The complete explanation of these procedures is beyond the scope of this article.

ü  A good doctor usually will try to help by recommending medicines first and will advise panchakarma if he does not see the expected benefits from the medicines alone

Caution/red signals:

ü  Avoid using OTC painkillers without consulting a doctor

ü  Avoid going to quacks who promise miraculous results because there are none

ü  Avoid using products promoted through the visual media, especially television and before deciding on doing so take the opinion of your family doctor

ü  There are incidents being reported of people being approached with the promise of miraculous results even on the road and being cheated of thousands of rupees

ü  If the joint pain is associated with symptoms such as fever, you may need to go in for more detailed tests such as ESR; Differential count etc.This will be determined by your physician.

Final word:

Remember, successful treatment and recovery depends on the right doctor as well as a good patient. You will be on the path to recovery if you choose the right doctor and the right system of medicine.


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