steo arthritis or joint degeneration is crippling Indian population.
Patients suffering with this condition are increasing alarmingly. A
recent pan-Indian health survey reveals that osteoarthritis has
emerged as the numero uno ailment in India, even trouncing traditional heavyweights like AIDS , diabetes ,cancer and hypertension.
The survey – titled ‘TNS Arogya 2006-07 The Heath Monitor’ –
Conduct by TNS, an ISO-accredited market research agency in Delhi, in
October 2007, was carried out across 15 cities – Delhi, Lucknow , Ludhiana, Jaipur, Varanasi, Chennai, Bangalore, Hyderabad, Cochin, Kolkata, Patna, Mumbai, Ahmedabad, Nagpur and Indore. According to the study, in the age band of 25 to 35 years, osteoarthritis is the second most prevalent disease in
India after diabetes. Despite this, reports the study, awareness amongst
Indians about the bone aliment is almost nil as compared to high profile
Diseases like cancer, AIDS and diabetes.
Osteoarthritis – or degenerative join diseases (DJD) – is a common rheumatological disorder .
The World Health Organization (WHO) estimates that 70 million Indians are its victims, nearly 80per cent of them above 75 tears
The objectives of the TNS annual survey are to map the state prevalence rates of important diseases in India and to calculate the stated incidence rates for commonly occurring aliments in the country. This research is a point to the healthcare habits of Indians – their attitudes towards well-being and preferences for over –the-counter (OTC) medicines for common ailments.
Osteoarthritis – or degenerative joint disease (DJD) – is a common rheumatological disorder. The World Health Organization (WHO) estimates that 70 million Indians are its victims, early 80 per cent of them about 75 years. Although the symptoms occur earlier in women, the prevalence of osteoarthritis among men and women is at par, say experts.
Osteo arthritis has become a common phenomenon in the urban population. It is also steadily growing in the rural popution. Once thought as old man’s disease is striking young generation.
Often called “wear and tear” arthritis, osteoarthistist (OA) is the most common form of arthitist in the world over. In most case, over time, symptoms being to occur. OA is the most commonly found in the:
Hands and fingers
Wrists, elbows, shoulders, and ankles can also be affected by OA, but this occurs less frequency. When OA is been a history of injury or stress to that joint.
Typically, OA comes on slowly. For many, the first signs are joints that ache after physical work or exercise. As the disease progresses, other most common symptoms include:
• Pain in joint
• Swelling or tenderness in one or more joints
• Stiffness after periods of inactivity, such as sleeping or sitting
• Flare –ups of pain and inflammation after use of the affected joint
• Crunching feelings or sounds of bone rubbing on bone (called crepitus) when the joints is used.
If you are experiencing any of these symptoms, it’s important to talk to your doctor to find out if you have OA. It most often occurs in the following areas:
Because knees are primarily weight-bearing joints, they are very commonly affected by OA. If you have OA in your knees, you may feel that these joints are stiff, swollen, and painful, making it hard to walk, climb, and get in and out of chairs and bathtubs.
OA in the hip can cause pain, stiffness, and severe disability. hips both support the weight of the body and enable movement of your lower body. when you have OA in your hips, you may also feel the pain in your groin, inner thigh, or knees. OA in the hip can lead to difficulty moving, bending and walking.
Fingers and Hands
When OA occurs in hands and fingers, the base of the thumbs joint is commonly affected and people experience stiffness, numbness, and aching. Other symptoms of hand and finger OA include:
• Heberden’ s nodes: small bony knobs that appear on the end joints of fingers
• Bouchard’s nodes: small bony knobs that appear on the middle joints of fingers
If you have OA of the spine, you may experience stiffness and pain in the neck or in the iower back. Sometimes arthritis-related changes in the spine can put pressure on the nerves, causing weakness or numbness in your arms or legs.
What causes osteoarthritis?
While the exact cause of OA is unknown, joint damage can be due to repetitive movement (also known as “wear and tear”). It can also begin as the result of an injury. Either way, with OA there’s erosion of the cartilage, the part of the joint that covers the ends of the bones.
• Cartilage acts as a shock absorber, allowing the joint to move smoothly.
• As cartilage breaks down, the ends of the bones thicken and the joint may lose its normal shape.
• With further cartilage breakdown, the ends of the bones may begin to rub together, causing pain.
• In addition, damaged joint tissue can cause the release of certain substances called prostaglandins, which can also contribute to the pain and swelling characteristic of the disease.
Here are some factors that may increase your risk of developing OA.
Age is the strongest risk factor for OA. Although OA can start in young adulthood, in these case, it is often due to join injury.
OA affects both men and women. However , before age 45, OA occurs more frequently in men; after age 45, OA is more common in women.
Joints injury or overuse caused by physical labor or sports
Traumatic injury to a joint increases your risk of developing OA in that joint. Joints that are used repeatedly in certain jobs may be more likely to develop OA because of injury or overuse.
The chances of getting OA generally increase with the amount of weight the body’s joints have to bear. The knee is particularly affected because it is a major weight-bearing joint.
People with joints that don’t move or fit together correctly, like bowlegs, dislocated hips, or double- jointedness, are more likely to develop OA in these joints.
An inherited defect in one of the genes responsible for manufacturing cartilage may be a contributing factor in developing OA.
If you experience joint pain, stiffness, and / or swelling that won’t go away, you should make an appointment to see your doctor. Your doctor . your doctor will be able to determine if you have arthritis and ,if so, what type.
When you see your doctor about your symptoms, he or she may ask questions about when and how you started experiencing them. The doctor will probably give you a physical examination to check your general health, and examine the joints that joints that are bothering you.
You may also need other tests to help confirm the diagnosis of OA and determine the extent and severity of joint damage. Some of these may include:
x-rays can helps the doctor determine weather you have OA or rheumatoid arthritis (RA). A series of x-ray obtain over time can show how fast joint damage is progressing. X-ray of the affected joints can show cartilages loss, bone damage, and extra bone growth (known as bone spurs) that can develop on the surface of normal bones.
If your doctor is still uncertain about the diagnosis or suspects that you may have an infection, he or she may perform joint aspiration. In this procedure, your doctor , your doctor withdraws and examines synovial fluid (a liquid that lubricates the joint) from affected joints using a needle.
If you are experiencing some of these symptoms, the sooner you talk to your doctor, the sooner you may get diagnosed and get treatment.
What’s behind the OA scenario?
India, a place of work and worship, is crippling due to over exposure of foreign culture. It does not mean that we should oppose foreign culture but we should not leave our tradition. Our tradition. Our traditions are scientific, intend for healthy living.
Globalization is turning out to be the major destructor of health. More and more sophistication and comforts are leading us to become more and more sedentary. Unhealthy food and food that does not suit our lifestyle and environment is invading our kitchens. All these factors are the major causative factor that are making Indian population suffer not only with osteoarthritis but with many other lifestyle diseases like coronary Artery diseases (CAD), Hypertension (high blood pressure) Diabetes Mellitus (DM) and so on.
Osteo arthritis and Ayurveda
Ayurveda clearly described osteo arthritis as “sandhigate vata”, a disease caused by the vata dosha. Joint or sandhi in Sanskrit , is nurtured by sleshmaka kapha or the synovial fluid and the joint is kept intact by the mamsa (muscles), kandara (tendons)and snaya (ligaments). These structures will be maintained in normalcy by the proper food and activities of the individual. Hyper and hypo activities, injury and improper food habits will give rise to imbalance of the structures and resulting in detangement of the doshas leading to degeneration of the joint.
Vata dosha, a primordial factor related to the functional aspect of the body , maintains the sensory and functional aspects of the body. Vata dosha governs all movement in the physiology, from the subtle, fleeting movement of a though flitting across your mind to the coursing of blood through your arteries and veins.
When deranged/ aggrevated vata dosha lodges in the joint / sandhi it induces its specific qualities like dryness, roughness of the joint and thus produce degeneration of the joint.
The management of the dieases is
B)Individual specific approach
Here common procedures explained for vata dosha like sneha (internal and external oleation) and sveda (fomentation procedures), vasti (medicated enema), rakta mokshana (bloodletting through venesection and leech), agni karma (thermal cauterization) and other medicines and diet prescribed are used. The severity will determine the course of the treatment.
Individual Specific Approach:
According to the Prakruti (nature of the individual) and his strength the treatment is determined specific. It is more effective treatment. For example- For a lean person who is suffering with knee OA he should be prescribed fresh Guggulu (gum resin of commiphora mukul) and obese patient should be prescribed old guggulu.
Joint rejuvenation is possible with Rasayana therapy, a unique therapeutic procedure having inscrutable results. Rasayana therapy should be strictly taken under the therapy regenerates almost all the types of cells like blood, bone, bone marrow etc. along with Rasayan therapy, the other procedures aimed at rejuvenation of the joint includes Vasti (medicated enema), the top most therapeutic procedure having enigmatic results. But before starting therapies primary treatments should be done to make body fit for undergoing those procedures. These primary procedures will any how stop the degeneration of the joint and relieve the pain and stiffness immediately. These primary therapies are
a)Upakarmas – sneha (oil therapy), sveda (fomentation therapy)
b)Lepa – Ubtans
c)Bandhana – knee cap and other fixtures
d)Bheshaja kalpa – medicinis
External and internal oil application is the basic step in reducing the aggrevated vata dosha and soothes the chennels of the dosha and soothes the channels of the body. Sneha , fat in general, has the properties to reduce the vata dosha. Vasa (muscle fat) and majja (bone marrow) are said to be specific fat for joint disease. These two fats i.e. vasa (muscle fat) and majja(bone marrow) should be given internally and also to be applied externally.
For consuming internally and for external application the fats should be cooked (sneha paka) accordingly with or without specific herbs. These fats can be given in small doses for internal administration for longer period. For panchakarma purpose the internal administration is very specific and should be done by an expert ayurvedic physician .
Different kinds of external application to be carried depending upon the severity of the disease like abhyanga (smearing, in the early conditions), seka (pouring lukewarm/hot oil), pichu (applying cotton soaked oil on the affected and vasti (retaining oil on the affected site and enema). These procedures are very effective vasti is the most effective among the procedures.
Fomentation of different joints will ease the stiffness and provides much relaxation for the joints. It enhances the blood circulation by dilatation of the local blood vessels thus enhancing the clearance of the local toxins and wastes.
There are different types of formentation procedures explained in ayurveda like panda sveda (bolus formentation), avagaha sveda (dipping type fomentation), Nadi sveda (fumigating type formentation) etc. the selection of the sveda depends upon the condition of the disease as well as the patient.
External application of different kinds of pastes / ubtans also ease thejoint stiffness and reduces pain and inflammation. Herbal powders prepared from the herbs like Rasna (Alpine galaga), kusta (sausurea leppa), kulatha (Dolichos biflorus), kola (zizypus jujube) etc applied with kanji (fermented rice washed water) or lima juice or specific decoctions will be more useful.
External bandaging of the affected known as bandhana can be the present day knee support and lumbar support. They restrict the movement of the joint and support the muscle of the joint and thus avoiding futher damage of the joint. These supports are meant for alternate support of the joint and as such these are not main stream theyapy.
There are number of medicines available for Osteo arthritis. Don’t limit the treatment with calcium supply only. Out of 80 percent people who suffer with osteoarthritis will have a normal serum calcium level normal. So its not that they are deprived of calcium but the channels supplying calcium are blocked. Also it should be noted that the synovial membrane covering the joints is the part which is torn and it is this torn synovial membrane and leading to the degeneration of the bone. So the synovial membrane , which is made up medicines containing glucosamine, chondratin will be of much benefit rather than simply stuffing the body with calcium.
Ayurveda has understood the very basics of this physiology and thus we come across a very few calcium preparations for the treatment of osteoarthritis. Medicines aiming in improving calcium channel clearance and medicines which regenerate cartilage were given much importance.
Some of the is useful preparations for Osteo arthritis.
Rasnadi Kashayam, Gandharva hastadi Kashayam,
Yoga raja guggulu, maha yoga raja guggulu, saptavimshati guggulu, simhanada guggulu, rasnadi guggulu
Vatavidhamsini ras, amavatari as, vatachintamsini ras,
Kukkutanda bhasma, pravala bhasma, mukta pisti
Ksheerabala 101 avarti drops, dhanwantaram 101 avarti drops, gandha tailam
Kottam chukkadi choornam, kola kulathadi choornam
Dhanvantaram tailam, Narayana tailam, Maha Masha tailam, Kebukadi tailam
Ksheera vasti – it has been proved very effective in the cases of osteoarthritis and osteo porosis.
Virechna – virechana clears the Pureesha dhara kala/asthi dhara kala i.e the layer responsible for the absorption of precursors of bone (bone forming elements).virechana clears the toxins and waste material that is logged in this layer and enhances absorption of bone precursors.
Old wheat, red rice, brown rice, moong dal, lentils, cows milk, ghee, bone marrow, fish, chicken, mutton are very good.
Food that which enhances the formation of collagen is highly beneficial. Foods which are rich in fibre and vitamin C will help to produce collagen.
Patients suffering with Osteo arthritis should do exercises depending upon the severity of the disease. Doctor’s advice is a must. Physiotherapy is very promising in recovering from Osteo arthritis clubbed with Ayurvedic treatments.