OSTEOARTHRITIS (DEGENERATIVE ARTHRITIS)

There are two types of osteoarthritis -primary osteoarthritis and secondary osteoarthritis. :

• Primary Osteoarthritis It is mainly due to normal biological aging process and not resulting from injury or disease. Ageing causes water content of cartilage increase and protein make up of cartilage degenerate due to friction, this is purely biological process. Total loss of cartilage cushion between bone and joint due to repetitive use of worn joints leads to inflammation of cartilage causing pain and swellings. Inflammation further enhancing the disease by outgrowth of new bone like spur /osteophyte around (visible on X-ray).
• Secondary Osteoarthritis caused due to co-morbidity such as obesity, gout, diabetes, hypothyroidism, repeated trauma, congenital abnormalities etc. Obesity directly leads to mechanical stress on cartilage and joint. It is the second most common cause of osteoarthritis after aging, particularly osteoarthritis of the knee. Occupational hazard among heavy weight lifters is also very common. Repeated trauma to joint tissue, bones, cartilage and ligaments causes early osteoarthritis of knee, for example in soccer player, army military personnel, wrong or heavy exercises done by athlete or sportsperson. Crystal deposit in gout can cause cartilage degeneration and osteoarthritis. Congenital abnormalities at birth are vulnerable to mechanical wear and tear leading early degeneration and loss of joint cartilage. Endocrine disorders can also lead to secondary osteoarthritis

The patients present with any one or combination of the symptoms listed below :

• Pain, that aggravates after activity
• Stiffness particularly in morning and after rest
• Swelling after extended activity
• Feet- pain and tenderness is usually felt in big toe with swelling of ankles or toes
• Fingers- spur (bone growth) at edge of joint leading to swelling, redness and tenderness at the base of thumb

This pain is usually accompanied by limited range of motion and cracking sound when joints bends.

Diagnosis is made from the history, signs on physical examination, and X-ray of joint.

Complications include:

• Unable to stand up after sitting, difficult in walking, thereby restricting daily activities or leading to trips and fall
• Chondrolysis, causing rapid break down of cartilage
• Osteonecrosis, bone death which may require surgery
• Stress fracture, due to repeated injuries
• Rupture of tendons and ligaments

This is chronic disease and there is no permanent cure for it. The main aim of medical management is to reduce pain, stiffness and swelling; and to Improving joint flexibility and mobility, so that can help patient to live independently. Also, care and appropriate action should be taken to avoid or treat obesity.

Walking daily for 30 minutes is always recommended because moving is considered an important part of treatment. Walking daily can help to reduce pain and help maintaining healthy weight. Strengthening or building muscle around affected area of joint eases the burden on joint and decreases pain and improves the range of motion.

• Analgesic are the first option used by allopathic doctors to relieve pain
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly given to reduce/ease inflammation and related pain of affected area/joints
• Corticosteroids are very powerful anti-inflammatory medicine given orally or injectable as per severity of condition
• Hyaluronic acid is the substance which occurs naturally in joints. The main function of hyaluronic acid is to absorb shock and give lubrication to joint. Break down of it leads to osteoarthritis.

The focus of this therapy is to deal with pain management, improve range of motion and flexibility with variety of exercise. Heat and cold therapies as suggested by doctor improve blood circulation at affected region, which helps in healing.

Surgery is warranted only when osteoarthritis is very severe and when other standard of care has failed to ameliorate the patient. It can either be repair or replace depending upon severity and conditions of patient. Mainly hip joint and knee joint surgeries are common.

Homeopathic medicines have provided evidence in the treatment of osteoarthritis, and helps in avoiding going for surgery as well.

• Bryonia Alba :is indicated in inflammation of joints that are red and hot. Right-sided complaints are prominent with stitching pain in the joints. Pain is aggravated by movement and relieved by moderate pressure and rest.
• RhusTox : pain mostly in left side, goes from left to right side. Recurring attacks due to being chilled. Legs feel as if made of wood. Osteoarthritis set after recurrent sprain of joint and after over excretion. Pain worse in damp climate; there is restlessness and the pains are worse on first motion, better by continued motion.
• Kali Carb : is a deep acting Remedy. Pain are shifting, stitching, stabbing and burning character relieved temporarily by cold application and not by rest or motion. The patient shrieks because of pain. Backache accompanied by great weakness that drives the patient out of bed at night.
• Arnica: chronic osteoarthritis with a feeling of lame bruised sore feeling. The pain worsens from touch and may occur in joints with a history of traumatic injury.
• Ruta Graveolens : arthritis in elderly women with frequent-bone fracture attributed to brittleness of bone. Feeling of stiffness and lameness. Pain is worse from cold /damp and exertion. Tendons and the capsules of the joints are affected easily. Arthritis may have developed after overuse, from repeated wear and tear of cartilage.
• Kalmia Latiflora:mainly for osteoarthritis that starts in higher joints and extends to lower joints. For example, pain and inflammation often start in the shoulder, moving to the elbow, wrist and hand. The knees are frequently affected. Pain appears quite suddenly and is worse from motion and often worse at night.
• Apis Mellifica: is a remedy for acute conditions with redness, tenderness, and swelling. The joints feel hot and have stinging pain. The hands and knees are often affected. Warmth can aggravate the symptoms and cool applications bring relief.
• Calcarea Fluor : joints become enlarged and hard, and nodosities or bone spurs may develop. Osteoarthritis after chronic injury to joints often responds to this medicine. Pain is better by heat and motion.
• Rhododendron : small joints of hands are principally affected. Descending type of pain that is worse in rough windy weather, at night and at rest. The patient feels better by motion, wrapping up the joint and applying heat.

At H4ALL we found that there is a remarkable relief in pain, swelling which improves the overall life quality of senior citizens. As you can see there are many medicines in homeopathy that can treat OA effectively.