INTRODUCTION-
Osteoarthritis of Knee, is a very common disease all over the world after Diabetes & Hypertension. Commonly, it is known as wear-and-tear arthritis because the natural cushioning between joints & cartilages wear away. Due to this, the bones of the joints rub more closely against each other. So, the shock-absorbing benefits of cartilage is loosed in a great way. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine. Osteoarthritis symptoms can usually be managed in homoeopathy although the damage to joints can’t be reversed. Staying active, maintaining a healthy weight and receiving certain treatments might slow progression of the disease and help improve pain and joint function.
SYMPTOMS OF OA-
Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:
1) Pain, affected joints might hurt during or after movement (painful mobilization).
2) Joint stiffness might be most noticeable upon awakening or after being inactive.
3) Joint tenderness is felt when light pressure is applied to or near it.
4) Loss of joint flexibility (not be able to move through full range of motion in affected joint).
5) Grating sensation (feeling of grating sensation when joint is used and popping or crackling sounds can be heard).
6) Bone spurs, these are extra bits of bone, which feel like hard lumps, can form around the affected joint.
7) Swelling can be seen, this might be caused by soft tissue inflammation around the joint.
Risk factors of OA-
Factors that can increase your risk of osteoarthritis include-
1)Older age (The risk of osteoarthritis increases with age).
2)Sex-Women are more likely to develop osteoarthritis, though it isn’t clear why.
3)Obesity- As increased weight adds stress to weight-bearing joints, such as your hips and knees. Also, fat tissue produces proteins that can cause harmful inflammation in and around joints.
4)Joint injuries- While playing sports or from an accident, or any such old injuries can increase the risk of osteoarthritis
5)Repeated stress on the joint- commonly seen in sportspersons, if certain sport places repetitive stress on a joint, that joint might eventually develop osteoarthritis.
6)Genetics-Some people inherit a tendency to develop osteoarthritis.
7)Bone deformities- In some individuals who are born with malformed joints or defective cartilage.
8)Certain metabolic diseases- It includes diabetes and a condition in which your body has too much iron -hemochromatosis.
Complications-
Osteoarthritis is a degenerative disease that worsens over time, often resulting in chronic pain, joint pain and stiffness can become severe enough to make daily tasks difficult. Depression and sleep disturbances can result from the pain and disability of osteoarthritis in many patients.
Diagnosis –
1)Taking detail case history of affected Patient
2)Physical examination of Knee joint & its adjacent affected parts can give clear diagnosis of OA of knee.
3)Laboratory Investigations in OA knee-
a) X-rays of Knee joints-which can show bone and cartilage damage as well as the presence of bone spurs
b) MRI scans-MRI scans may be ordered when X-ray do not give a clear reason for this disease.
c) Blood tests to be done in OA are- DC, TLC, ESR, RA factor, CRP, ,(Serum Uric acid are required to rule out other conditions that could be causing the knee pain)
Aim while treating a case of Osteo-arthritis Knee- To relieve the pain and To return of its mobility.
TREATMENT-
The treatment plan must be included combinations of medicines & exercises. The patients of OA knee should be encouraged for-
1)Weight loss.
2)Some physical exercises-
a) Strengthening exercise which help to keep the knee joint mobile and flexible.
b) Sit to stand. Sit in a chair. Slowly stand up & sit back down again without using the hands. Focus on keeping the feet shoulder-width apart and knees over the feet. Repeat it for 30 seconds.
c)One-leg balance- Stand next to a table & place one hand on it for support. Lift one leg and balance on the other for up to 10 seconds. Repeat it on the other side.
3) Simple exercise– Walking, Swimming & Biking. . Start with just for 10 minutes. After few days, slowly increase that time to more 5 to 10 minutes. The goal is to work up to 30 minutes of any one above exercise, 5 days per week.
4) Range-of-motion Exercises-
a)Sitting knee extension. Sit in a chair. Slowly extend one leg as much as you can, or until it’s parallel to the floor. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.
b)Sitting knee flexion. Sit on the edge of a chair. Lift one knee and place your shin in your hands. Gently pull your shin toward your thigh. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.
c)Wearing of Knee caps- helps less bending of knee joints & less joint rubs. So pain & stiffness naturally will be less.
Avoidable activities for OA patients-
1)Do not sit in floor with bending knees, it is adviced to use western mode of toilet.
2)Do not frequent go up & down up stairs.
Homoeopathic approach to Osteo-arthritis of Knee-
First of all , we must know the treatment available in allopathy for OA-
It includes medicine as well as surgery in which it includes-
1)Pain relievers and anti-inflammatory drugs to relieve acute unbearable pain.
2)Injections of corticosteroids/hyaluronic acids into the knee joints-Those are the powerful anti-inflammatory drugs. Hyaluronic acid is normally present in joints as a type of lubricating fluid.
3)Calcium, Vitamin-D are often times found in there prescription &
4)Surgery-includes Arthroscopy, Osteotomy & Arthroplasty of Knee joint.
Now, in homoeopathy selection of homoeopathic remedies for treatment must be based upon the theory of individualization and symptoms similarity by detail case taking. But, the difficulty here is, due to the unbearable recurrent knee joint pains, stiffness & immobility felt by the patient , it may not give sufficient time to the treating doctor for a smooth treatment. So, it is better to formulate a well programmed homoeopathic treatment protocol ( Constitutional /Miasmatic medicines+Nosode/Sarcode/Imponderabilia medicines as intercurent remedy+ Pain relieving remedies) can be given during only acute exaggerations of symptoms– (like Mother tinctures such as- Apocynum andro, Gaultheria procumbens ,etc. & biochemics like- Mag. phos, Cal. phos, Calc. fluor, Kali. mur etc . or some acute potentized drugs like Ledum, Phytolacca,Rhus tox, Bryonia, Belladonna, Ruta, etc.) for short period +External applications may be made by using medicines- Arnica,symphytum, Eucalyptus Oil ,Turpentine Oil on homoeopathic way + Emotional remediesif patient is a long sufferer, treated previously in other ways of treatment without much benefit, loses hope for his recovery & produces abundant mental symptoms than physical symptoms- besides homoeopathic medicines, another similar therapy like homoeopathy –called “BATCH FLOWER REMEDY THERAPY”, is also effective in this case.) for a certain period of time(at least for 6 months) rather than giving a single or one type of remedy through out the treatment period.
Some important homoeopathic & batch flower remedies are given below, which helps me a lot in the treatment of OA knee are –
1) Kali. Iodatum-
Rheumatism of Knee with effusion in joint- so huge swelling of Knee found.
Pain–< night, while bending the knee & lying on affected side.. >by motion & open air.
2) Calcaria carb. – Osteoarthritis of knee joint especially in fat and obese persons. < when getting up from a sitting position, by walking & Cold. Cold , clammy knees is another feature of Calcarea carb. There is cramps in calves when stretching out the legs at night. They have a special craving for eggs and undigestable things.
3) Sulphur – It is a polycrest, constitutional & miasmatic drug,it has all signs of inflammation( Swelling, hot sensation, redness ,painful, loss of functions of affected joint etc.),it is a great remedy to be used & its action to absorb the effusions from joints.
4) Rhus Tox. – Rheumatism caused by damp weather and worse in damp climate; Pains –< 1st. motion, cold, night & > by continued motion.
5) Ledum pal. – Pain-Sticking, tearing, throbbing. < by motion , night, warmth of bed. >by holding knee in ice-water.
6) Ruta graveolens –It is effective for Osteoarthritis of knee joint where the patient feels the knees give way , while ascending and descending stairs.
7) Bryonia alba- Knee- Stiff, painful, swollen ,red & hot, stitching & tearing type of pain,< motion . > by pressure & rest.
NOW SOME HOMOEOPATHIC MOTHER TINCTURES ARE-
1) Apocynum – A good drug for Rheumatic pains, stiffness of joints with swellings.
2) Gaultheria procumbens- Joint pains accompanied with gastric disturbances. Both External & internal uses can be done.
3) Jacaranda caroba- It is a remedy for the rheumatism with urinary symptoms. Rheumatic pain in the right knee. Gonorrheal rheumatism.
4) Nyctanthes arbo. – Remittent fever with sharp shifting pain in knee joint,Synovitis,etc.
FINALLY FEW BIO-CHEMIC SUPPORT IN OA WHICH IS ADVICED ARE-
1) Calcarea phos– Rheumatism of the joints. Cold, change of weather, motion, getting wet, generally aggravates symptoms while relieved by rest, warmth and by lying down.
2) Calcarea fluor -Chronic synovitis of knee-joint. < during rest, change of weather >by heat, warm application
3) Kali. mur- relives the sub- acute inflammatory stages of joints.
HAPPY HEALING
Contributor- Dr. Apurva Varangi
