सन्धिगत वात मन्ति सन्धिगतः सन्धीन् शूलशाफौ करोति च | (Su. Ni. 1/28)वातपूर्णपतिस्पर्श शोफ सन्धिगतोऽनिलः|| प्रसारणाकुञ्चनयोः प्रवृत्तिं च सवेदनाम् | (AH. Ni. 15/
by Ayurveda
Arthritis Vat Exemption
Usually occurs in women aged 50 and above, white hair, and wear glasses or contact lenses; Women who have a tendency to arthritic vata are prone to rheumatism.
However, it should be noted that such a woman will become ill even if these three factors do not exist, unless her body has had a lot of sexual intercourse (for health). This disease is called arthritis vat i exemption.
Clinical Features
- Degeneration and loss of function of joint like extension and flexion
- Pain in joint Swelling in joint as if it is filled with air
- Cracking sound or crepitus (Madhava)
OSTEOARTHRITIS(OA)
Definition: – OA is degenerative joint disease that results from breakdown of joint cartilage and underlying bone
Incidence
- It is the most common form of arthritis, affecting about 3.3% of the world population.
- Among those over 60 years old, about 10% of males and 18% of females are affected.
Classification Based on Causes
- Primary Osteoarthritis: Predisposing factors are genetic, metabolic disorders, age, idiopathic avascular necrosis, endocrinal factors and obesity.
- Secondary Osteoarthritis: Usually caused by local factors like – Trauma, incongruity, mal alignment, inadequate blood supply, infections of the joint, diseases interfering nerve supply of the joint, inflammatory diseases, nutritional bone diseases like rickets, osteomalacia etc.
Arthritis Vata treatment
Vata causes rheumatoid arthritis, also known as arthritic Vata. It’s caused by a certain imbalance in dosha (health factors) or metabolic process that disrupts joint health and causes inflammation. Rheumatoid arthritis is most common among people with autoimmune disease—meaning their immune system is overactive and attacking their own body tissue.
Commonly Affecting area of Osteoarthritis
- Knee
- Hip
- Spine
Clinical Features
- Pain: Made worse by prolonged activity and relieved by rest
- Stiffness: Common in the morning
- Crepitus: Cracking noise when affected joint is moved
- Joint locking and joint instability
Investigations:
- In the early stages the radiography may be normal, but joint space narrowing becomes evident as articular cartilage is lost.
- Other characteristic radiographic findings
- include sub chondral bone sclerosis, sub
- chondral cysts, and osteophytosis.
- A change in the contour of the joint,
- due to bony remodeling, and subluxation
- may be seen.
Management:
Pharmacological Measures
- NSAIDs often decrease joint pain and improve mobility in osteoarthritis (on an average about 30% reduction in pain and 15% improvement in function).
- Analgesics: For mild to moderate symptoms effectiveness is similar to NSAID. While opoid analgesic such as morphine decreases pain
- Injections: Intra articular injection of hyaluronic acid is being used for treatment of patients with knee osteoarthritis
Non-Pharmacological Measures
Ayurvedic treatment focuses on three aspects to regulate and balance female bodily functions, these three aspects being – Yoga, Panchakarma Therapy and dietetics.
One of the important non-pharmacological measures in Ayurvedic therapy is Panchakarma Therapy which comprises of internal cleansing procedures for purification of body and mind to rectify imbalances present in them.
Such internal cleanliness frees an individual from Arthritic Vata, for which most women above 40 years suffer from.
- Reduction of Joint Loading: Osteoarthritis may be caused or aggravated by poor body mechanics. Correction of poor posture and a support for excessive lumbar lordosis can be helpful. Excessive loading of the involved joint should be avoided
- Patient education: Patients with hip or knee osteoarthritis can participate safely in conditioning exercises to improve fitness and health without increasing their joint pain or need for an analgesics or NSAIDs ill.
- Exercise: Regular physical activity plays a key role in self-care and wellness. Third types improve cardiovascular fitness, help control weight, and improve overall function. The third type, range-of-motion exercises, helps reduce stiffness and maintain or increase proper joint movement and flexibility.
- Orthotics: The use of orthoses (commonly referred to as splints, braces or insoles as applicable) can reduce the symptoms of osteoarthritis at various joints. In the lower limb, orthoses are used for the foot and ankle and knee. In the upper limb, splinting of the base of the thumb leads to improvements after one year.
Surgery
Arthritic Vata, in some cases of ovaritis and leucorrhoea (discharge of white liquid laced with pus), surgery may be necessary. After all non-invasive methods have been tried, try to pinpoint which of your six energies is out of balance—sometimes only a skilled expert can do that—and heal it through means such as acupuncture. In extreme cases an operation might be necessary.
- Osteotomy: (A surgical operation where a bone is cut) Pain is sometimes relieved by correcting deformity. It also initiates biological regeneration by reducing vascular engorgement in the sub chondral bone.
- Arthroplasty: (Replacement of dysfunctional Joint surface. This is less effective to relieve pain. It is only indicated in case of very old persons whose expectancy of life is not much while he will still have a mobile joint.
- Arthrodesis: It is artificial induction of joint ossification between two bones via surgery),This is best in abolishing pain. But this offers total stiffness.
- Excision of the joint
Ayurvedic management:
- Panchkarma treatment –1st day mild laxative detox avleha 10 gm with hot water.
- deepan pachan – tab . deepan 2bd after food .for 15 days.
स्नेहोपनाहाग्निकर्मबन्धनोन्मर्दनानि च | स्नायुसन्ध्यस्थिसम्प्राप्ते कुर्याद्वायावन्द्रितः ।।युसन्ध्यस्थिसम्प्राप्ते कुर्याद्वायावतन्द्रितः || (Su. Chi. 4/8)
by Ayurveda
- Snehana abhyangam and steam for 7 days
- janu basti with sandhyas janu basti oil , joint care oil
- Lepam jatamayadi punravaha had jod apply on knee than earkpatra, erandpatra should be tied on knee joint with crabe bandage for seven to fifteen days according to condition of patient.
- If pain is more
- Agnikarma
- Marma points – just back of the knee joint .
Cupping Therapy Points-
Siravedya – four finger below the knee joint
Diet
Batter checked for spoilage of batter. Pacing caulk again on the wash every morning. Emeralds: Emerald disc, roasted asafoetida, roasted asafetida, dry ginger, chilli, peepal cumin powder get fan combustion of kalk in kalka and caulk combustion of sesame in forthosh. Then in the morning from the movie, do 1 Kalk.
Oral drugs
- Rasna saptak kashaya 10 ml with hot water./ maha rasnyadi kashya .
- mahavata vidhvamsak rasa2 bd. After food
Mahayograja guggul 2bd. After food
- Tab. Rasnayadi guggal 2 bd after food
- Gandharvahastyadi taila 10 ml with milk at night.
- Ajmodyadi POWDER 3 GM WITH HOT WATER.
- PERTHE’S DISEASE
Definition
It is a child hip disorder initiated by a disruption of blood Avascular flow to the head of femur leads to whole or part of femoralne head become avascular. Due to which, the bone dies and stops growing. It is also called as Legg-Calve-perthes disease.
Incidencce:
- It occurs roughly 5.5 of 100,000 children per year.
- More at the age of 5-10 years
- Boys are affected about 3 to 5 times more often than girls.
Clinical features
- Pain in hip reffered to knee, ankle or groin exacerbated by leg movement especially internal hip rotation
- A trophy of thigh muscles may occur from disuse and inequality of leg length
- Inflammation of damaged area due to some activities like standing, walking, running Kneeling or stooping repeatedly
- Slight raise of temperature
- Trendlenburg test positive: The greater trochanter will be feeling slightly higher than the normal
Investigation
X-ray shows flattened and later defragmented, femoral head.
- Physiotherapy
- Traction
- Braces
- Orthotics
- Surgery (Salter innominate osteotomy)