OSTEOARTHRITIS

<p>OSTEOARTHRITIS</p><p>Osteoarthritis is a condition where cartilage - the spongy, protective tissue in your joints - becomes thin and loses its ability to stretch and bend. When cartilage becomes thin or is completely worn away, the bones in your joints can start to rub against each other. This leads to the symptoms of osteoarthritis: pain, swelling, stiffness and - in some cases - a feeling that the joint might lock or give way.</p><p>Osteoarthritis <br>(OA) can be defined as the degeneration of the hyaline cartilage covering articular surfaces. Secondary effects of the disease include the inflammation of the synovial membrane and <br>subchondral bone <br>(the bone in contact with the cartilage) and the formation of bony growths around the edges of the joint surface. It can appear at any age, but tends to occur more commonly</p><p>in women and in people aged over 40 years. Many people have osteoarthritis without noticing any symptoms. For those people who do experience symptoms, the most common sites are the fingers and the joints that support the weight of your body - your spine (backbone), hips and knees .Osteoarthritis is not the same as osteoporosis - a condition where the bones become thin and are more likely to break - although sometimes people can have both conditions.</p><p>CLASSIFICATION OF OSTEOARTHRITIS</p><p>Given the puzzling <br>etiology <br>of osteoarthritis, different classifications of the disease have been proposed, yet all coincide in making a clear distinction between primary or idiopathic osteoarthritis and secondary osteoarthritis. According to the American College of Rheumatology (ACR):</p><p>􀂾 <br>Idiopathic</p><p>- Localized (spine, knee, hip, hands, feet, elbow, shoulder, and other joints)</p><p>- Generalized (involving 3 or more joints)</p><p>􀂾 <br>Secondary</p><p>- Trauma</p><p>- Developmental and congenital diseases (dysplasia, etc.)</p><p>- Metabolic diseases (gout, etc.)</p><p>- Endocrine disorders (diabetes, hypothyroidism, etc.)</p><p>- Calcium deposition diseases (pyrophosphate, hydroxyapatite, etc.)</p><p>- Other bone and joint diseases (rheumatoid arthritis, etc.)</p><p>- Neuropathic (Charcot) <br>arthropathy</p><p>- Septic arthritis</p><p>Different developmental stages of osteoarthritis have been identified:</p><p>􀂾 <br>I. DESTRUCTION OF THE CARTILAGE<br>: proteolytic damage to the cartilage matrix.</p><p>􀂾 <br>II. INFLAMMATION OF THE SYNOVIAL MEMBRANE<br>: <br>fibrillation <br>and erosion of the cartilage surface. Release of degradation products from the synovial fluid.</p><p>􀂾 <br>III. REMODELING OF SUBCHONDRAL BONE<br>: the synovial cells consume the degradation products. Production of inflammatory <br>proteases <br>and <br>cytokines<br>.</p><p>The evolution of the disease</p><p>1. Edema of the cartilage: <br>There are no clinical or radiological signs. The edema can only be perceived under an electron microscope.</p><p>2. Fibrillation:</p><p>Cartilage begins to wear down.</p><p>3. Fissuring:</p><p>Presence of deep cracks in the cartilage.</p><p>4. Ulceration-Eburnation:</p><p>The <br>subchondral bone <br>of the joint surface is exposed.</p><p>causes</p><p>The cause of osteoarthritis is largely unknown. Different factors can speed up or worsen cartilage loss in different people. Sometimes osteoarthritis is caused by an injury or overuse of the joint, which may result from particular types of work or sport. Problems with the hips or knees may be worsened by being overweight, which can put too much strain on these joints. A family history of osteoarthritis or other joint problems may make you more likely to develop the condition, especially in the fingers. Growing older also increases the likelihood of developing osteoarthritis. Whatever the cause, the main problem in osteoarthritis is the damage to your cartilage which can result in pain and stiffness.</p><p>Osteoarthritis usually happens gradually over time. Some risk factors that might lead to it include:</p><p>• Being overweight</p><p>• Getting older</p><p>• Joint injury</p><p>• Joints that are not properly formed</p><p>• A genetic defect in joint cartilage</p><p>• Stresses on the joints from certain jobs and playing sports.</p><p>Injury - can damage to bone, ligament and cartilage that ultimately leads to severe pain.</p><p>Infection - Any kind of infection to the joint may result osteoarthritis.</p><p>Obesity and advanced age - Both are very common cause of osteoarthritis.</p><p>Overuse - Overuse of knee joint can cause bursitis which ultimately leads to intense pain.</p><p>Sprain- Due to sudden unnatural movements causes pain as well as restriction of movement of the joint.</p><p>Malignancy - Myeloma, metastatic carcinoma.</p><p>Dislocation - Also causes severe arthritis.</p><p>Other causes - Include Sarcoidosis, Sickle cell disease, Lupus, Kawasaki disease, Crohn’s disease, bone tumors, bleeding disorders etc.</p><p>FACTORS THAT CAN ACCELERATE OSTEOARTHRITIS</p><p>Age: Osteoarthritis is a disease that appears with age, due to wear and tear on the joint produced by use over the years, together with the fact that the tissue is less able to recover with age.</p><p>Obesity: There is a clear relationship between obesity levels and the probability of developing osteoarthritis. There is also a relationship between the level of obesity and the functional severity of the disease. Obesity precedes osteoarthritis; it is not a result of the disease.</p><p>Physical Activity: The continuous, persistent and repetitive use of a joint (especially by top-level athletes) can lead to osteoarthritis in a specific joint, given that such activity increases the risk of early joint degeneration.</p><p>Work Activity: The development of osteoarthritis has been linked to certain jobs that call for the continuous use of certain anatomical areas over long periods of time. This is the case of lumbar and knee osteoarthritis among miners, and osteoarthritis of the elbow and wrist among pneumatic-drill operators, among others.</p><p>Among others, the main <br>signs and symptoms <br>of osteoarthritis are:</p><p>􀂾 Pain; restricted, painful movement</p><p>􀂾 Stiff joints</p><p>􀂾 Loss of mobility</p><p>􀂾 A feeling of insecurity or instability</p><p>􀂾 Functional impairment</p><p>􀂾 Soft spots around the joint</p><p>􀂾 Inflammation around the joint</p><p>CLINICAL SYMPTOMS OF OSTEOARTHRITIS</p><p>The clinical symptoms of osteoarthritis vary depending on the part of the body affected and certain indications are specific to each joint. Some of the different kinds of osteoarthritis are described below:</p><p>Osteoarthritis of the spine</p><p>In addition to the typical symptoms of the disease, osteoarthritis of the spine involves neurological symptoms caused by compression of spinal nerve roots.</p><p>Osteoarthritis of the knee (gonarthritis)</p><p>This is a very common complaint. It usually appears together with osteoarthritis of the hands within the context of primary <br>polyarthritis<br>,</p><p>The main symptom is mechanical pain with stiffness and functional impairment, which become more severe as the disease progresses. <br>In initial stages, pain is felt only when the knee is completely flexed. <br>As the degenerative process advances, the symptoms become more evident, flexion is more limited, joint swelling appears and is sometimes accompanied by joint effusion and cysts. Joint atrophy and deformity are observed in advanced cases, together with joint-ligament instability.</p><p>Osteoarthritis of distal interphalangeal joints</p><p>This is one of the most frequent and typical kinds of osteoarthritis. Patients complain of slow, gradual swelling of these joints until so-called Heberden nodes are formed<br>. <br>Single nodes appear initially, but become multiple as time goes by. They are more common in women than men. These nodes may begin with just a little or no pain; or they may appear suddenly, as an acute inflammatory reaction with pain, reddening, swelling and functional impairment.</p><p>Osteoarthritis of proximal interphalangeal joints</p><p>This ailment is generally associated with distal interphalangeal osteoarthritis, and frequently also with rhizoarthritis and osteoarthritis of the thumb. It usually begins after the signs and symptoms of distal interphalangeal osteoarthritis have appeared, but the clinical symptoms are similar, with pain and characteristic deformity and swelling of the bone, in this case caused by so-called Bouchard nodes.</p><p>Osteoarthritis of the hip (coxarthrosis)</p><p>This is one of the most frequent and incapacitating forms of osteoarthritis. It appears in men and women alike and is frequently the only part of the body suffering from osteoarthritis.</p><p>The main symptom is mechanical pain, located in the groin and irradiating to surrounding areas.</p><p>Osteoarthritis of the shoulder</p><p>Osteoarthritis of the shoulder is not frequent, but is still the second cause of shoulder pain. It is usually also associated with trauma or a previous joint disease. The symptoms are pain which, when intense, is accompanied by stiffness and limited mobility.</p><p>Osteoarthritis of the ankle</p><p>Osteoarthritis of the ankle is not frequent, despite being a weight-bearing joint. The primary form is rare (some experts even hold that it does not exist). When the secondary form appears, it is usually associated with fractures, trauma and inflammatory diseases. The clinical symptoms are mechanical pain, stiffness after resting and loss of function.</p><p>Osteoarthritis of the elbow</p><p>Osteoarthritis of the elbow is not frequent and is usually secondary to trauma or a previous joint disease. The symptoms are pain and moderate limitation of mobility.</p><p>How Is Osteoarthritis Diagnosed?</p><p>Osteoarthritis can occur in any joint. It occurs most often in the hands, knees,</p><p>hips, and spine.</p><p>Warning signs of osteoarthritis are:</p><p>• Stiffness in a joint after getting out of bed or sitting for a long time</p><p>• Swelling or tenderness in one or more joints</p><p>• A crunching feeling or the sound of bone rubbing on bone.</p><p>No single test can diagnose osteoarthritis. Most doctors use several methods to diagnose the</p><p>disease and rule out other problems:</p><p>• Medical history</p><p>• Physical exam</p><p>• X rays</p><p>• Other tests such as blood tests or exams of the fluid in the joints.</p><p>How Is Osteoarthritis Treated?</p><p>Doctors often combine treatments to fit a patient&#x27;s needs, lifestyle, and health. Osteoarthritis</p><p>treatment has four main goals:</p><p>• Improve joint function</p><p>• Keep a healthy body weight</p><p>• Control pain</p><p>• Achieve a healthy lifestyle.</p><p>Osteoarthritis treatment plans can involve:</p><p>• Exercise</p><p>• Weight control</p><p>• Rest and joint care</p><p>• Nondrug pain relief techniques to control pain</p><p>• Medicines</p><p>• Complementary and alternative therapies</p><p>• Surgery.</p><p>Keeping active</p><p>Regular physical activity benefits everyone, whether or not they have osteoarthritis. It helps to reduce your pain, strengthen your muscles, maintain your joint functions and improve your sleep and overall health. Inflammation in your muscles, tendons and other tissues may make it harder for you to stand up straight, turn and bend, or take a deep breath. Your physio or doctor can suggest suitable exercises to stretch and strengthen your muscles. These exercises will improve your posture and help to maintain flexibility. You should aim to do this stretching program every day, or at least five times per week. What if it hurts to exercise? The level and type of exercise you will be able to do varies from person to person - while some people can aim to keep or improve their fitness through exercise, others may be aiming to remain mobile. It’s normal to feel some pain in your muscles when you start an exercise program, or change to different types of activity. However, if pain feels unusual or severe, or lasts for more than 2 hours after you have stopped an activity, it is probably best to avoid or change that activity. Applying a heat pack to a sore joint may ease swelling and/or pain. It may be best to rest your joints when they are very painful, but you should try to return to regular exercise as soon as possible as this is best for them in the long run. Try to plan your exercise for times when you are experiencing the least pain - generally when you are least tired. Osteoarthritis is a degenerative joint disease where the pathological changes in the joint are almost irreversible. Homeopathic medicine can alleviate the pain significantly but cannot cure the disease completely. Most cases respond well as far as the long-term pain relief is concerned. Homeopathic medicines are definitely suggested for osteoarthritis, especially for early cases where the medicines can slow down the degenerative process and offer considerable pain relief.</p><p>History of Injury: A major injury is a common cause of knee osteoarthritis, especially in the case of cruciate-ligament injuries and <br>meniscal <br>tears. A tear can alter the mechanical function of the joint and make the patient predisposed to osteoarthritis in any other joint.</p><p>Bone Mineral Density: It has been observed that patients with a higher bone mineral density are at greater risk of suffering from osteoarthritis. This may be caused by increased biomechanical stress on the cartilage, which leads to its degradation.</p><p>Genetics: Heredity is believed to be a factor in osteoarthritis in that patients may be predisposed to getting the disease but do not necessarily inherit it.</p><p>Systemic Diseases: Endocrine disorders such as hypothyroidism and diabetes often occur in conjunction with osteoarthritis. A relationship has also been detected between osteoarthritis and metabolism diseases.</p><p>Other risk factors appear to be menopause, muscle fatigue, joint instability and osteoporosis, etc., while some drugs, such as non-steroid anti-inflammatory drugs (NSAIDs), can accelerate the process.</p><p>Making a diagnosis of oste1. <br>PHYSIOPATHOLOGY OF OSTEOARTHRITIS</p><p>The <br>physiopathology <br>of OA is not completely understood, but progress is being made.</p><p>Under normal conditions, the components of the cartilage matrix are gradually replaced. <br>Chondrocytes <br>are the cells responsible for this metabolism, in which synthesis (<br>anabolism<br>) and destruction (<br>catabolism<br>) are balanced in a coordinated way. When this process is altered, a series of changes occurs in the morphological and biomechanical characteristics of cartilage that make it fail to perform its function analysis How can other therapists help?</p><p>Many people with osteoarthritis visit a physiotherapist (physio). These practitioners will show you exercises to do at home to strengthen and stretch the muscles in your joints and improve your function. They will also show you pain relief techniques, including the use of heat packs and walking sticks. They may use massage and other activities to keep your joints as flexible and pain-free as possible..</p><p>OSTEOARTHRITIS AND HOMEOPATHY….</p><p>Oxalic acid<br> - left sided rheumatism with sharp pains through the lower lobe of the left lung which is noteworthy of this remedy. Rheumatic gout of joints, especially worse from sweats. It may have disordered stomach, salivation, tasteless eructations, burning in stomach etc. pain under point of scapula, between shoulders, extending downwards to small of back. Violent aching pain back down the thigh relieved by change of position.<br>. Aconitum napellus:<br> Helps to prevent inflammation and pain that suddenly occurs when you expose to cold weather and wind. During this case, you feel panicked, agitated or fearful.</p><p>Benzoic acid -<br> pains in uraemic and lithaemic constitutions. When the urine is scanty the patient suffer more whereas it is heavily laden with deposits and is copious, the pains are relieved. The urine in such a state of a hoarse. Checking of these deposits aggravates the pain. The urine contains uric acid forming the red deposits. The pain cease on catching cold and the inflammation of tongue and stomach starts. In the latter case the patient vomits everything he eats. The suppressed pains go to the stomach.</p><p>Belladonna:<br> Flare ups occurring suddenly with a feeling of heat and aching pain signify the need of this homeopathic remedy. When the joints become red and inflamed and you feel hot to the touch, this remedy gives effective relief.</p><p>Phytolacca<br> - chronic bruised state of body, bone pain, body aches, pain in joints, worse at night, from warm application. He wants cold things, rheumatism of joints with enlargement of parotid and sub-maxillary glands. Pain in the cardiac region shooting in to right arm.</p><p>Calcarea phosphorica:</p><p>Gives relief from</p><p>stiff and sore joints that become worse from cold and drafts and also relieves achy bones and tiredness. Bone spurs or calcium deposits will appear, particularly in the neck area.</p><p>Cimicifuga:<br> Relieves stiffness and severe pain that worse from cold, particularly when your neck and longer joints get affected. Inflammation will become severe at the time of menstruation.</p><p>Chelidonium <br> - rheumatism with edema, heat, tenderness and stiffness. Constipation and whitish stools. Pain is aggravated by slightest movement or touch. The only relief is constant bathing with hot water.</p><p>Guaiacum<br>. - Rheumatic and gout engrafted on syphilitic or tubercular constitutions. Sore swollen joints more painful from warmth and motion. Gouty abscesses of joints. The leg and ankle bones are especially affected shooting pain in legs from feet to knees. Pains in tibia. Better by cold bath and cold application.</p><p>Lithium Carb<br> - chronic rheumatism due to uric acid. Palpitation and shocks about the heart the heart. Painfulness of the soles of feet and small joints with a sense of burning therein.</p><p>Kalmia latiflora:<br> Severe arthritis pain when appears quite suddenly indicates the need of this remedy. Particularly this gives relief when the pain appears in higher joints and extended to lower ones. One can not forget this remedy for osteoarthritis, rheumatism when affection travels down wards with numbness. Pain with palpitation of heart and slow pulse. Pains shift rapidly pain in ulner nerve.</p><p>Pulsatilla<br>:<br> Relieves when the pain moves suddenly from one joint to another. Most often your knees and hips are affected and you feel severe pain in the heels.</p><p>Berberis Vulg.<br> - pain in heels relieved by putting most of the weight on them. Arthritic and rheumatic affection if attended by renal sticking pain and backache.</p><p>Ruta graveolens:<br> Useful when you feel extreme stiffness and lameness that worse from cold and damp. Most often, tendons will be affected.</p><p>Ledum palustre:<br> Useful when the arthritis starts in the lower joints and spread to higher ones. Most often, you will notice inflammation and pain in the toes and it extends through ankles and knees. Remarkable remedy helpful in treatment of osteoarthritis, gout and rheumatism which is of ascending nature, better by cold application, there is deposition of chalk stones in finger joints, wrists and toes. Irritable patient with desire to be alone. Pain may be caused by alcoholism, insect stings, and punctured wound. Pain worse by warm applications.</p><p>Rhus toxicodendron:<br> Gives relief when the arthritis pain that becomes worse in the morning and in wet, cold weather. During this period, you will feel extremely restless. Applying heat and repeated motion relieves the symptoms in joints. Recurring attacks due to getting chilled when hot. Rheumatism caused by damp weather and worse in damp climate; there is restlessness and the pains are worse on first motion, better by continued motion and again worse after moving for sometime when it becomes necessary for him to repose.</p><p>Sticta Pulmonaria<br> - rheumatism of right shoulder blade or joint, wrist joint, ankle joint and knee joint. It also reduces fluid in the joints.</p><p>ARNICA..</p><p>Bryonia Alba<br>. - Excellent remedy which is useful in treatment of osteoarthritis, pain with inflammation which is aggravated by movement and relieved by moderate pressure and rest. There is inflammation of joints which are hot and swollen. The patient feels chilly.</p><p>Rhus tox<br> A general remedy for gout. There may be aversion to food which smells as soon as served. Swelling of joints which may be red or pale. Abdomen bloated with wind. Albumin in urine which becomes black like ink, scanty urine with dropsical swelling, marked irritability from pains or odors. Worse by motion, touch or mental effort. Better by warmth, rest or sitting. Gout and rheumatism in smokers.</p><p>Kali Carb<br> - pains stitching, stabbing and burning character relieved temporarily by cold application and not by rest or motion. The patient shrieks on account of pain. Backache accompanied by great weakness and profuse sweating. If he covers the painful part, the pain goes to the un-covered part. Aggravation after eating and uncovering.</p><p>Natural Remedies for Osteoarthritis…</p><p>Fresh juice extracted from carrot and apples contain various nutrients and help in curing osteoarthritis.</p><p>Ginger serves as an anti-inflammatory agent and is a wonderful remedy for osteoarthritis. You can consume ginger in any form.</p><p>Even turmeric is a good remedy for osteoarthritis and is used to reduce inflammation and ease pain.</p><p>The silicon present in the horsetail helps in increasing the strength of connective tissue and rebuilding bones, thereby treating osteoarthritis.</p><p>Yucca is an herbal remedy beneficial for reducing arthritis pain.</p><p>Castor oil is an excellent remedy for reducing pain and swelling.</p><p>Cherries, blueberries and hawthorn berries help in enhancing collagen matrix integrity and are great for curing osteoarthritis.</p><p>Cayenne contains capsaicin that is used to ease pain caused due to osteoarthritis.</p><p>Devils claw is the best analgesic and anti-inflammatory herb used for treating osteoarthritis.</p><p>Angelica root can be used in the form of oil or compress to reduce pain, spasms and swelling in the joints.</p><p>Celery seed acts as an inflammatory drug used for curing osteoarthritis.</p><p>White willow helps in reducing pain caused by osteoarthritis.</p>