The word, 'arthritis' means 'inflammation of the joints'. It is derived from two greek words, 'athron' meaning joints and 'it is' meaning inflammation. It is generally a chronic disease process.
Arthritis occurs in various forms. The most frequent being osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative joint disease which usually occurs in the older age group. It is the most common joint disease of mankind. Knee osteoarthritis is the leading cause of chronic disability in developing countries.
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Under the age of 55 years, the joint distribution of osteoarthritis in men and women is similar; in older individuals, hip osteoarthritis is more common in men while OA of interphalangeal joints and thumb base is more common in women. Similarly knee OA is more commonly seen in women. Osteoarthritis can also occur secondarily to some other disease but the true cause of OA is unknown.
Osteoarthritis results from structural changes in the articular cartilage in the joints, usually those which are weight bearing, such as the spine and the knees.
The most powerful risk factor for OA is age. A progressive increase in prevalence of OA is seen with increasing age.
Major trauma and repetitive joint use both are risk factors for OA. Damage to the articular cartilage may occur at the time of injury or subsequently (during use of the affected joint), but even normal cartilage will degenerate when the joint is unstable.
Also the association between obesity and knee OA has been well documented, the casual relationship between the two has been recently shown.
Secondary osteoarthritis is the osteoarthritis caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, congenital disorders involving abnormal joints at birth, gout, diabetes and other hormone disorders.
Obesity or overweight causes excessive mechanical stress on the cartilage and thus causes osteoarthritis. It is the most powerful risk factor for the osteoarthritis of the knees. Those whose occupation is weight lifting, osteoarthritis was believed to be due to the excessive weight of them. Repeated damage to the joint tissues such as the bone, cartilage and ligaments is believed to cause early osteoarthritis. Osteoarthritis of the hip joints are believed due to the structural abnormalities of the joints that had been present at birth.
The main symptoms of osteoarthritis are pain and stiffness in joints. The pain is often deep and localized to the involved joint. Typically, the pain of osteoarthritis is aggravated by joint use and relieved by rest, but as the disease progresses it may become persistent.
Nocturnal pain interfering with sleep is seen particularly in advanced OA of the hip and may be enervating.
Stiffness of the involved joint upon arising in the morning or after a period of inactivity (e.g. a two wheeler ride or sitting for long hours) may be prominent but usually lasts less than 20 minutes. Systemic manifestations are not a feature of primary OA.
In some patients it may be due to stretching of nerve endings in the periosteum, covering osteophytes. Muscle spasm and joint instability leading to the stretching of the joint capsule also may be sources of pain.
In some patients with OA, joint pain may be due to synovitis. In advanced OA, histologic evidence of synovial inflammation may be as marked as that in the synovium of the patient with rheumatoid arthritis. In contrast, sometimes synovitis is absent in the early stages of OA even in patients with chronic joints pain, suggesting that the pain may be due to some other factors.
Notably, even in the absence of synovitis, joint pain in OA may be relieved by a non-steroidal anti-inflammatory drug (NSAID), consistent with the fact that these drugs have analgesic actions independent of their anti-inflammatory effects.
Physical examination of the OA joint may reveal localized tenderness and bony or soft tissue swelling. Crepitus of the bone is a characteristic feature. Synovial effusion even if present is usually not large. Palpitation may reveal some warmth of the joint. Periarticualr muscle atrophy may be due to disuse or to reflex inhibition of muscle contraction. In advanced stage of OA, gross deformity, bony hypertrophy and marked loss of joint motion may be striking.
In many patients the disease stabilizes and in some, regression of joint pain and even of radiographic changes occurs.
The conventional method of treatment involves the prescription of non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, naproxen as well as acetaminophen.
Application of hot packs and advising certain physical therapy is in use now a days. Warm paraffin applications or applications of topical creams containing capsaicin can be used for local pain relief.
Application of heat to the OA joint may reduce pain and stiffness. Often, the least extensive and most convenient is hot shower or bath. Exercise should be designed to maintain range of motion and strengthen muscles surrounding the joints.
The conventional line of treatment provides instant relief and even if provides relief it is temporary and in the long term can cause severe complications.
It is not advisable to have pain killers in this kind of disease. The aim of Treatment here should be to treat the causative factor of the disease and provide adequate nutrition to the bones and prevent its recurrence. The Joint Aid plus, Aamvatantak churna are formulated in such a way that serves these purposes.
The Joint Aid plus contains ingredients like Nirgundi, Shallaki, Guggul that are useful in treating inflammation of the joints, and Ashwagandha that provides nutrients to the bones. While Giloy and Guggul are good rejuvenators.