Wednesday, 3 August 2016

Osteo Arthritis

A degenerative disease of joints resulting from wear of the articular cartilage, which may lead to secondary changes in the underlying bone. It can be primary or it can occur secondarily to abnormal load to the joint or damage to the cartilage from inflammation or trauma. The joints are painful and stiff with restricted movement.
Joint pain is of deep ache, localized, nocturnal pain; interfering with the sleep. Movement in the affected joint becomes increasingly limited, initially as a result of pain and muscular spasm, but later because of capsular fibrosis, osteophyte formation and remodeling of bone. Stiffness of the joint involved upon arising in the morning or after a period of inactivity. There may be repeated effusions into the joints. Crepitus may be felt or even heard; associated muscle wasting is an important factor.

The pain is often described as a deep, dull ache, localized to the involved joint, aggravated by use of that joint-especially by weight-bearing in the case of knee or hip O.A and relived by rest. Although the pain is initially intermittent, with progression of the disease it may become constant, increasingly severe and disabling. Nocturnal pain interfering with sleep is seen particularly in advanced O.A of the hip.   


The diagnosis of Osteoarthritis (O.A) is usually based on clinical and radiographic feature.

No laboratory studies are diagnostics for O.A, but specific laboratory testing, may help in identifying one of the underlying cause of secondary O.A., because primary O.A is not systemic. The Erythrocyte sedimentation rate, Serum chemistry determination, Blood counts and Urinalysis are normal.

Management of O.A consists of use of Drugs, Physical measures, Patients education, Rest and Surgery, of both primary and secondary Osteo-arthritis.

Treatment of O.A is aimed at reducing pain, maintaining mobility, and minimizing disability. The vigor of the therapeutic intervention should be detected by the severity of the condition in the individual patient. For those with only mild disease, reassurance instruction in joint protection, and an occasional analgesic may be all that is required. For those with more severe O.A, especially of the knee or hip, a comprehensive program comprising a spectrum of non-pharmacologic measures supplemented by an analgesic and (or) anti-inflammatory drug appropriately.

Internal medications to relieve inflammation and pain like Guggulu, Rasna, Sallaki Etc are prescribed in the initial stages. External applications in the form of warm medicated oils, LEPAM (medicinal pastes) are applied to reduce edema and stiffness.
In advanced stages, treatments like Janu Vasthy, Pizhichil (Warm oil bath) , Njavara Kizhi (rice bolus application) and medicinal poultices are very effective.

Namami Approach to Osteo Arthritis Treatment
At Namami, we have incorporated Ayurveda, Yoga, modern physiotherapy, Acupressure and acupuncture treatments in handling Osteo arthritis. The usual course of treatment for hospitalization is 2 to 3 weeks based the severity of disease. A follow up course of medication with dietary and lifestyle changes lasting 6 months to one year can bring excellent results in the management of Osteo Arthritis.

Namami is ayurvedic treatment center in Kerala with the most classical and traditional manner, situated by the banks of River Periyar near Cochin International Airport.

By Jibu James, B.A.M.S,
RMO, Namami Purnagram

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