Chronic knee pain

A 65 year old Female patient is suffering from knee pain since 5 years. She has swelling under the knee joint and has continuous pain in it. It is not the case of Vericose Vein. It can be OA. Please suggest ayurvedic treatment for pain management but the patient also have Renal stone of about 11mm to 15mm sized multiple stone. No BP problem and no Sugar problem. Please advise treatment for her.

World Arthritis Day 2018 World Arthritis Day (WAD) was established in 1996 by Arthritis and Rheumatism International (ARI) to raise awareness of issues affecting people with rheumatic and musculoskeletal diseases (RMDs). It is celebrated every year on 12th October. 'Don't Delay, Connect Today' theme initiated in 2017 by the European League Against Rheumatism (EULAR) continues to give importance on early diagnosis and access to care in 2018. ‘Don’t Delay, Connect Today’ campaign calls on people including the public, physicians, health professionals and policy-makers to connect early for earlier diagnosis of RMDs and timely access to evidence-based treatment. The overall goal is to highlight RMDs as major public health problem globally and that early diagnosis and timely access to treatment can prevent further damage and burden on the individual and society. Why is early diagnosis important? Early diagnosis is important to prevent further damage, if not treated early daily activities are affected, reducing the quality of peoples' life and affecting physical abilities. Delay is often due to a lack of awareness hence it’s important to know the symptoms of RMDs and consult a healthcare professional early. RMDs are commonly divided into inflammatory and non-inflammatory types: Common non-inflammatory RMDs are degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia Common inflammatory RMDs are rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica. RMDs can be hereditary; can also be triggered by lifestyle factors such as smoking, excessive weight, sedentary lifestyles, increasing age and having occupations that lead to injury and overuse of joints/muscles; however, in some cases the causes are unknown. Early medical treatment of inflammatory RMDs, particularly in the first 12 weeks, can prevent joint and organ damage and improve long-term function. What is Arthritis? The word arthritis actually means joint inflammation; in public health arthritis is used as a shorthand term for arthritis and other rheumatic conditions. What are the most common types of arthritis? The most common forms of arthritis are osteoarthritis, gout, fibromyalgia, and rheumatoid arthritis. What are the symptoms of arthritis? Symptoms of arthritis in affected joint are- swelling, pain, stiffness, decreased range of movements. How does body weight influence arthritis? Maintaining a healthy weight reduces the risk of developing osteoarthritis. Health tips for living with RMDs/Arthritis- (a)Healthy living- Improve your wellbeing by keeping high on emotional wellbeing, self-management and motivation and by making healthy life style choices such as: Don't smoke. Avoid stress- As stress can alter behaviour, affect sleep patterns, change appetite and increase muscle tension therefore use relaxation techniques to help manage stress. Get adequate sleep- Get enough quality sleep to protect your mental and physical wellbeing and quality of life. Reduce alcohol intake (b) Healthy eating- Healthy and balanced diet is important for people with rheumatic and musculoskeletal diseases (RMDs). Control your salt and sugar intake: Try to reduce sugar intake as it is high in calories especially in soft drinks, ready meals and confectionery foods. Salt intake should be less than 5 grams per day for adults. Too much salt can cause high blood pressure, an increased risk of heart disease and osteoporosis. (c) Physical activity and fitness- Being physically active is good for general health and can have specific benefits for people with RMD/Arthritis. Consult your doctor or physiotherapist about the type of exercise most appropriate for your condition. Exercise may be in the form of cycling, dancing, walking, gardening, swimming, yoga etc. Source : NHP

#HolisticMedicine #CCA update Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints. There are different types of arthritis: Degenerative Arthritis Osteoarthritis is the most common type of arthritis. When the cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age and previous injury (an anterior cruciate ligament, or ACL, tear, for example).  When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by: balancing activity with rest using hot and cold therapies regular physical activity maintaining a healthy weight  strengthening the muscles around the joint for added support using assistive devices  taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines avoiding excessive repetitive movements If joint symptoms are severe, causing limited mobility and affecting quality of life, some of the above management strategies may be helpful, but joint replacement may be necessary. Osteoarthritis can prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements. Inflammatory Arthritis A healthy immune system is protective. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can go awry, mistakenly attacking the joints with uncontrolled inflammation, potentially causing joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes. With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage. Infectious Arthritis A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic. Metabolic Arthritis Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability. Diagnosing Arthritis Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

67/Female with Severe pain in Knee Joint Treated with Analgesics but not Resolved Kindly Give ur suggestions

Sandhigatavata (arthritis): Cure & care by ayurveda nagalandpost.com Sep 5, 2017 8:15 PM  According to Ayurveda Sandhivata disease comes under vatavyadhi. Sandhigatavata (Osteoarthritis) is common amongst the elderly and obese persons. Sandhigatvata is chronic disease and not only it affects the body & health but also affects daily activities of a person. So the patient is hampered physically as well as mentally. Since knee is the weight bearing joint it is more susceptible to wear and tear. Sandhigatavata occurring at the knee joint as a result of wear and tear is termed as Janusandhigata Vata. In old age, all Dhatus are deranged leading to Vata Prakopa and making the individual prone to many Vataja diseases. Sandhigatavata is one of such disease commonly affecting a large number of individuals. Sandhigatavata can be compared with Osteoarthritis of contemporary medical science. Osteoarthritis is the most common form of arthritis affecting the weight bearing joints of the knees, hips, lower spine and peripheral joints of fingers and toes. According to World Health Organization (W.H.O) Osteoarthritis is the second commonest musculoskeletal problem in the world population (30%) after back pain (50%). The reported prevalence of O.A from a study in rural India is 5.78 %. Only 25-30% of OA are symptomatic even though prevalence rate is about 80% at age of 65 years.  Signs & symptoms of osteoarthritis: The symptoms of Osteoarthritis can include: Pain, Stiffness, A Grating or Grinding Sensation when the joint moves (Crepitus), Swelling (either hard or soft). Sometimes the knee may either lock or give way when you put weight on it. Almost anyone can get osteoarthritis, but it’s most likely if: • you’re in your late 40s or older  • you’re overweight • you’re a woman  • your parents, brothers or sisters have had osteoarthritis  • you’ve previously had a severe knee injury  • your joints have been damaged by another disease, for example rheumatoid rheumatoid arthritis arthritis or gout. Signs & symptoms of sandhigatavata: The signs and symptoms of Sandhigatavata is Shotha (swelling) Vatapurnadritisparsha (crepitation), Sandhishotha (swelling), Prasaran Akunchan Svedana (difficulty in flexion and exteention) Hantisandhi (destroy of joint), Sandhishula(joint pain) . The main symptom of Sandhigata Vata according to Ayurveda is Vatapurnadrutisparsha and as per modern concept one of the main symptoms of Osteoarthritis is Crepitus which is similar to Vatapurnadrutisparsha The term Sandhi means Sandhana' i.e. the union of two or more structures together. When the Vata Dosha is increased it is prone to get lodged in the Asthis(bones) and Sandhis(joints). These signs and symptoms of Sandhigatavata closely resembles with Osteoarthritis which is due to destruction of articular cartilage, synovial fluid and synovial cavity of large joints. Most commonly affected joints are knee joints. It limits daily activities such as walking, dressing, etc. Ayurvedic line of treatment of sandhigata vata:  Among Swedakarmas mainly Valuka Sweda, Jambeera Potli Sweda, Patra Potali Sweda, Janu Basti etc are indicated  Virechan yogas mentioned for Sandhigata Vata like Trivritadi churnam, Hareetaki prayog, Aragvada palavaprayog, Eranda Kwatha pryog, Eranda taila prayog etc. are used.  Vasti:- treatment of O.A. can be overcome by Anuvasana vastis with vatanasaka tailas like Nirgundi, Saindavadi tailas etc. Niruhavasti formulations. with Dashmula Kwath, Maharasnadi Kwath, Rasna Erandamula kwath, Tikta Ksheera Basti etc. are indicated.  Some of the important Sandhigata Vata (O.A.) Nasak guggulu, vati, kwatha are as follows Rasnadi guggulu drugs, Rasona panda, Vatari guggulu, Yogaraja guggulu, Rasnadi kwath, Vyadhi sardoola guggulu, Rasna saptaka kwatha, Siva guggulu etc.   External lepas, tailas for symptomatic relief; Himsradilepa, Satapushpadilepa, Vija yabhairava tailam, Sainda vadi tailam.  Rasa Aushadies used in Sandhigata Vata (O.A.):- Ekanga Ver Rasa, Vatagajendraras, Amapramathini Vatika, Mahavat Vidhamsa Rasa, Amrita manjariras etc. Even pathya & apathyas are mentioned in Ayurvedic classics.  Acupunture: A cure depends upon how well the cause of the disease is understood and in consequences to what extent it can be eliminated. Acupuncture should be used where it can give better & long lasting results.  Cupping: Wet cupping creates a mild suction by leaving a cup in place for about 3 minutes. The practitioner then removes the cup and uses a small scalpel to make light, tiny cuts on your skin. Next, he or she does a second suction to draw out a small quantity of blood. Treatment for osteo-arthritis: According to modern point of view main goals of therapy of O.A are: • Relief of pain  • Reduction of inflammation.  • Preservation of Functional capacity In medical science potent Analgesics, Anti-inflammatory drugs and also corticosteroids are generally prescribed for this disease. But these drugs are not so effective and pose increased risk of gastric erosion, hepatic and Nephrotoxicity etc. adverse effects. And also it is clearly said that, current treatment of Osteoarthritis is purely to pacify symptoms because there is no disease modifying Osteoarthritis drug yet. Intra articular steroids are widely used in Osteoarthritis particularly for the knee, these injections may provide marked symptomatic relief for weeks to month. Pathya: Pathya is referred to the Ahara and Vihara, which causes pacification of the disease. Apathya is referred to the Ahara and Vihara, which causes complications and aggravate the disease. Ahara is the base and cause for the Strength, Complexion and Vitality of the living beings. It has the ability to promote health as well as to control the disease Pathology. The benefits of food like health, strength, longevity and energy are achieved only when the food is consumed by the person according to its Swabhava, Samyoga, Samskara, Matra, Desha, Kala, Upayokta and Upayoga Samstha.  Otherwise it will end up in manifestation of diseases.  List of pathya ahara helpful in the disease sandhigata vata: Purana Shali (Old variety of Rice), Laghu Rakta shali (Red variety of Rice), Shasthika shali (Rice harvested in 60 days), Yava (Barley), Chanaka (Chickpea), Kulatha (Horsegram), Shruta Sheeta Jala (Luke Warm Water), Panchkolashruta Jala (Water with Panchakola), Shunti siddha jala (Ginger Water),Purana Sidhu (Old Wine), Gomutra (Cow’s Urine), Lasuna (Garlic), Ardraka (Wet Ginger), Sunthi (Dry Ginger), Takra (Buttermilk), Patola (Bottlegourd), Karavellaka (Bitter gourd), Varthaka (Brinjal), Nimba patra(Neem leaves), Shigru (Drum Stick), Jangala Mamsa(Forest meat).  List of apathya ahara harmful in the disease sandhigata vata: • Navanna (New variety of Rice), Masha (Black gram), Taila (Oil), Dushita Jala(Polluted water), Sheeta Jala (Cold water), Nutana Madya(New Wine), Aluka (Potato),  Dadhi (Curd), Guda (Jaggery), Matsya (Fish), Anupa Mamsa (Marshyland Animal meat). • Dravyas possessing Guru (heavy), Snigdha(oily), Ati Drava (watery), Picchila (slippery) and Abhishyandi (sticky) Guna are considered as Apathya for Sandhigatavata. For better understanding, the Pathya and Apathya for the patients so as to reduce the severity of the disease.  • Consumption of incompatible food items i.e. Viruddha Ahara should be strictly avoided since, it is considered to be a chief etiological factor of the disease.   • Most of the vegetables are good to reduce the formation of vata. However, they should be consumed warm and along with some spices to counteract their cold nature. • Cold beverages, Cold water, Ice cream should be avoided as they can precipitate the disease.   • It is better to avoid excessive water intake after consuming food as it interferes with the concentration of the digestive enzymes and slows down the digestive process. Conclusion: In modern science, mainly analgesics, Non steroidal anti inflammatory drugs or surgery are options for the management of Osteoarthritis. These treatments don’t give satisfactory relief and also causes some adverse effects. Ayurveda is the science of life and longevity. Ayurveda has a ray of hope to such patients because of its holistic approach of cure and prevention of disturbance in physiology.  Note: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. The drugs described in this article are for general information/educational purpose only. Anyone should not use these without consulting a qualified Ayurveda doctor/physician.