Joint Pain and pain while movement are among the most common problems for which a patient consults a doctor. There are several conditions that affect the normal functioning of the joints leading to the manifestations of different diseases. Injury due to trauma is one of the issues, leading to impaired joint function but the main issues that cause dysfunction in joints are inflammation and degeneration.
The various conditions affecting different joints include
Ankle and foot
Joint problems can be caused by several issues, however, the main causes are
Wear and tear. With age, the cartilages lining the bones tend to get worn out leading to reduction in the space between the bones and produces grating when the joint is moved. The bones can also get weak due to several factors like age, lack of exercises, deficiency of Calcium or Vitamin D and after menopause in women. This can also lead to chances of fracture and can cause joint pain and other problems in the joints.
Inflammation is a process, wherein the body secretes several chemicals to breakdown substances that are not functional or are foreign to the body, to disintegrate the unwanted materials and remove them. This is a protective function meant to protect the healthy tissues from invading organisms like bacteria and viruses and from being affected by the damaged tissues. Inflammation may be triggered by damages to the tissue as in the case of injury, or by infection or by a process called auto-immunity. However inflammation that gets out of control can badly damage the tissues leading to impaired functioning. Auto-immunity is one such condition where the immune system mistakes parts of the body for invading organisms and start attacking the body’s own tissues leading to damage to the structures involved.
Damage due to Injury
Injury can cause structural damage to any of the tissues of a joint like the bones, the menisci, tendons and ligaments that can affect the functioning of the joints and lead to diseases.
The goal of ayurvedic treatment for joint pain and other joint problems is to get rid of the symptoms like pain, tenderness, swelling, redness, stiffness etc associated with the problem, to enable the person to perform the normal activities and to prevent further complications and recurrence.
Treatment of joint problems is vary varied based on the causes of the problem
Joint problems caused by Inflammation are treated by using anti-inflammatory analgesics (pain medication) in the initial stages. Physical therapy like rest, hot and cold packs are also used. If the inflammation is due to auto-immunity, drugs known as “DMRDs” Disease Modifying anti- Rheumatic Drugs are used. Steroids, Methotrexate, Hydro-chloroquine, Sulfasalazine and several other compounds have emerged in the category of DMRDs over the years. They are used over extended periods to keep the auto-immunity under check. They are effective at keeping the inflammation under control and preventing damage to the tissue but non-selectively suppress the immune system. They are known to cause several severe adverse effects with prolonged use. A new class of drug called TNF alpha inhibitors have come into use over the past few years and are very effective in controlling the inflammation and protecting the joints. They also have to be used over long periods of time, are very expensive and treatment of Joint Problems due to degeneration, is very limited in scope and mainly comprise of providing relief of joint pain through pain medication, nutritional support by way of administering Calcium, Vitamin D, Glucosamine, Chondroitin etc and Physical therapy to strengthening the muscles and other structures that support the particular joint function. Persons not responding to the same are advised to undergo Joint replacement surgery. Joint replacement surgery is a great advancement in the management of severe degenerative joint problems but has the limitation in terms of effective life of the replaced artificial joint (Maximum of 10-15 years) and is also limited by the suitability of the patient for surgery in terms of their general health condition and that of Cardiac function in prospective patients.
Joint problems due to injury which are minor and are self-limiting are managed by rest, immobilisation, pain medication and physical therapy. However several major injuries that do not respond to the conservative approach are treated through surgical correction.
The Ayurvedic approach to treatment is very individualised. However the approach to treatment of patients suffering from Inflammatory conditions differs significantly from that of Degenerative conditions.
It is seen that chronic joint problems tend to be similar after a long time. Ie, if inflammatory conditions last long, they lead to degeneration and degeneration over a long period of time leads to inflammation. So patients who suffer from either of these conditions for a long period of time will have combination of inflammation and degeneration which have to be addressed simultaneously.
According to Ayurveda, the initial stages of Inflammatory conditions are considered to be associated with toxicity and are dealt with by detoxification. Detoxification in Ayurveda is three prong. For mild level of toxicity Ayurveda advocates very light food with warm fluids and rest. For moderate level of toxicity, Ayurveda advocates administration of herbal decoctions that help the liver to metabolise and eliminate the toxins. For toxicity of a high degree, Ayurveda advocates Panchakarma (The five methods of Cellular Bio-purification). Ayurveda also advocates a number of herbs that have a very effective anti-inflammatory action, the main one is Guggulu and it is one of the most important herbs used in Ayurveda for the treatment of Inflammatory conditions. Ayurveda also employs a number of therapies like Dhanyamladhara (Pouring of warm fermented liquid), Abhyanga ( Oil massage), Podikkizhi (Herbal powder massage), Ilakkaizhi (Herbal leaf massage) and a large variety of Vasthis (Enemas) which are very effective for inflammatory conditions. Course of Vasthi as a continuous process numbering 8, 15 and 30 are called Yoga Vasthi, Kala Vasthi and Karma Vasthi respectively and are very effective in reducing very severe inflammation and restoring normalcy. It is seen to be the main tool used in bringing down the inflammatory markers like ESR, CRP etc significantly.
Ayurveda also is very effective in addressing degenerative skeleton-muscular conditions. Ayurveda recommends a holistic approach to treatment comprising of diet, lifestyle, herbal medicines and therapies for addressing degenerative joint conditions. There are many medicines in Ayurveda that help to strengthen the joints and reduce the degeneration. Ayurvedic physicians can choose ideal combinations for each individual. The therapies like Tailadhara (pouring of medicated oils), Nhavarakkizhi (massage with bolus of rice boiled in medicated milk) and Ksheera vasthi are among the most effective therapies for preventing degeneration and to strengthening the joints. It is very important to note that if there is associated inflammation, the anti-degenerative therapy is advised only after the inflammation is brought under control.
At AVN Arogya, we have developed excellent products that help relieve the problems like, pain, swelling, stiffness and loss of strength associated with Joint problems. They also help in preventing further degeneration with regular use. Patients who have recently developed the problem invariable respond to these medicines and can prevent further episodes through maintenance comprising of exercises and in some cases anti-degenerative medicines. Those who have very severe problems and those suffering for long duration with the problems require therapies that can be carried out at any of our centres. Those who are in excruciating pain and severe symptoms or other concomitant diseases and complications and who require complete rest and close monitoring would be advised admission at our Hospital in Madurai and given treatment comprising of Medicines, Ayurvedic Therapies, Counselling and Physiotherapy. In almost all cases we are able to avoid the need for surgery or powerful drugs which are harmful in the long term.
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