Arthritis

Rheumatoid arthritis

This is the commonest form of chronic inflammatory joint disease. It is also known as rheumatism or synovitis. It usually affects people over 40 years of age and females are more prone. It affects small and large peripheral joints, with systemic disturbance to other parts of the body, including the heart, lungs, eyes, nerves and muscles.

The discomfort of rheumatoid arthritis develops slowly and tends to be most severe on awakening. Rheumatoid arthritis in older people may cause deformities of hands and feet as muscles weaken, tendons shrink and the ends of bones become abnormally enlarged.

If the treatment is started at an early stage of the disease, it gives relief in most people. Generally symptoms may progresses for five years or more, eventually tending to stabilize or decline the movement of joints. So, permanent disability can be prevented by early treatment.

Juvenile rheumatoid arthritis

It is an inflammatory arthritis characterized by persistently negative tests for rheumatoid factor associated with a number of other common features like chronic fever and anemia and secondary effects on the heart, lungs, eyes and nervous system. It commences in childhood before the age of 16 years.

In some cases, juvenile rheumatoid arthritis presents with high fever, pericarditis, mono or polyarticular synovitis, with progressive erosion of cartilage. Here, the rheumatoid factor is not present in the blood. This typical type is called Stills disease.

In children younger than the age of five, juvenile arthritis attacks can last for weeks and recurrence is also possible, but symptoms may be less severe. Patients require heavy physical therapy and exercise. Now-a-days permanent damage is rare.

Infectious arthritis

Infective arthritis can accompany septicemia at any age. It is usually a complication of an injury or some other disease. It is less common than arthritic conditions that come on with age. Symptoms have an abrupt onset with severe pain and swelling of a single joint associated with a swinging fever, severe malaise or primary injury.

Large joints (arms and leg joints) are most frequently affected. Generally the joint is hot, tender and swollen with marked limitation of movement. The diagnosis may be missed and if left untreated, can result in permanent disability.

Psoriatic arthropathy or Psoriatic arthritis

Psoriatic arthritis or arthropathy is a complication of psoriasis - the joint/s get affected due to the progression of the psoriasis. This can be reversed by treating the psoriasis.  Please click here to read more about psoriasis.

Osteoarthritis

It is also known as arthrosis or degenerative joint disease. It is not a single disease. Rather it is the end-result of a variety of patterns of joint failure. It is a degenerative and destructive disorder of the hyaline cartilage and adjacent bone of joints. It is the most common form of arthritis, particularly in the elderly. In osteoarthritis, the protective cartilage at the end of the bones in joints, gradually wears away and the inner bone surfaces become exposed and rub against each other.

It generally confines to one or only a few joints in a majority of patients. The joints most frequently involved are those of the spinal joints, hips and knee joints (weight-bearing joints).

The mechanism of osteoarthritis is generally unknown, but some people have a genetic predisposition. Misuse of steroids can also bring about an early onset of the disease. It may be due to trauma, joint mal-alignment, foreign bodies and damaged cartilage from septic arthritis.

The symptoms are gradual in onset; pain and stiffness develops gradually. Pain is usually made worse by exercise, whereas stiffness in the morning or after inactivity improve with movement. As the disease progresses, movement in the affected joint becomes increasingly limited and tenderness and a grating sensation develop and a crepitus may be felt on joint movement. Overgrowth of all tissues in and around the joint causes joint enlargement. Associated muscle wasting occurs as the disease progresses, causing increasing instability and the joints become more prone to injury. Locking of joints may occur, if bony outgrowths (osteophytes) protrude into the joint cavity.

Other arthritic conditions include  ankylosing spondylitis (arthritis of the spine), bone spur (bony growths on the vertebrae or other areas), gout (crystal arthritis), and systemic lupus (inflammatory connective tissue disease).

Rheumatoid arthritis

Juvenile rheumatoid arthritis

• Loss of appetite.
• Weight loss.
• Enlarged lymph glands and spleen.
• Anemia.
• Retardation of growth.
• Blotchy rashes on the arms and legs.
• Abdominal or chest pain.

Infectious arthritis

• Fever.
• Severe pain, swelling and tenderness of a single joint.
• Large joints are more commonly affected.
• Severe malaise.

Osteoarthritis

Rheumatoid arthritis

• In addition to sign and symptom analysis, blood tests are commonly done to confirm the diagnosis. The majority of sufferers have antibodies called rheumatoid factor (RA factor).
• Investigation shows high CRP and RA Factor.

Infectious arthritis

• Testing a sample of fluid from the affected joints.
• Blood culture.

Osteoarthritis

• X-ray finding:-
• X-ray shows loss of joint space and formation of marginal osteophytes

Consult a Doctor if

Top

• Pain and stiffness come on quickly, whether from an injury or an unknown cause.
• A child has swinging fever, weight loss and loss of appetite associated with pain or a rash on armpits, knees, wrists, and ankles.
• Joint pain associated with fever.

Acupressure & Acupuncture in Arthritis

Top

Generally this therapy offers effective relief from pain when administered by a trained practitioner.

Hydrotherapy and Arthritis

Top

Swimming or other water exercises, preferably in a heated pool improves movement of affected joints and improves muscle strength. Shower for three minutes under very hot water followed by thirty seconds of cold water; this method improves circulation and skin function.

Diet and Nutrition in Arthritis

Top

• Avoid overeating and don't eat too quickly.
• Chew everything very thoroughly.
• Don't be anxious or stressed at meal time.
• What to eat in arthritis
• All alkaline forming foods, which include generally all fruits and vegetables except pulses, asparagus, peas, broad beans, Brussels sprouts. Other alkaline forming foods are millet, yoghurt, fresh coconut, soya products and egg white.
• Bananas, pineapples, apples and grapes.
• Carrot, celery, beetroot, parsley, alfalfa, garlic, mushrooms.
• Fruits — all berry fruits, blueberries, blackberries and cherries.
• Sprouted grains, seeds and nuts.
• Nuts and seeds, especially of sunflowers, sesame, walnuts, pumpkin seeds; almonds should be taken raw and fresh.
• Grains — millet, rice, corn are the best. Use rye and oatmeal in moderation. Wheat causes many problems for many arthritis patients, so avoid it.
• Goat's milk or soya milk, egg and cottage cheese in moderation.
• Oily fish.
• Spirulina and wheat grass.
• Turmeric and ginger.
• Low-fat and low-protein vegetarian diet.
• Raw and fresh, fruit and vegetable - juices are of enormous benefit to a patient. These must be freshly prepared and not canned or packed. Dilute the juice and drink slowly.
• Garlic may be taken raw or cooked.
• What to reduce in arthritis
• All acid-forming foods, especially meat and dairy products. Home made cottage cheese is fine. All these products increase inflammation.
• Citrus fruits - sometimes the body does not metabolize these correctly.
• Pulses.
• What to avoid in arthritis
• Foods to which you are allergic. Use the trial and error method, preferably under the supervision of a homeopathic physician.
• Nightshade family vegetables : tomatoes, potatoes, peppers, capsicum/capsica, chillies.
• All wheat flour, and everything made from it - bread, pasta, cereal and cakes.
• Sugar and artificial sweeteners.
• Added salt and hot spices.
• All frozen and processed foods - cakes, cereals, jams, sausages etc.
• Coffee, tea, cocoa, alcohol and soft drinks.

Home Remedies and Arthritis

Top

• Hot fomentation and rest are very effective.
• Hot fomentation from a heating pad or a hot bath or a hot water bottle wrapped in a towel.
• Sea bathing has been found to be valuable.
• Reduce weight if you are obese.

Herbal Treatment for Arthritis

Top

There are many herbs which help in arthritis by decreasing pain, stiffness and swelling, by blocking the inflammation. Choose from the following:-

• Curcumin extract: 400 gms, three times daily. This is a turmeric extract and has a powerful anti-inflammatory action.
• Ginger:1-2 gms, three times daily of powdered root or make a tea from the fresh root or cook.
• Chinese Skullcap (Scutellaria): 2-4 gms, three times daily. This has a highly potent anti-inflammatory and anti-oxidant effect.
• New Zealand Green-lipped Mussel: 350 mg, three times daily. This is a very effective herb. It is anti-inflammatory and also repairs the collagen part of cartilage.
• 5 ml tincture made from 2 parts willow (salix spp) bark and 1 part each of black cohosh (cimicifuga racemosa) and nettle (urtica dioica), taken three times a day for relieving pain.
• To relieve muscle tension, rub a tincture of lobelia (lobelia inflata) and cramp (viburnum opulus) bark on the affected area.
• A poultice for swollen painful joint: mix two tablespoon mullein + two tablespoons slippery elm + one teaspoon cayenne + one teaspoon lobelia.

Please E-mail dr_ramanand@rediffmail.com for any questions/treatment