Arthritis

Dr. Hrushikesh Saraf

ARTHRITIS:
Commonly known as joint pain  is one of the commonest disease observed in about 80 % of the population during their life span. Though all joint pains are known as Arthritis, there are different types of Arthritis and treatment depends actually on exact diagnosis of the condition. Osteoarthritis, rheumatoid arthritis, Goutyt Arthritis, JRA, etc are different types of Arthritis. Most common of them is Osteoarthritis.

OSTEOARTHRITIS:
Knee joint is the most commonly affected joint by Osteoarthritis in Indian group of people and that too due to sitting crossed legged and sqatting habit of many Indians. On the contrary hip joint osteoarthritis is more common in western population. Other Joints like shoulder, elbow are also involved but rarely.

SYMPTONS:
Usual complaint of the people Suffering from Knee OA is

  • Pain while sitting crossed leg,
  • Pain while stepping down staircase
  • Swelling of joint,
  • Difficulty in walking,
  • Pain on posterior aspect of joint.
Early diagnosis and regular treatment works in reversing the changes in the joint to some extent and reduces above mentioned symptoms. Treatment is started after thorough examination of patient . Many a times

  • Obesity
  • Bad Posture
  • Wrong, improper working Habits
  • Lack of exercises
  • Female physic
are the contributory/exaggerating factors for early knee joint pain.


TREATMENT:
Improving the above factors, gait training and quadriceps strengthening exercises are enough for patients whose arthritis is in primary stage. Investigations like x ray and blood test to rule out other causes of arthritis helps to start right modality of treatment at proper time.Osteophyte (i.e new bone Fragments ), loose bodies in joint are more responsible for damaging joint. They can be removed Arthroscopically to prevent further damage.

Various modalities of treatment are available with modern science and advance technology which assures complete relief from pain.
In early cases
  • Medications
  • Physiotherapy
  • Local heat therapy
is sufficient to give complete relief from pain. 30-40% cases are benefited from this treatment if in addition they do regular exercises/physiotherapy suggested by Orthopaedic Surgeon. It has been observed that Knee Club concept, where group of people do physiotherapy together, suits well for this group of patients.

Next group of patients usually require one or the other minimally invasive procedure like

A) Arthroscopically
  • Loose body removal
  • Joint Clearance/ Lavage
B) Intraarticular injections -
  • Local steroids
  • Hyluronidase
  • Excision of Cyst m.b cyst
After these small procedure, this category of patients also becomes pain free and what is mandatory is to continue with there physiotherapy.
Large category of patients with severe osteoarthritis or cases which are consulted at a late stage( e.g complete joint space lost with multiple osteophyte, restricted joint movement, pain at rest) needs one or the other surgical procedure like
  • Unicondylar joint replacement
  • Total knee/ Hip joint replacement
  • Excision of Cyst m.b cyst
To conclude, early diagnosis and physiotherapy can prevent one from undergoing major surgical procedure for joint pain / Arthritis. Keep yourself fit by having balanced weight, regular Pranayam/Meditation, regular yoga/exercises, diet control which will in return keep you away from osteoarthritis.
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