Musculoskeletal Disorders

<< Treatments | Musculoskeletal Disorders

1. Osteoarthritis

1. Osteoarthritis

Osteoarthritis is the most common cause of chronic joint pain. It is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of one or more of your joints.

Osteoarthritis affects 15-20% of the population .Osteoarthritis occurs most often in knees, hips and hands. Other joints, particularly the shoulders, can also be affected.

Osteoarthritis rarely affects other joints, except as a result of injury or unusual physical stress. It is the leading cause of pain and disability among the elderly. Osteoarthritis is the third leading cause of life-years lost due to disability. Obesity and joint injury are important potentially modifiable risk factors for the development of osteoarthritis.

Main symptoms of Osteoarthritis
• Pain
• Stiffness
• Tenderness
• Limitation of movement
• Crepitus (a crunching or grating sound or feeling)
• Swelling

Arthritis is an inflammatory condition of one or more joints, manifesting typically with pain , tenderness , swelling , and morning stiffness of the affected joint or joints.
Osteoarthritis is essentially a vatha disorder, with the involvment of pitha and kapha doshas.

Osteoarthritis is a common condition affecting both women and men, especially in the latter decades in other words during the Vatha predominant life stage. Vatha has dry and light qualities and its vitiation leads to imbalance of Kapha dosha. This depletion leads to osteo arthritis in which the cartilage in the joints wears away causing friction, pain and limited joint mobility and affects the large weight-bearing joints, like the hips and knees, also hands, feet, and spine.

Occurrence of arthritis indicates the manifested stage of the disease. This stage may have been preceded by joint discomfort or cracking and popping during the starting stage of the disease. Left untreated, most arthritic conditions progress to the advanced stage of disease with deformity, destruction of the articular surface and loss of function.

Osteoarthritis Treatment principle
  • Ayurvedic therapies for arthritic conditions should always be individualized.
  • Classical descriptions of arthritic diseases cannot be accurately matched with the disease entities currently described in Western medicine.
  • Inspection (Darshanam), Palpation (sparshanam ) and Clinical interview (prashna) will lead to an individualized diagnosis.

The treatment model used in Ayurveda thus includes treatment procedures such as Panchakarma for returning the toxins to the gut for excretion, rehabilitation of agni , lifestyle and dietary changes to address the initial cause of vitiation of agni and build-up of ama.

Osteoarthritis is manageable rather than curable.

Depending upon the individual’s stage of progression of the disease the prognosis can be made. Aim of treatment can be disappearance of symptoms, reduction of symptoms, non-progression of the disease or, in the worst case, slower rate of disease progression. It is important for the patient to understand the goals and to appreciate the potential outcome of their efforts.

Osteoarthritic Treatment Procedures
  • External application of Paste of Medicated powder: It is useful in the acute stage for reducing oedema, burning sensation and pain.
  • Dhara or Pouring of medicinal liquids: Based on symptoms, dhara or pouring of warm herbal decoction, medicated milk(Ksheera kashaya) over affected joints for 45-50 minutes is useful. This procedure can reduce pain and oedema within hours.
  • Internal administration of ghee or oils: This includes oral administration of ghee or oils processed with bitter and astringent herbs. This is the first step of Panchakarma treatment procedure. Choice of preparation is made by physician after assessing patient’s condition.
  • Steaming and other heating procedures: This provide flexibility to stiffened joint structures. It is useful in removal of blockage of subtle channels or srothas.
  • Virechana or Medicated purgation: It is a cleansing method, performed by giving some herbal purgatives which helps to regain power of fire principle.
  • Vasthi or Enema like procedure: Designed to clean the lower alimentary canal and most effective in Ayurvedic treatment bringing cleansing of subtle channels or srothas spread all over the body.This is very effective in removing abnormally increased Vatha principle. Special ingeredients may be added to it making it a brimhana vasthi which can cause regeneration of affected joints.
  • Rasayana therapy: This therapy follow pancha karma.Formulations and procedures meant for rejuvenation of asthi or bone dhathu are used here.These medicines will be continued for long period.

2. Osteoporosis Treatment

2. Osteoporosis Treatment

Osteoporosis may be considered as thinning of the bones.

After the age of 60, half of the female population and one third of men are affected by osteoporosis.

This occurs when the body fails to form enough bone or when too much old bone is reabsorbed by the body or both. People who had insufficient calcium and protein during childhood, who are bedridden, or have a hereditary disposition are more likely to develop osteoporosis.

Diseases such as chronic rheumatoid arthritis, chronic kidney disease and hyperparathyroidism make people vulnerable to this condition. People on antiepileptic drugs, corticosteroids are also at risk of osteoporosis.

Menopause and the surgical removal of the uterus and ovaries can cause a fall in the primary female sex hormone, estrogen. Estrogen activates bone cell producing cells called osteoblasts but absence of estrogen causes increased activity of osteoclasts which cause re absorption of phosphates and calcium from bone cells to body and thus helping osteoporosis.

Within 5-8 years after menopause bone density will have been reduced by 4%. As age increases, the chances of getting a fracture also increases.

Signs and symptoms
Early stage osteoporois does not have any signs or symptoms
Later the condition is suspected when fracture happens with little or no trauma
  • Pain or tenderness in bones
  • Loss of more than 6cm of height
  • Low back and neck pain due to fracture of vertebrae
  • Fracture of vertebrae can result in curved back
  • Fracture healing requires long period in patients with osteoporosis.

Treatment
Treatment procedures and medicines used for vatha predominant conditions are successfully employed in osteoporosis.
  • Internal or External application of ghee or oils. This includes oral administration of ghee or oils processed with bitter and astringent herbs. External application of medicated oils is also useful. The choice is made by a physician after assessing the patient’s condition.
  • Sweating. After above oleation process, mild to moderate sweating or steaming is done with boiling herbs in water.
  • Vasthi. This is a very important treatment process for vatha predominant conditions. Here medicated oils, ghee, honey, powdered herbs, rock salt and herbal decoction are mixed in a very peculiar manner. This is administered through the anus as an enema. Here medicines reach emulsion form which causes increased bio assimilation.

3. Rheumatoid Arthritis (RA)

3. Rheumatoid Arthritis (RA)

Rheumatoid Arthritis (RA) is an autoimmune disease affecting any ethnic group. Its prevalence is 1%. Though it affect all age groups, it is more common in 30-50 years. Women are affected three times in comparison to male. It affect joints and its covering called synovial membrane and in the later stages leading to degenerative changes. During progress of the disease it may affect many other organs such as covering of lungs ie, pleura and covering of heart or pericardium.

The disease starts with morning stiffness, loss of appetite, general weakness and sometimes may be associated with mild fever and generalized muscle pain. When joints are affected, it become swollen, stiff, and warm and pain starts.

The common joints affected are knee, wrist fingers, neck and ankle. As joint inflammation progress, excess synovial fluid is produced and the joint become swollen. It is considered that the degenerative changes happening to the joint are not directly proportional to the swelling, pain or stiffness of the joints. In advanced stages chronic inflammation affect cartilage, bones, ligaments and deformity of joints happen. In RA patients there may be periods of remission and bouts of flare ups or increased disease activity. Ayurveda consider rheumatoid arthritis as a systemic disease caused by vitiated rakta or blood tissue and Vatha.

Signs and Symptoms:
  • Pain & morning stiffness in the smaller joints of the hands & feet.
  • Warm, Swollen and tender joints are affected in a symmetrical pattern or both side of body is affected.
  • Generalized fatigue and feeling of unwell.
  • Sleep disturbance.
  • Fever and headache.
  • Restricted movement in the affected joints.
  • Deformed joints in advanced stages.
  • Nodules or firm lumps under the skin of pressure points such as fingers, knuckles, hands and elbows.

Treatment
General approach: Any treatment procedure or formulation will be pacifying Vatha and Raktha
 
  • Snehana - Generally snehana or oleation is done with medicated ghee processed with milk and bitter medicines.
  • Vamana-Medicated vomiting
  • In conditions with Kapha predominant symptoms such as itching etc.
  • Virechana-Medicated purgation
  • Purgatives with drying nature for patients will snigdha or oily body.
  • Purgatives with oily nature indicated for patients with dryness.
  • Vasthi -Medicated enema with medicated oils/ghee and Ksheeravasthi(containing medicated milk) are useful.
  • Lepa - Paste made of suitable medicines are applied over areas where pain, discoloration, edema or burning is felt. When paste gets dried itself, it will be removed.
  • Abhyanga - Mild massage with suitable oils may be done in appropriate conditions.
  • Pariseka - Pouring of herbal decoctions, medicated milk is very useful especially when patient is suffering from burning sensation or throbbing pain.
  • Blood letting - Since Vatha Raktha is primarily caused by vitiated Raktha or blood tissue, bloodletting in a controlled manner is very useful to reduce pain. Bloodletting is done only after proper oleation with suitable medicated ghee otherwise it may result in Vatha aggravation.
  • In the Uthaana Vatha , Raktha Lepa, Pariseka, Abhyanga and Avagaha are the procedures required.
  • In Gambheera Vatha Raktha, in addition to procedures mentioned above, Panchakarma procedures are necessary.

At Amulya we have got a very good success rate in managing Osteoarthritis disorders, Osteoporosis disorders & Rheumatoid Arthritis (RA) disorders


Note:  As we all are genetically different with different constitutions and patterns, we respond to treatments in many different ways. Hence Standard Ayurvedic Treatments are always individually formulated. This article is intended only for information. It is not a substitute to the standard medical diagnosis, personalized Ayurvedic treatment or qualified Ayurvedic physician. For specific treatment, always consult with a qualified Ayurvedic physician.