Shoulder Joint

• Adhesive capsulitis
• Frozen Shoulder
• Peri-Arthritis Shoulder

Elbow Joint

• Tennis elbow
• Golfer’s Elbow

Wrist Joint

• Carpel Tunnel Syndrome

Ankle and foot

• Plantar Fasciitis
• Achilles Tendonitis
• Calcaneal Bursitis

Hip Joint

• Avascular Necrosis of Head of Femur

Knee Joint

• Rheumatoid Arthritis
• Osteo Arthritis

Causes of Joint Problems

Joint problems can be caused by several issues, however, the main causes are

Degeneration

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

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.

Symptoms Of Joint Problems

• Pain – Pain may be at the joint or in parts of the body associated with the joint.
• Swelling – Swelling is often a sign of inflammation.
• Stiffness – Stiffness is caused by the body to prevent excessive movement in order to protect the damaged part.
• Limited range of movement – when a muscle or tendon is affected, it is not possible to move the joint through the full range that is normally possible.
• Tenderness – Tenderness is pain on touching the part and is a sign of inflammation.
• Weakness – Weakness of the part of the body associated with the joint is often seen.
• Inability to move the part – When a tendon or muscle is affected, the person is not able to move the affected part. Movement may also be restricted by pain.
• Fever – Joint problems can also be a part of a systemic issue and a disease that not only affects the joint but also other organs in the body  Ex. Ankylosing Spondylitis.

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.