Arthritis (Joint pain, Sandhi Vata, Amavata)

Arthritis

 (Joint pain, गठिया, Sandhi Vata, Amavata)

“Manage your Pains”

 “Say No To Creaking Bones”

"WORLD ARTHRITIS DAY OCTOBER 12." 

                             Its in your hand take action.                             

Arthritis is a painful condition that usually becomes worse in winter. According to  the western concept : there are three kinds of arthritis. Osteoarthritis also called old age or degenerative arthritis. Rheumatoid arthritis an inflammatory form of arthritis and gout, which involves the bog toe of the foot, and is due to uric acid imbalance.

Arthritis literally means  inflammation of one or more joints which leads to  pain and swelling. All age groups are susceptible to arthritis. They especially affect joints, tendon, ligaments, bones and muscle. This results in restricted movements and eventually deformity. Healthy food habits will improve the body's response to inflammation, will provide adequate nutrients and boost immunity. Please skip one meal a day. Reduce the quantity of rice intake. Start walking.

Arthritis is  now a major problem both in India and in the western world. They can cause permanent disability to various degrees in individuals, irrespective of their age. About 14% of Indian population suffers from some form of arthritis. This effectively means that close to 150 million people are victims of arthritis in India. Arthritis can be a debilitating condition in most people causing a loss of productivity and sometimes making simple day to day tasks difficult to perform. Arthritis is basically a metabolic disorder. 

Arthritis impacts everyday life in numerous ways. Just imagine if you were to be sedentary every day, pretty soon you would be so stiff that it would be just about impossible to move. But if you get up and move around every day, you will get stronger and will loosen up as well. Joints facilitates our movements but over the years they become susceptible to wear and tear and as we grow older, joint problems could increase. Here's how can you keep joints pain at bay. as far as nutrition is concern maintain your body's pH balance. Acidic food causes the lubricant in the joints to gradually dry up. Osteoarthritis survives on wrong food and overweight. 

If you know swimming, and have the facility to do so, it is a good exercise to reduce weight. Take 1 teaspoon Triphala powder mixed with honey followed by warm water at bed time.

According to Ayurveda  joint pains are the result of accumulation of toxins in the joints. These toxins are  made when we eat foods that are incompatible with each other and a rich diet that includes lots of dairy, fried and refined foods, non veg and alcohol. When these foods are eaten on a regular basis, they overwhelm the digestive system. As a result, the toxins rot in the colon, spread all over the body through the blood and ultimately accumulate in the joints

                                   Inflammatory conditions that affecting joints

                         "Planned diet, exercise, physiotherapy is the key for pain free life."

Introduction

Arthritis is associated with joint inflammation. It can impact a single joint or multiple, making it harder to go  about one's routine activities. With increasing age, a person faces many health related problems and nowadays almost every other person is facing some health issue or the other. The main reason is why this is happening is our diet, our poor routine  and lack of discipline. In this hectic pace of life, people do not eat food on time nor do they pay attention to the various small things which cause discomfort in their day  to day life. These small things which are a cause of slight discomfort, if ignored for long may  become a severe problem. One such problem is the joint pain. Nowadays not only the elderly  but even youngsters in large numbers are suffering from joint pain. Hence it has become very neccessary to deal with such a condition before it is too late.

Arthritis is a very painful condition that usually becomes worse in winter. What ever type of Arthritis one is  suffering from, be it osteoarthritis, rheumatoid arthritis or any other form, most patient report stiffness, and worsening of pain during winters. This is because:
*  The nerves and the receptors that sense pain, becomes insensitive during winter.
* Cold temperature causes  constriction of blood vessels and reduces blood circulation to hands and feet  that increases pain in arthritic joint.
*  Muscles have more spasms  and stiffness in colder temperatures.
*  Vitamin D deficiency. Sunlight exposure causes vitamin D to naturally form in the skin 
*  During winter, sunlight exposure decreases and vitamin D deficiency worsens. 

Arthritis can appear in the form of Osteoarthritis, cervical  Spondylosis, Lumbago or Lower Back Pain, Rheumatoid Arthritis and Ankylosing Spondylitis, among others. Over time, a swollen joint can become severely damaged.

Osteoarthritis of the cervical spine or lumbar spine causes pain in the neck or low back. Bony spurs, called. Osteophytes is formed along the spine  and irritate the spinal nerves causing severe pain that can radiate from the spine  as well as numbness and tingling on the affected parts of the body.

                 Lemon juice cures anemia, joint pain, bleeding oral diseases and scurvy.

Types Of Arthritis :

Depending upon the damage caused to the joints the most common types of arthritis include :

●     Osteoarthritis (Sandhivata, संधिवात, संधिशोथ)

Osteoarthritis is more common among the elderly. Osteoarthritis is more common in women as compared to men especially after the age of 45. It is a degenerative disease that results when the cartilage surrounding the joints begin to wear down. Osteoarthritis causes the cartilage to break down. Cartilage is a hard slippery tissue that covers the ends of bones, where the joints is formed. The degeneration of cartilage causes the bone to rub against each other, leading to joint pain and stiffness. It is more painful in weight bearing joints such as the knee, hip and spine.
                                                 

                                                                                          

●     Rheumatoid Arthritis   (गठिया, )

Rheumatoid arthritis majority affects middle aged people. It an auto-immune disorder results of inflammation of the membranes that make up the joint tissue lining. It causes joint pain, stiffness and the joints are often warm to the touch. It is more frequent in females than males. This commonly occurs in joints of hands and feet.  It causes irreversible joint damage. C reactive protein. (C.R.P) increased. Tab Hydrooxychloroquine prescribed. Tab Colchicine 5 mg daily.

                                               

                                                              Consult a Rheumatologist 

According to Unani

At times, accumulated phelgm, can also lead to joint pain, which usually occurs as a reduction of the fluid between the joints (synovial fluid). A few causes of this condition are

• Extreme cold
• Increase of phelgm in the body
• Cold climate
• Cold temperament

                                                                 "Music therapy good for pain."

●      Ankylising Spondylitis

It is a form of arthritis that involves primarily the spine and joints of extremities, such as shoulder, hip and knee. It strikes young adults (usual men in their 30s), causing pain stiffness, inflammation and possibly disability in severe cases. It is known as cervical spondylitis if the cervical region is affected and lumbar spondylitis if the lumbar spine region is affected.
                                                   

                                                           

●     Gout (Vatarakta)

Gout is caused where there is too much uric acid in the blood. Gout is created because of the deposits of needle like crystals of uric acid in the joints, The crystals causes inflammation, swelling and pain in the affected joints, which is often a big toe.. Apart from a big toe, it affects foot, ankle, knee and some times back etc.

                                               

                                                   

●     Infective / Septic Arthritis

Infective arthritis is commonly diagnosed in children. It is caused by bacteria. Early diagnosis can minimize damage to the joints. Septic arthritis is a painful infection in a joint that can come from germs that travel through your bloodstream from another part of your body. Septic arthritis can also occur when a penetrating injury, such as an animal bite or trauma, delivers germs directly into the joint. Septic arthritis : It  present with sudden onset of fever (usually high) and painful swelling with restriction of joint movements. It usually affects the knee, hip  or ankle joints. In tuberculosis, the swelling may increase gradually  and persist for days  and weeks. 

●    Psoriatic arthritis

      It is caused due to problem in immune system.

●  Post viral arthritis in Chikengunia 

      Post-viral polyarthralgia, fibromyalgia, chronic joint pain, adhesive capsulitis, and plantar fasciitis can also occur. When these arthritic manifestations last more than 3 months following the onset of chikungunya fever, the illness can be called chronic chikungunya arthritis.

●   Lupus  arthritis

     It is caused due to problem in immune system.

● Monsoon can worsen you joint pain

.

●    Acute Rheumatic fever : This give rise to swelling and pain in the joints. Involvements of joints due to this condition is very common. Fever and painful, tender joints are common signs and symptoms. Symptoms of rheumatic fever can include: Fever. Arthritis (painful, tender joints), most commonly in the knees, ankles, elbows, and wrists.

                     "Movement of all the joints in the morning is a must."

According to Ayurveda  joint pains are the result of accumulation of toxins in the joints. These toxins are  made when we eat foods that are incompatible with each other and a rich diet that includes lots of dairy, fried and refined foods, non veg and alcohol. When these foods are eaten on a regular basis, they overwhelm the digestive system. As a result, the toxins rot in the colon, spread all over the body through the blood and ultimately accumulate in the joints

In this philosophy, there are three kinds of arthritis :

Vata arthritis (dry cracking joints with limited mobility)

Pitta arthritis (swollen and painful joints with a burning sensation) and

Kapha arthritis (due to  overeating and combination of incompatible foods)

Causes

●     Autoimmune disease

●   Rheumatoid arthritis

●   Overweight.

●     Exposure to cold items/over exertion

●   Osteoarthritis serves on wrong food and over weight  especially the knee joints are affected.

●   Osteoporosis

●   Injury

●     Old age, wear & tear of joints may occur due to ageing

●     Prolonged poor posture, overuse of joints.

●     Diabetes/ obesity/ trauma/bacterial infection

●     Calcium & vitamin deficiency in women due to pregnancy/ lactation / menopause.

●     Infection : Post viral arthritis, in chikungunya

●     Poor eating habits junk food and weak digestion allow impurities to accumulate, circulate and build up in joints. This inhibits joint function, mobility and comfort.

●     Monsoon season (Increase pain due to the drop in atmospheric pressure, due to which the fluid in the body swells, causing painful symptoms.

●     Patellar dislocation / patellar chondromalacia.

Bacterial Infection

Acute bacterial infection and tuberculosis can result in arthritis. Arthritis caused  by acute bacterial infection is termed septic arthritis.

●     Salt is a cause of headache, insomnia, sinuses, epilepsy, rheumatoid, arthritis and even cancer.

●     According to Ayurveda, arthritis occurs due to the aggravation of Vata dosha and is known as "Sandhivata" According to Ayurveda, joint pain are the result of the accumulation of toxins in the joints. The toxins are made when we eat foods that are incompatible with each other, and a rich diet that includes lots of dairies. Fried and refined foods, non vegetarian and alcohol. When these foods are eaten on regular basis they overburden the digestive system. As a result, the toxins rot in the colon, spread all over the body through the blood, and ultimately accumulate in the joints.  There are three kinds of arthritis.  Vata arthritis (dry cracking joints with limited mobility; Pitta arthritis (swollen and painful joints with a burning sensation); and Kapha arthritis (due to overeating and combinations of incompatible foods) 

Bacterial Infection

According to Unani

• Extreme cold
• Increase of phelgm in the body
• Cold climate
• Cold temperament

       "If one has sour(fermented) food excessively one may suffer from  swelling." 

Sign & Symptoms

●     Reduced mobility

●   Redness

●   Crackling sounds in joints or knees, 

●   Hip pain and decrease range of motion.

●   Its impact on one's daily routine can lead to mental health issues.

●   This isolation can also lead to anxiety and depression.

●   Stiffness 

●    Weak warm and red swollen (inflamed) joints

●     Deformed joints

●   Trouble sleeping

●   Fatigue

●   Sharp pain in the hands and neck , shoulders, hip, knees,  or any area of the joint.

●     Swelling stiffness and limitation of joint movement

●     Myalgia / early morning stiffness

●     Joint swelling usually symmetrical, involving joints of fingers, wrist, elbow and knee joint.

●     Later on, deformities take place in the affected joints.

●   Extra articular features it may involve skin as rheumatoid nodules, interstitial lung disease and pericarditis, neuropathy and vasculitis due to circulating " ’ama’  or toxins. Some times gouty deposits at the back causing backache.

●  Hemophilia : Children with clotting defects  can also present with swelling of a joint. A history of bleeding tendency in the child or a family history aids the diagnosis.

Risk Factors

●   Excess body weight

●   Decrease physical activity.

●   Family history

●   Age

●   Gender

●   Previous joint injury

●   Damaged or deformed joints

●   Post Covid 19 Syndrome- cases of arthritis increased after pandemic. 

Diagnosis

Blood test:

●     For Rheumatoid (R A) factor, and

●     For C- reactive protein CRP

●     Sugar fasting and PP

●     If the pain is severe check your Vitamin D levels.

●     X -Ray

●   M.R.I

●   Bone biopsy for spinal tumor.

“Daily movements of all joints is a must”

Lifestyle

●   Regular yoga helps combat arthritis.

●  Control weight: Controlling your weight will reduce strain on weight bearing joints, and movement of your joints as normal as possible.

●     Expose your body to the sun for at least 30 minutes a day. Direct sunlight is a good source of Vitamin D, which maintain calcium level in your body and B12.

●   Use staircase instead of lift if possible.

●   Adequate rest Joint heals if you keep them still.

●   Increase flexibility :Stretching keeps our joint fit. Take breaks to stretch.

●  The chair's backrest should support your lower back and top of your computer screen should be at eye level.  

●   Sleep on hard mattress, and change its direction every month to avoid backache.

●   Avoid using pillow to keep cervical spondylitis at bay.

●     Food should be warm

●     Straight back chairs with lumber curve.

●     Avoid sleep during day time

●     Avoid constipation at all cost

●     Include ghee in your diet

●     Include light foods and avoid oily food items

●    Maintain a good posture. If your job involves sitting for long hours, ensure that you maintain a 90-110 degree thigh bent with thighs completely supported by the chair, relaxed shoulders and feet flat on the floor. The chairs backrest should support your lower back and the top of your computer screen should be at eye level.

●  Take a hot shower or warm bath: A hot shower can help reduce stiffness and pain. Swimming in a heated pool is both a great exercise and is soothing for the joints.

●   Stay active : Cold weather makes us lazy. Being active even when it's  cold helps in reducing arthritic pain .Continue your walk and exercise in winter as well. If the cold is keeping you from going outside, exercise indoor.

●   Vit D Supplementation: Vitamin D Deficiency  might play a role in the joint pain and stiffness. Vitamin D is also essential for maintaining good bone health and decrease the risk of osteoporosis.

Diet

Dietary Modifications: We often see fat intake increases during winter particularly saturated fats. Saturated fats are those that are solid at room temperature (ghee and butter). Increasing the intake of saturated fats not only increases the body weight and worsen joint pain  particularly in the knees, but it also increases the inflammatory re-opens of the body and worsens arthritic pain and stiffness. On the other hand, Omega 3 fatty acids are known to be  anti-inflammatory and reduce pain, stiffness and swelling. Many arthritis patients use Omega 3 fatty acid capsules. These are naturally found in chai seeds, flax seeds, nuts, dry fruits, avocado and soybean. Non vegetarian sources are fish and fish oil.

Avoid

 Avoid using air conditioners continuously as it aggravates body pain.
Avoid cold exposure: Wear warm cloths and stay away from cold. Also dress in layers. Always
make sure to cover your ankles, knees, and hands using socks and gloves. For local relief use a hot water bottle or a heating pad.
Avoid dehydration : During winter, fluid intake decreases. We feel less thirsty and run the risk of getting dehydrated. This is specially true for the elderly. Make a conscious effort  to stay hydrated.

"Exercise help eliminate acid waste from your body,  but don't over exercise either it can increase the pH of the body too."

Exercise
●   Work out : Exercise such as weight training is vital for the health of your bones at all ages. Regular exercise not only makes your bones healthy but also protect you from the risk of fractures and osteoporosis. It also helps maintain a healthy posture and improve your balance.
●    Exercise with soft smiley ball for rheumatoid arthritis patient having swelling in fingers.
                                            

                                                

●      Physical exercises and yoga advocated at appropriate stages of recovery.

●      Exercise is an important part of treating arthritis. Exercise reduces joint pain and stiffness, increases flexibility and improves endurance, develops muscles strength, decreases bone loss, helps controls joint swelling, minimize fatigue and improves sleep, enhances weight loss. Keep bone and cartilage strong and healthy.

●     Daily round movement of wrist joint & shoulder joint to keep the upper spine fit.

●   Daily walking for half an hour.

●     Gentle exercise for your knee Stretch your quadriceps can ease the tension in the knee joints. Stand with feet hip-distance apart. Bend your right knee and hold the top of your right foot with your right hand. Bring your right heel as far as possible to your buttocks

●   Stretch your calves This gentle calf stretch increases flexibility in your leg muscles and knee joints. Bring your right foot a few feet in front of your left foot. Bend your right leg making sure your knee doesn't go past your toes. Keeping your left leg straight, press your left heel toward the ground to stretch the calf of your back leg.

● Knee Strengthener The seated leg raise exercise helps strengthen the muscle around your knees.  Sit on a chair with both legs bent at 90 degrees. Slowly raise your right leg so that it's parallel to the floor, keeping your left foot on the ground.

●     Build up your leg muscles Step into stair with your right foot, then with your left foot. Step down in reverse.

●     Leg stretch Lay on your back with your legs straight. Lift one of your legs and pull it toward your chest until you feel a comfortable stretch. Hold your leg up using your hands.

●     Swimming  & Cycling is good exercise to keep fit and mobile.

●   Straight Leg Lift

●   Butterfly Exercise It is good to keep the lower spine fit.

                                              

                                                

 “Exercise is vital for those who suffer from any form of stiffness and arthritis” 

Yoga

A.    Pachimotanasana
                                                         

●     In the seated position, extend your legs out in front of your toes pointed up.

●     Inhale raising your arms above your head. Now exhale, reaching your toes, ankles, or calves.

●     Bending your knees if necessary, gently press the crown of your head towards your toes as you breathe deeply. This asana tones and flexes the spine.

                                               

B.    Bhujangasana (Cobra Pose)
                                                          

●     Lie down on your abdomen by taking legs apart
●   Keep the palm beside chest.

●     Breathing in, lift the upper part of your body, up to naval region

●     Hold it for 10 seconds by feeling the stretch on your abdomen. It is beneficial for the spine.

C.     Trikonasana  (Triangle pose)
                                              

●     Bring your legs apart so your feet are wider than your shoulders

●     Raise both arms out to the side up to shoulder height so that they are parallel to the floor, Palms turned down.

●     Turn your left foot 90 degrees outwards

●     Keep both hips facing forwards

●     Turn your right foot slightly towards the left foot and keeps the hips forward

●     Press your hips to the right and place your left hand on your thigh above your knee

●     Bring your right arm so it is straight with fingertips towards the sky

D.    Garudasana (Eagle Pose)
                                                 

●     Stand straight on both feet

●     Raise the right leg and wraps it around the left leg

●     The right thigh will be over the left thigh and the right feet will touch the calf muscles from behind

●     Similarly, wrap the right hand around the left hand

●     Place the palms together to resemble the beak of an eagle

●     Try to maintain the balance and slowly bend the left leg and lower the body until the right toes touch the ground. This is the final pose.

E.    Virabhadrasana (Warrior Pose)
                                             

●     Stand with your legs three to four feet apart and turn your right foot slightly to the right, and your left foot 90 degrees to the left

●     Align your left heel with your right heel

●     Expand your arms out stretching them parallel to the floor, with your palms facing down.

●     As you exhale, bend your left knee, bringing your left thigh as parallel to the floor as Is comfortable for you.

●     Keep expanding your arms away from your body keeping the torso long and the shoulders entered over your pelvis.

●     Press your outer right heel into the floor and focus on firming the right leg as you bend the left knee.

●     Do not allow your back to "sway" out instead, keep the tailbone tilted slightly towards the pelvis. This asana strengthens the legs and knee muscles and improves balance.

●     This pose helps sciatica, rheumatism and osteoarthritis of knee and hip. It strengthens the legs and also makes them more flexible.

Pranayama

●     Bhramari- Breath in till the lungs is full of air. Close the ears with the thumb and eyes with the middle fingers. Press forehead with both the index fingers lightly closes the eyes. Then press the eyes and nose bridge with remaining fingers. Concentrate on Ajna Chakra. Chanting of om simultaneously.

●     Bhastrika- Sit in a comfortable Asana. Breathe in through both nostrils forcefully, till the lungs are full and till the diaphragm is stretched. Then breathe out forcefully. Vata, Pitta and Kapha three doshas get balanced.

●  Anulom vilom Alternate nose breathing.

●  Kapal bhatti  Normal inspiration but  forceful expiration.

Meditation
●  Meditate on ajya chakra (between two eye brows) for ten minutes in the morning.
                                                 

“Rest and relaxation will help you stay strong both mentally and physically”.

Swimming
·    Swimming is the good exercise to reduce weight.

Mudra

·      Vayu Mudra
                                                   

Formation

Index finger tip is to be placed at the base of the thumb and the thumb is to be placed on the back of the index finger gently. Other fingers are to kept be straight. Good for arthritis and pain.

Apana Vayu Mudra

This mudra can save a person from 'heart attack', hence a mudra is called Sanjeevani Mudra, one that gives life to a dying person. This mudra gives instant results and the pain is reduced immediately.

Formation :

This is combination of two Mudras Vayu and Apana. From Vayu mudra by placing the tip of index finger at the base of the thumb and then form Apana Mudra by joining tip of the thumbs with the middle and ring fingers.

Effects :

There is combined effect of Vayu mudra and Apana Mudra. Vayu mudra relieves the pain instantly and Apana mudra maintains space to reinforce blood circulation to the heart. 

Benefits: 

• This mudra cures- Arthritis, Spondylitis, Parkinson and Paralysis,

Perform Apana Vayu Mudra-

1. When there is sleeplessness.
2. When there is over exertion.
3. When there is stress.
4. When climbing staircases and hills.
5. When there is crises.

·      Sandhi Mudra

Sandhi Mudra

The mudra relieves joint pain. This mudra is formed differently by each hand.

Formation :

Right Hand : Join the thumb finger tip and ring finger tip together.

Left Hand : Join the thumb finger tip and middle tip together.

The mudra helps in balancing energy in the joints.

Effects :

Space is balanced between the cartilage and the joints muscle. This mudra also provides calcium.

Benefits :

• Pain experienced while climbing down after a long hike is pacified.
• Resolves tiredness in the elbows after the long hours of work on a computer.
• This mudra helps relieve pain in the hip joints and knee joints due to arthritis.
• For people suffering from chronic pain  in the joints, this mudra resolves  the pain by persistent effort.

                               "ELIMINATE ARTHRITIS FROM INSIDE OUT"

·      Prana Mudra
                                                                          

Formation

The tip of little fingers and ring fingers are joined with the tips of the thumbs.

Marma

·      Amsa Marma

Location- It is located at the back in between neck and shoulder. With both the hands touch at the back of the shoulder. The point where middle finger touches are Amsa Marma.

Stimulation- It can be pressed with the help of middle finger. It is good for frozen shoulder, cervical spondylitis.

·     Gulpha Marma

Location- At the ankle joint. It is present at the lateral aspect of the lateral malleolus.

By pressing this point there is stimulation of whole lumbosacral plexus. It helps in sciatica, prolapsed inter-vertebral disc and lumbar spondylosis.

"Eat right to stay strong and fight arthritis".

Diet

Food to eat :

Healthy diet for an arthritic patient
●   Omega 3 fatty acid like  fatty fish including salmon and tuna.

●   Follow balanced meal plans : Fresh leafy vegetables like broccoli, kale and spinach. Fruits like pineapple, papaya, mango, strawberry, raspberry, banana etc. should be consumed regularly.

●  Anti inflammatory properties of turmeric, black pepper and ginger can relieve pain.

●  Chia seeds and dry fruits like figs, almonds and walnuts.

● Joint pain can also arise  due to deficiencies of certain vitamins or minerals. Vitamin D, vitamin B12 and calcium deficiency may weaken the bones, so be sure your diet has enough calcium and proteins. Some calcium rich diet includes seeds (till, sunflower, flax seeds) and nuts are rich in calcium and so is paneer. Food rich in vitamin D, Vitamin E, can help prevent arthritis.
●   Costume plenty of milk products  and green leafy vegetables to make your bones and joints strong.

●  Alkalize your body by eating sprouts, leafy greens, apple cedar.

●  Drink citrus fruit juice especially Pineapple

●  Have buttermilk with lunch

●     Fish is a good source of cod liver oil which helps fight arthritis.

●     Drink plenty of water which is necessary for joint lubrication. It also helps in weight maintenance. Think of drinking water as ridding your body of toxins.  Sip plenty of warm water as an adjuvant

●     Eat all items lubricated with olive oil or ghee.

●     Foods which are easily digestible and do not make wind or gas are beneficial.

●     Vegetable juices and soups are beneficial.

●     Mixed juices of carrot, cucumber and beetroot are also beneficial.

●     Fruit like apple , Papaya walnuts  can be taken.

●   Cooked vegetable gourd, bitter gourd, fenugreek, spinach, and pumpkin are beneficial.

●     Cooking with spices like cumin, coriander, ginger, asafetida, garlic, fennel and turmeric also helps a lot.

●   Grate the carrot squeeze some lemon juice, enjoy raw or steamed. It is an effective remedy for aching joints.

●   Eat more onions they contain phytochemicals that improve your immune system.

●     Include whole grain,  pumpkin seeds and omega -3 rich foods to reduce the chances of joint pain.

“Healthy flexible joints rely on strong digestion and metabolism”.

 Avoid

●  Avoid dairy, red and processed meat, excess sugar, egg plant, potatoes.

●  Avoid soda and other commercial drinks.

●  Avoid Acidic food : As it causes the lubricant in the joints to gradually dry up. Skip sugar laden foods.. 

●   Avoid salt in your dinner, particularly on painful days. 

●    Starchy food : Preparations made with maida, rice, sweet corn soup, urad dal.  

●    Cold foods refrigerated  water, cold milk, ice cream, frozen food,

●    Avoid eating hot spicy and fried foods and junk food.

●    Avoid food of high purine content that affects liver, kidney, brain

●    Avoid processed food and preserved food plus saturated fats.

●  Sour foods Raw mango, curd, Kadhi (curd produced delicacy) tamarind, tomatoes, pickle, tomato ketchup.

●    Fruits : banana, muskmelon, grapes, watermelon and citrus fruits should be avoided.

●   Alcohol excess

●   Vegetable : Peas, okra , cabbage, cauliflower ,broccoli,  radish, okra, colocasia , (Arbi).  potatoes  

●     Aerated drinks : buttermilk, milk shakes

●     Gas / Wind forming foods like  potato, colocynth, (Arbi), cauliflower, white beans, red beans,  raw salads, Lobia, kidney beans, chickpeas, raw salads.

●  Eat chapati made of wheat, black chana dal, soyabean, jao, ajwain and flax seed.. 

●     Avoid diuretics

●     Excess intake of tea, coffee, white sugar, yoghurt, chocolate and cocoa.

●      Too much alcohol consumption can lead to thinning and weakening of  bones.

●     Smoking should be avoided. Cigarettes' smoking produces free radicals that weakens your body's immune system, and causes bone loss.

●     Sleeping during day time avoided.

●     Staying up late in the night and mental tensions like worry, anxiety, fear, stress, grief etc. should be avoided

●     Avoid foods like fermented foods, sweets, rice, pickle, tomato ketchup, brinjal and sour drinks.

●    Keep diabetes & Thyroid problem at bay: As it causes bone damage.

●     Control fat and cholesterol intake.

                                                  "No Curd, Rice, Sour & restrict salt."

Beneficial Herbs

●   Giloy (Tinospora cardifolia) : The stem is used after removing the skin.

●     Ashwagandha and Siddha Makardhwaj (Withania somnifera)- it helps in relieving pain in tender and swollen joints and increased mobility. 5 gram of Ashwagandha powder twice a day for three weeks with lukewarm water or milk and 100 gram of Siddha Makardhwaj daily with honey for the next four weeks.

●    Guggulu (Commiphora wightii) Tab

●   Turmeric :  (Curcuma longa) Haldi  is a well known anti-inflammatory herb. Drink turmeric milk: Add a pinch of turmeric to boiling milk, consumed just before bedtime. Or take it as a decoction twice  a day, sipping it slowly while it is still hot. Just add a pinch of haldi to water, and boil till the water turns a golden haldi color.

●    Ginger : It reduces inflammation and reduces joint mobility. Boil some in water and sip this decoction while it is still warm.

●     Methi- It helps in controlling degenerative disorders.  Fenugreek is a popular home remedy for joint pain due to its antioxidant and anti- inflammatory properties. Swallow 1 tsp of finely ground fenugreek seeds (or overnight soaked seeds) followed by a glass of lukewarm water in the morning.
                                                     

                                                       

●     A poultice of the aerial part of Amarbel  (Cuscuta reflexa) is an effective remedy for arthritis. Boil it in water add a pinch of salt and do hot fomentation.

                                              

●     Jeera- It improves digestion

●     Dhania- It is a beneficial antacid and helps in combating with gas related troubles.

●     Hing (Ferula asafoetida)Asafoetida

●     Rasna (Alpinia galangal)

●     Sunthi (Zingiber officinale) Ginger

●     Rasona (Allium sativum) Garlic. Add garlic to your food. Garlic is anti-inflammatory.

●     Guduchi (Tinospora cordifolia) Amruthaballi

●     Errands (Ricinus communis) Castor oil

●     Devadaru (Cedrus deodara) Himalayan Cedar

●     Gokshura (Tribulus terrestrial

●     Punarnava (Boerhavia diffusa) spreading hogweed

●     Chitrakoot (Plumbago zeylanica) leadwort

●     Katuki (Picrorhiza kurroa) Kutki

●     Triphala (Amla,Harda,baheda) One tsp at night with warm water.

●     Ajamoda Ajwain

●    Bala (Sida cordifolia)

●     Yashti (Glycyrrhiza glabra)

●     Shatavari (Asparagus recemosus)

●     Nagamalai (Sida veronicaefolia)

●     Varuna (Crataeva nurvala)

●   Ksheerbala taila : This oil is composed of three elements - Cow's milk, a herb named bala and till oil. This combination reduces the imbalance if air (Vata) in the body.

                                  "Oil application is the panacea for pain."

Home Remedies

●    Having Ashwagandha powder along with milk on regular basis will quickly heal arthritis Fresh leaves of (6 -7 nos.) of Harsingar (Nyctanthes arbour- tristis), Adrak  (Zingiber officinale) juice and honey are mixed and taken orally.

●     Ginger & Honey tea Reduce joint pain and inflammation with this ginger and honey drink. Crush some ginger, in three cups of water till it's reduced to two cups, and add a teaspoon of honey. Drink it warm twice a day.

● Garlic milk Thus garlic milk helps in a great way  to clear the clogged metabolic  paths and reduce body cholesterol. Take 4-5 cloves of garlic and boil them in a glass if milk. Do not add sugar. Consume this milk twice a day after breakfast and dinner.

●    Juice of Champa (Michelia champaca) plant is effective. It leaves tied over painful parts.

●    For Local Application- Take 1 tsp of turmeric + Lime ( चूना )+ 1 tsp of  honey, do it at night. Put a bandage over it. Apply it on the area of pain for 8- 10 days/or a month for relief. 

●   Take 1 cup of mustard oil and add 10 g camphor to it. Heat the oil till the camphor dissolves completely. Massage the lukewarm oil on the affected area. It will reduce inflammation and stiffness.

●    Take 3 tbsp. green gram, (moong) Soak in 250 ml water overnight to get sprouted gram. Add 2 crushed garlic cloves to the sprouted gram and mix well. Consume two times a day. You may add sendha namak or rock salt for taste. 

"Be regular with your medicines, and if these self remedies don't help you much do visit your Rheumatologist for expert care".

     

                            "Do not take joint pain lightly. Start treatment early."

Precautions

●   Maintaining a healthy weight

●   Regular knee exercises

●   Keeping sugar levels in check

●   Eating nutritious food

Treatment
Alopathic

Treatment according to type of arthritis : depending on the symptoms and disability status.

·    Medicines :
Pain killers may be described

Intra-articular injections and Vasco supplements can be offered /Calcium supplements

Rheumatoid Arthritis Drug: Tab Hydrooxychloroquine.
  DMARDs- disease modifying anti rheumatic drugs
a . NSAIDs Non-steroid anti- inflammatory drugs Ibuprofen 300mg TDS, Meftal 500 mg TDS, Diclofenac 50 mg TDS, Indomethacin sustained release SR 75mg at bedtime all the drugs should be taken after food.

b    b . Paracetamol 100 mg TDS to reduce pain and stiffness.

    c . Chondroprotective agents for protection of cartilage, like glucosamine sulphate and chondroitin sulphate. 

         d .   Steroid In Rheumatoid Arthritis as  Intra- articular

Fo  e  For acute septic arthritis  needs surgical opinion and treatment with intravenous antibiotics.

f.

●   ●  Physiotherapy  physiotherapist can teach you how to work out stiffness without further damaging your joints. Physiotherapy is also useful after an injury and joint surgery. It is recommended for hip and knee osteoarthritis.  Get physiotherapy to ease the discomfort. It helps in muscle strengthening, increasing spine flexibility, But it should be started only after consulting a doctor.

Fo 

●  Hydrotherapy- Functional difficulties of osteoarthritis patients are generally walking and climbing stairs and much can be done to re-educate such patients in the pool.

●   Thermotherapy- It involves the application of heat. It helps in improving circulation and relaxing muscles. Heat can be conveniently applied by using infra red light, heating pads, hot towels or paraffin wax, which relieves pain and stiffness in an easy way.

●  Electrotherapy- It is the use of electric currents for medical treatment. The patient frequently wears the device while sleeping. It helps  reduce pain, enhance blood circulation, increase joint flexibility and promote deep tissue repair.

●  External support devices- Knee sleeves maintain warmth and (mild) compression. Corrective brace can also be used. Or apply a cotton band or socks over a knee overnight.(cut the socks from front).

●   Occupational therapy - Application of heat locally.

●  Knee replacement. Sometimes severally damaged knee joints and hip joints are surgically replaced  

● Tuberculosis of spine : Antitubercular treatment for 18 months and absolute bed rest for about 3 months is mandatory. If surgery is required decompression and fixation of the spine is done along. Total joint replacement is the most successful and commonly offered surgery for arthritis.

●  Spinal tumor can be treated effectively with chemo/radiotherapy. If the tumor has to be excised completely the spine stabilized with screws, rods and an inter-body cage. Surgery should be done in well equipped centers.

 Ayurvedic 

To treat arthritis, the first step is to detoxify the colon. In this phase, avoid heavy cereals and stick to a diet of fruits, vegetable juices, tulsi tea / herbal tea and one meal consisting of a light khichadi (of brown old rice and mung or dalia)

●  Take Triphala daily to detoxify the system. (Triphala is not just a laxative it is also a colon tonic). 

●   Haritaki are recommended for those who suffer from vata arthritis. Amlaki for pitta arthritis.

●    Bibhitaki  for kapha arthritis.

Vata Arthritis

Avoid irregular meals, cold foods like white rice, curd, cucumber radish, ice cream and sherbat. Instead eat cooked oats, whole wheat porridge. Soups and spices and hot prakriti.. Avoid pulses that are not easily digestible such as rajma and white channa

Pitta Arthritis

Avoid all fermented foods, curd, alcohol and wine, aged cheese and animal proteins. Cut down on your qualities of food you eat and avoid fried and refined. Colonic detoxification helps these group the fastest. This group is also prone to  food and other allergies. Bitter herbs like Karela, and neem benefit this group immensely.

Kapha Arthritis

This occurs due to obesity, which stresses the joints. This group should  not only loose weight, but also reduce the quantities of food they eat, as well as cut down on rich foods. Herbs such as shallaki, ginger, turmeric and Ashwagandha greatly reduce the pain associated with arthritis.

Myth : Pulses are high protein. 

Fact :  Pulses only have 30% protein. The rest is carbohydrates. In comparison meats have 100% protein. Therefore people on dal/ vegan protein diet can't be said to  be on a high diet.

● Ayurveda and Panchkarma has proved very effective in the treatment of joint pain. Many patients are leading are now leading a  normal life after getting successfully treated by them.

According to Ayurveda diet correction and improving metabolism are the long term and sustainable solution for arthritis. Ama Pachana correction of metabolism: By increasing the ‘Agni’ or digestive fire either through therapeutic fasting, deepana and pachana- Appetizer & digestive drugs and also through 
Ayurvedic treatment includes detoxification of the body, which would help in  reducing the inflammation, pain killers, steroids prescribed to suppress the pain and inflammation do little to cure the pain.
Treatment includes internal medicines ,oil massages and panchakarma therapies with diet restrictions and exercises.

● Vata arthritis- Avoid irregular meals, cold foods (cold Prakriti) foods like white rice, curd, cucumber, radish, ice creams and sherbets. Instead eat cooked oats, whole wheat porridge, soups and spices. Also avoid pulses that are not easily digestible, such as rajma, lobia, urad and white Channa

●  Pitta arthritis- Avoid all fermented foods curd, alcohol and wine, old cheese, and animal proteins. Cut down on quantities of food you eat and avoid fried and refined foods. Colonic detoxification helps this group the fastest. This Group is also prone to food and other allergies. Bitter herbs like Karela, and neem benefit this group immensely.

●   Kaph arthritis- This occurs due to obesity, which stresses the joints. This group should not only loose weight but also reduce the quantities of food they eat, as well as cut down on rich foods.

●   Herbal supplement like Shallaki and Guggulu, Chandra Prabhavati.

●  Laxative  Take Triphala daily it detoxifies the system, it  is not just a laxative, it is also a colon tonic.1 tsf triphala powder with honey followed by warm water at bed time.

●   Medicines Tab Rumalaya forte.

 Tab Lakshadi guggul- to consume 30 min after food.
 Gandha oil- 10 drops to be taken with hot milk 1 hour before breakfast and dinner.

●   Tiger Balm for local application.
·    Kayakalpa therapies For detoxification and rejuvenation.
  Panchkarma as detoxification or cleansing therapy. To treat arthritis the first step is to detoxify the colon. In this phase, avoid heavy cereals and stick to a diet of fruits, vegetable juices, tulsi tea / herbal tea. One meal should consist of light khichadi (of rice and moong dal). After the correct assessment of local toxins in the  body, few detoxifying Panchkarma therapies such as virechana (purgation) and vasti (medicated enema) to expel the root cause out of the system followed  by a course of internal palliative medicines and achieve sustain relieve from the symptoms.

●   Abhyanga  Massage therapy : External oleation of affected joints with medicated oil.  Massage with oil daily an important part of the lifestyle. Apply gentle pressure while massaging. Sesame oil, Mustard oil, coconut oil are used as base oil for external application. Oil massage helps in  removing the stiffness and muscles spasm and improves blood circulation. Once the oil reaches beneath the skin, it starts healing from inside. Other oil includes :

 a . Dhanvantaram Tailam- It is a poly herbal Ayurvedic medicated oil with anti inflammatory and anti rheumatic properties. This oil is useful in arthritis, fracture pain. The oil is generally for external use.
b .   Mahanarayana tel  (oil) This oil is used for massage for arthritis.

c .  Narayana Herbal oil- Narayana oil is used in the treatment of arthritic pain, backaches, sprains etc. 
Take two tbsp of mustard oil, along with the whole clove of garlic. The oil should be heated. When the oil is still hot start massaging your aching knees. 

●     Janu Dhara- Medicated oil poured over the knee.

●   Janu Vasti- A type of oleation by retaining the oil for a stipulated time over the affected area.

●     Patra potli sweda- Fomentation with Herbal leaves like betel leaf.

●     Shashtica Sali Pinda Sweda- Special type of fomentation made of rice and milk.

●    Vasti- Treatment with medicated liquids

●    Potli massage (Poultice Massage)

●    Pizhichil (Rich oil massage)

●     Svedana (Steam bath)

●     Vasti (medicated enema)

 ●    Virechana Purgation. Triphala 1 tap at bed time with warm water. Or Isabgol.

 ●    Shamana chikitsa- Includes oral medicine and external application.

 ●    Shodhan chikitsa- Includes Ayurveda Panchakarma and Kayakalpa therapies for detoxification and rejuvenation.
    

Naturopathy

●    Skip one meal a day.

●  Fasting (langhana)- Some patients are made to fast in initial, acute stages: the digestive and metabolic systems are strengthened and digest accumulated  ama (Toxins)

●   Control your diet: Take plenty of green cooked vegetables and reduce the quantity of rice intake.

●   Practice yoga and start walking

Rheumatoid Arthritis

Unani

A few remedies :

•      Castor leaves 1-2
•       Castor oil 3 tbsp
•       Mustard seeds 2 tbsp

Castor leaves are heated on a pan and are smeared with castor oil, which has been heated with mustard seeds and the leaves are tied around the affected areas (usually knee joints) like a bandage and left overnight.. This relieves a pain quite an extent.

Roghan e kafoor

Olive oil 1/2 cup

Camphor 1 tbsp

Camphor mixed with olive oil is warmed on a pan and application of an oil on the affected parts provides pain relief and comfort to the patient as this oil acts as an anti-inflammatory agent.

   

"Formula for Arthritis - 1:1:1:1 Turmeric, dry ginger, fenugreek & ajwain.(aniseed), mix all,  take 1 tsp twice a day for 1 week."

Link: https://madhuchhandacdmo.blogspot.com/2017/08/arthritis-joint-pain-sandhivata-amavata.html

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.