Osteoarthritis is the most common type of joint disease which affects nearly 21 million people in the US and an estimated 70 million people in India. This disease primary affects weight bearing joints and is known to cause pain, stiffness, and limitation of joint movement. Previously believed to be a degeneration of the cartilage between the bones, osteoarthritis is now believed to be a mix of inflammation and degeneration which affects not only the cartilage but also the entire joint organ, including the subchondral bone as well as the synovium.
The main presenting symptom of osteoarthritis is pain which can be caused due to inflammation and swelling, increase blood flow, inflammation of the synovial fluid, muscular fatigue, joint swelling, torn menisci (buffers between the cartilage and bones) and muscular spasm. While this disease is primarily associated with ageing, other factors like obesity, trauma, previous surgery or infection, and genetics are known to increase the risk of occurrence and severity of this condition
Treatment for osteoarthritis usually involves patient education, hot and cold compresses, weight loss measures, exercise, physical therapy, occupational therapy, and unloading in certain joints such as the knees and hips. Pharmacological interventions include the use of acetaminophen, oral and local use of anti-inflammatory drugs, as well as intra-articular corticosteroid injections. In early osteoarthritis, inflammation causes swelling of the cartilage, and this stage may last for years or decades. In advanced osteoarthritis, the cartilage begins to soften and degenerate, thereby causing a loss of joint space. In osteoarthritis of the knees, the greatest loss of joint space is commonly seen in the medial or inner side of the joint, usually resulting in varus or outward deviation of the joint and leg.
In the early stage of osteoarthritis, simple measures like weight loss, regular and graded exercises, application of heat or cold, and the use of simple anti-inflammatory medicines for some time can help bring about a complete relief or perceived cure from the condition. However, osteoarthritis is a long-term or lifelong condition and if there is a continuation of the cause – for example, disturbed joint mechanics or recurrent trauma – the condition can recur or persist. After this initial stage has passed, simple treatment measures usually do not work. In advanced osteoarthritis, there are no known modern or allopathic pharmacological interventions which can significantly alter the progress of the disease or modify structural damage to affected joints.
At this stage, Ayurvedic herbal medicines have a very positive role to play in the treatment and management of osteoarthritis. Ayurvedic medicines can be given in high doses and for prolonged periods without any significant risk of adverse effects; however, it is important to use only herbal medicines and avoid using herbo-mineral combinations or Ayurvedic bhasmas (metallic ashes). Ayurvedic herbal medicines work in the comprehensive management of osteoarthritis by gradually reducing inflammation and swelling; helping in the repair of torn or damaged muscles and menisci; repairing damage to the cartilage; removing inflammation and swelling in the joint capsule and synovial fluid; and gradually treating damaged ends of bones. While local applications provide immediate and temporary relief from pain, it is oral treatment which forms the mainstay of therapy.
Depending upon the severity of the condition and the extent of joint damage at the time of commencing treatment, Ayurvedic herbal treatment may be required for periods ranging from two to eighteen months. However, it is possible to reverse a major part of the disease process and help rehabilitate affected individuals having even advanced osteoarthritis. Even individuals who have been advised arthroplasty or joint replacement can be successfully treated with Ayurvedic herbal medicines in such a way that quality of life can be restored to near normal and all symptoms can be completely eradicated. This is especially important considering the prohibitive cost of surgical options, and limitations of movement seen even after successful surgery. Ayurvedic herbal treatment has thus proved to be a highly effective treatment modality for the management of both early and advanced osteoarthritis.