Prof (Dr) Samarendra Prasad Mishra
The incidence of arthritic diseases in clinical practice are very common in now- a- days.. This disease produces a definite problem for aged persons/senior citizens as it hampers their walking habit & also normal routine works. So, life becomes disgust for them. This troublesome disease has extremely less amenable in other pathies including modern medicine. Most sophisticated knee surgery has also no surety for them. In this context, Homoeopathy has some scope in this disease to prevent further damage of knee joints, minimizing the most troublesome pains, stiffness & immobility. it is a degenerative disease , difficult to permanent cure with time to time troublesome symptoms .So, I have suggested a scientific clinical homoeopathic protocol basing on my personal clinical experience ,where at least within a period of 06 months, patient to be applied different groups of homoeo medicines singly basing on the character/symptoms of the disease with need of the patient & found it as good success.
Keywords: Osteo-arthritis of Knee & its modern concepts, Treatment options of OA of Knee including exercises, Homoeopathic treatment Protocol, Related homoeopathic & batch flower remedies.
Disease Profile– Osteoarthritis of Knee
Osteoarthritis of Knee, is a very common disease in now- a- days after Diabetes & Hypertension. Commonly, it is known as wear-and-tear arthritis because the natural cushioning between joints & cartilages — wear away. Due to this, the bones of the joints rub more closely against each other. So, the shock-absorbing benefits of cartilage is loosed in a great way.
Pathophysiology in OA of Knee-
This rubbing results in-
- Decreased ability to move &
- Sometimes, formation of an extra bits of bone is known as Bone spurs. It is just like a hard lump & remains around the affected joint.
The chance of developing osteoarthritis of Knee rises after age of 45. Women are more likely to have Osteoarthritis than men. it may be also hereditary. In some cases, it may result from injury/infection to knee or due to obese conditions.
Causes Osteoarthritis of Knee-
Age.(after 45 years) is the most common cause of OA, because, the ability of cartilage to heal decreases as a person gets older. It may also develop at earlier but % are less.
Weight. more body weight increases much pressure on the knees. So, obese persons are the more suffers of this disease
Heredity. genetic mutations might make a person more likely to develop Osteoarthritis of the knee. It may also be due to inherited abnormalities in the shape of the bones that surround the knee joint
Gender. women ages 45 and older are more likely than men to develop osteoarthritis of the knee.
Repetitive stress injuries. People with certain occupations like lifting heavy weights (55 pounds or more) are more likely to develop Osteoarthritis of the knee because of the constant pressure on the joint.
Athletics. Athletes involved in soccer, tennis, or long-distance running may be at higher risk for developing Osteoarthritis of the knee due to frequent injuries of knee. But, regular moderate exercise strengthens the joints and can decrease the risk of Osteoarthritis.
Other illnesses. Rheumatoid arthritis, metabolic disorders like iron overload , excess growth hormone & Diabetic Mellitus, produce the chance of higher risk to develop Osteoarthritis of Knee.
Symptoms of Osteoarthritis of Knee –
- Pain that increases when person is in active work, but gets a little better with rest
- Swelling of /around Knee joints
- Feeling of warmth in the joint(Hot sensation)
- Stiffness in the knee, especially in the morning or on sitting for a while
- Decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, use the stairs, or walk
- Creaking sound that is heard when the knee moves
Diagnosis of the Osteoarthritis Knee –
- Taking detail case history of affected Patient
- Physical examination of Knee joint & its adjacent affected parts can give clear diagnosis of OA of knee.
Laboratory Investigations in OA knee:-
- X-rays of Knee joints-which can show bone and cartilage damage as well as the presence of bone spurs
- MRI scans-MRI scans may be ordered when X-rays do not give a clear reason for this disease.
- Blood tests like- DC, TLC, ESR, RA factor, CRP, Serum Uric acid are required to rule out other conditions that could be causing the knee pain.
Aims while treating a case of Osteo-arthritis Knee- To relieve the pain and To return of its mobility.
The treatment plan must be included combinations of medicines & exercises.
The patients of OA knee should be encouraged for-
- Weight loss-
- Some physical exercises-like a) Strengthening exercise which help to keep the knee joint mobile and flexible .
Sit to stand. Sit in a chair. Slowly stand up & sit back down again without using the hands. Focus on keeping the feet shoulder-width apart and knees over the feet. Repeat it for 30 seconds.
One-leg balance: Stand next to a table & place one hand on it for support. Lift one leg and balance on the other for up to 10 seconds. Repeat it on the other side.
b) Simple exercise– Walking, Swimming & Biking. . Start with just for 10 minutes. After few days, slowly increase that time to more 5 to 10 minutes. The goal is to work up to 30 minutes of any one above exercise, 5 days per week.
c) Range-of-motion Exercises-
-Sitting knee extension. Sit in a chair. Slowly extend one leg as much as you can, or until it’s parallel to the floor. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.
-Sitting knee flexion. Sit on the edge of a chair. (Make sure the chair is stable and won’t tip over.) Lift one knee and place your shin in your hands. Gently pull your shin toward your thigh. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.
Wearing of Knee caps- helps less bending of knee joints & less joint rubs. So pain & stiffness naturally will be less.
Scope in Allopathy-
- Pain relievers and anti-inflammatory drugs to relieve acute unbearable pain.
- Injections of corticosteroids/hyaluronic acids into the knee joints-Those are the powerful anti-inflammatory drugs. Hyaluronic acid is normally present in joints as a type of lubricating fluid.
- Calcium, Vitamin-D are often times found in there prescription.
Surgery-includes Arthroscopy, Osteotomy & Arthroplasty of Knee joint.
Avoidable activities for OA patients-
- Do not sit in floor with bending knees
- Do not frequent go up & down up stairs.
- Use western type of Latrine
Homoeopathic approach to Osteo-arthritis of Knee
Homeopathy has wide scope for its treatment with its varieties of medicines in different forms. The selection of homoeopathic remedies must be based upon the theory of individualization and symptoms similarity by detail case taking. But, the difficulty here is, due to the unbearable recurrent knee joint pains, stiffness & immobility felt by the patient , it may not give sufficient time to the treating doctor for a smooth treatment. So, it is better to formulate a well programmed homoeopathic treatment protocol for a certain period of time(at least for 06 months) rather than giving a single or one type of remedy through out the treatment period. However, all types of the medicines in the protocol should neither be mixed nor to be given simultaneously. As per the need, they may be given singly in due course.
The suggestive Homoeopathic Treatment Protocol –
Selection of a-
|a. Constitutional /Miasmatic medicines||should be selected on the totality of symptoms|
|b. Nosode/Sarcode/Imponderabilia medicines||can be given as an intercurent remedy(like Like X-ray, Osteoarthritis Nosode, Sycotic Compound, etc) as weekly/ fortnightly/monthly once.|
|c. Pain relieving remedies||can be given during only acute exaggerations of symptoms– (like Mother tinctures & Biochemics as-Apocynum andro, Gaultheria procumbens, Hymusa, Guaicum sanctum/ officinale, Nyctanthes Arbor – tristits, Stellaria media, Biochemics like- Mag. phos, Cal. phos, Calc. fluor, Kali. mur etc . or some acute potentized drugs like Ledum, Phytolacca, Kalmia, Benzoic acid, Kali. iod, Rhus tox, Bryonia, Belladonna, Ruta, Colchicum, Guaiacum etc.) for short period.|
|d. External applications||may be made by using medicines- Arnica mont,
Symphytum, Eucalyptus Oil ,Turpentine Oil on homoeopathic way
|e. Emotional remedies||if patient is a long sufferer, treated in all pathies without much benefit, loses hope for his recovery & produces abundant mental symptoms than physical symptoms- besides homoeopathic medicines, another similar therapy like homoeopathy –called “BATCH FLOWER REMEDY THERAPHY”, is also effective in this case.|
Flow diagram of proposed Homoeopathic Treatment Protocol for an OA of Knee disease-
Some important homoeopathic & batch flower remedies are given below, which helps me a lot in the treatment of Osteoarthritis of Knee.
Rheumatism of Knee with effusion in joint- so huge swelling of Knee found.
Pain–< night, while bending the knee & lying on affected side.. >by motion & open air.
I have got much more response from this drug.
It is made from synovial liquid of arthritis – joint. A proving of the Osteo arthritis Nosode of the hip was read in the 18 th All India Homeopathic Conference at Madras on 10th October 1970 .The two preparations of the Osteo arthritis Nosode are done from the synovial liquid of joints. The Osteo arthritis Nosode that originated from Dr. Foubister comes from the knee of a patient suffering from an Osteo arthritis affection and the other stock from the hip of a similar case. OA of Knee, < from first motion , night. right side, > prolonged movement
3.Calcaria carb. – Osteoarthritis of knee joint especially in fat and obese persons. < when getting up from a sitting position , by walking & Cold. Cold , clammy knees is another feature of Calcarea carb. There is cramps in calves when stretching out the legs at night. They have a special craving for eggs and undigestable things.
4.Sulphur – This is a polycreast, constitutional & miasmatic drug.Contains all signs of inflammation( Swelling, hot sensation, Redness , Painful, loss of functions of affectedjoint etc.). In OA of knee- all signs of inflammation are found. So it is a great remedy to be used & its action toabsorb the effusions from joint.
5. Benzoic acid –
- Arthritis of Knee joints, cracking sound on walking.
- Pains-Tearing, stitching type.
- Knee- Swollen hugely with redness, < at night, motion.
- Urine-highly offensive, dark brown colour.
- Blood examination- ↑ of Uric acid
- Knee-swollen hugely with much stiffness.
- Hot sensation in knee area.
- Pain-< on heat & motion. >by Pressure.
7. Bryonia alba-
- Knee-Stiff , painful, swollen ,red & hot
- Pain—Stitching, tearing type.
- < motion . > by pressure & rest.
8.Rhus Tox. – Rheumatism caused by damp weather and worse in damp climate; Pains –< 1st. motion, cold, night . > by continued motion.
9.Sycotic co– Rhustox like modality. Can be given when Rhustox fails to act.
10.Ledum pal. – Pain-Sticking, tearing, throbbing. < by motion , night, warmth of bed. >by holding knee in ice-water.
11.Lactic acid – Osteoarthritis with diabetes.
12.Calcarea fluor – Chronic synovitis of knee joints.< rest, change of weather. >by heat.
13. Ruta graveolens –It is effective for Osteoarthritis of knee joint where the patient feels the knees give way , while ascending and descending stairs.
14.Phytolacca – Rheumatic modalities are in between Rhustox(Aggravation- Night & Bryonia- Aggravation- from Motion).
15. X-Ray– Rheumatic pain with trembling of limbs. Sensation of electric current in the limbs.
16. Arum met.– It is a syphilitic drug & has got solvent action to the joints having bone tissues formed.
17.Argentum met.– got the action in protecting cartilages of knees.
Homeopathic Mother Tinctures-
- Apocynum andro- A good drug for Rheumatic pains, stiffness of joints with swellings.
- Gaultheria procumbens- Joint pains accompanied with gastric disturbances. Both External & internal uses can be done.
- Jacaranda caroba- It is a remedy for the rheumatism with urinary symptoms. Rheumatic pain in the right knee. Gonorrheal Rheumatism..
- Nyctanthes arbortristis- Remittent fever with sharp shifting pain in knee joint . Synovitis
- Stellaria media- Joints are stiff. Rheumatic pains in different parts of the body..
Calcarea phos– Rheumatism of the joints. Cold, change of weather, motion, getting wet, generally aggravates symptoms. Relieved by rest, warmth and by lying down
2. Calcarea fluor -Chronic synovitis of knee-joint. < during rest, change of weather >by heat, warm application
3. Kali. mur- relives the sub- acute inflammatory stages of joints.
- Knee Osteoarthritis: Causes, Symptoms, Treatments – WebMD https://www.webmd.com/osteoarthritis/ostearthritis-of-the-knee-degenerative-arthritis.
- Boericke, William.(1996), . Pocket Manual of Homoeopathic Materia Medica & Repertory, Reprint ed., B. Jain Publisher (P) Ltd., New Delhi.
Prof. (Dr.) Samarendra Prasad Mishra
B.H.M.S(Hons), M.D.(Hom) Materia Medica(Utkal)
Ex- Professor Dept. of Materia Medica- MaharanaPratap Homoeopathic Medical College, New Rajendra Nagar, Raipur, Chhattisgarh.
Mob-09438564739, e- firstname.lastname@example.org