Osteoarthritis is a chronic progressive degenerative disease.

Affected part- Mainly articular cartilage of big weight bearing joint of body

Mainly in old age individuals.

Aetiology

It is commonly thought to be wear and tear of joint as one age.

Aetiology is multifactorial and still not understood.

Age- above 60 years

Heredity when multiple joints are affected

Abnormal stress

Strain on the joint

Loss of mucopolysaccharide contest

Obesity

Endocrinopathy

Genetic Factors

Pathology

Osteoarthritis is a degenerative condition primarily affecting the articular cartilage.

The first change is observed- increase of water content.

Depletion of proteoglycans from cartilage matrix.

Proteoglycans is gradually lost, so cracks and fissures appear

Collagens bundles are completely disorganised

This is called fibrillation.

Gradually out growth of bone and cartilage develop called osteophytes.

Articular ends of bones becomes in mineralised and hard.

Type

Primary 

Secondary

Primary Osteoarthritis

In primary type no obvious predisposing cause is seen.

It occurs old age

It is mainly occur in weight bearing joint (knee, Hip)

Involed- cervical spine ( Cervical Spondylosis)

Lumbal spine ( lumbar Spondylosis)

Knee joint ( Osteoarthritis of knee)

Hip joint (Osteoarthritis of  hip)

Terminal Pharangeal joint (Heberden's nodes)

Secondary Osteoarthritis

Aetiology

Trauma 

Diabetes

Gout

Rheumatoid Arthritis

Paget's disease

Hyperparathyroidism

Wilson's disease

SlE

Acromegaly

Chronic liver failure

Patient on dialysis

Patient on steroids

Sickle Cell Aneamia

Clinical Feature

Onset- gradually

Sex- female more affected

Character of pain- Aching Pain

Weight bearing joint commonly involve.

At first intermittent and then become continuous

Pain felt after exercise after a peroid of immobility

Gradually as the pain increase, patient tends to restrict the movement of joint which become stiff.

Stiffness is the prominent symptom.

When patient get up from bed in early morning after night rest

But after some movement stiffness becomes less.

It rarely last for more than 15 minutes.

It usually worst by activity or weight bearing disappear after taking rest

When the disease occur in female of the menopausal age of small joints are also involved .

This is called menopausal arthritis.

During walk patient may complaints crepitus 

Gradually all movement are restricted and patient becomes completely bed- ridden and invalid.

On Examination

• Stiffness- may be noticed
• Restricted movement- weight bearing joint show restricted movement
• Crepitus- felt during movement
• Heberden's Nodes- Bony and cartilage growth in dorsal aspect of terminal interphalangeal joint of the hand may be seen called Heberden's nodes
• Bouchard's Nodes- seen in proximal interphalangeal joint, called Nodal Osteoarthritis
• Tenderness- on the joint line.
• Irregular and enlarged looking joint.
• Deformity- knee deformity but rarely. Deformity is usually absent.
• Effusion- rarely and transient
• Wasting - wasting of quadriceps femoris muscle.

Investigation

Blood examination

X-ray

MRI

Arthroscopy

Synovial fluide

Treatment

• Bed rest- During acute stage rest is essential
• Diet- for reducing overweight.
• Occupation- may be changed as if required.
• NSAID- like Aspirin
• Physiotherapy
• Surgical treatment- Total replacement arthroplasty.
• Radiotherapy
• local Treatment- contrast bath- relieved spasm of muscle and stiffness
• Acupuncture- Multiple prickling by needles.

Homoeopathic medicine for Osteoarthritis

1. Rhus Toxiconderdron
2. Kali carb
3. Sticta P
4. Bryonia Alba

Rhus Toxiconderdron

It is very important remedy for Osteoarthritis.

Pain when patient lying down and better by walking.

Ailments from strains, overlifting, getting wet while perspiring.

Osteoarthritis in cold season.

Motion always " limber up" the Rhus Toxiconderdron patient, hence he feels better for a time of change of position.

Hot painful swelling of joint

Pain in tearing in tendons, ligaments, and fasciae.

Tenderness about knee joint

Numbness and fornication, after overwork

Trembling after exertion

Kali Carb

It is highly effective remedy for Osteoarthritis.

Backs and legs give out.

Uneasiness, heaviness, tearing in limbs and jerking.

Limbs sensitive to pressure.

White swelling of knee

Tearing in arms from shoulder to wrist.

Tearing pain in limbs with swelling

Limbs go to sleep easily.

Pain from hip to knee.

Pain in knees especially.

Kali Carb pain is sharp and cutting, nearly all better by motion.

Sticta P

Rheumatic pain in right shoulder joint, deltoid and biceps.

Swelling, heat, redness of joints.

Spot of inflammation and redness over the affected joint.

Pain severe and drawing.

Spasm, legs feel floating in air

Housemaid's knees

Shooting pains in knees.

Joint red, swollen, painful.

Rheumatic pains precede catarrhal symptom.

Bryonia Alba

Joint red, swelling, stiff

Stitching and tearing type of pain

Pain aggravated by slightest motion

Better by rest

Knees stiff and painful

Hot swelling of feet

Every spot is painful on pressure

Constant motion of left arm and leg.

The selection of homoeopathic remedies based on symptom similarities and the selection of doses depends upon  the Susceptibility of patient.

Don't take homoeopathic medicine without any prescription / without any advise of physician.