Degenerative joint diseases - Diagnosis and treatment

Joints start degenerating with age progressively after the age of thirty along with other organs of the body.

Degenerative joint disease is also called osteoarthritis (OA) has following components:


*Loss of joint cartilage
*New bone (osteophyte) formation in and around the affected joint.
*Disorganization of the joint.

Injury to a joint hastens the degenerative process. While some degree of osteoarthritic change is inevitable, only 25 per cent persons suffer from pain.

Common joints affected by osteoarthritis:


Commonly affected joints are the weight-bearing and frequently used joints:

*Joints of the fingers
*Knees
*Hip
*Neck (cervical spondylosis),
*Lower back (dorso-lumbar spondylosis).


What are the symptoms of osteoarthritis?


Pain is a constant symptom and usually limited to one or two joints. Pain is caused by irritation of nerves and spasm of muscles and ligaments adjoining the affected joint.

Stiffness in the morning or after rest, which usually relieved by movement or exercise.

Joint mobility may become restricted.

Crepitus (a soft crackling sound) may be felt and/or heard on moving the joints.

Pain and stiffness usually change with changes of weather.

Lumbar spondylosis causes chronic aching pain in the lower back. It sometimes aggravates to severe pain (lumbago). When this pain radiates to the thigh and legs, due to compression of nerves coming out from the spinal cord, it is known as sciatica.

Cervical spondylosis produces similar pain in the neck. Due to compression of nerves pain and spasm radiate to the shoulder and arm. This pain may mimic cardiac pain (heart attack). ECG will be required to distinguish the cardiac pain from the pain of cervical spondylosis.

What factors make one more susceptible to osteoarthritis?


#Obesity
#Sedentary life
#Lack of exercise
#Idleness make muscles weak and flabby; such muscles go into spasm and cause pain more readily than strong ones.

How to get relief from osteoarthritis?



Treatment of acute pain from osteoarthritis

*Rest for two or three days. Prolonged rest may worsen the situation.

*Local heat with hot water bottle, infra-red rays, short-wave diathermy(available in physiotherapy centers),

*External applications such as salicylate or diclofenac ointment.

*Injection of corticosteroid into the affected joint.

*NSAID such as aspirin, ibuprofen other newest NSAID in minimum effective dose for minimum number of days.

*Joint supports such as knee cap, cervical collar, to be used for minimum number of days and only during physical activity;
remove it when resting or not active.


Treatment of chronic pain of osteoarthritis

As soon as the acute pain is relieved, which may take two to three days, start the following.

*Isometric exercises to strengthen the muscles of the affected joint. This is the most important part of the treatment. You can learn the exercises required for you from an experienced physiotherapist or, orthopaedic surgeon.
Reduce weight if you are obese. More weight cause more strain to the weight bearing joints and they fail to recover.

*Maintain physically active lifestyle and exercise regularly. In manual workers and those who regularly exercise the problems connected with OA are less frequent, less troublesome and appear at a later age.

*If you have backache, use a hard bed with three inches thick rubberized-coir mattress for sleep. This provides both support and comfort. Hard bed does not mean you have to sleep on a hard surface.

*If you have cervical spondylosis, better not to use normal pillow. A rolled-up towel under the nape of the neck (not under the head) can be placed instead. Cervical collar is to be used when there is acute pain and not regularly. Cervical traction may be useful. If this is needed the treating surgeon and the physiotherapist will guide about the method and duration of such traction. Exercises to toughen muscles of the neck to start as soon as acute stage is over.

*In the case of weight bearing joints (knee or hip), implantation of an artificial joint may have to be considered if the joint is badly disorganized and patient completely incapacitated.

This article is also published in India Study Channel

The War Within - How Do We Produce Our Enemies!

We must know who are the culprits who are producing free radicals, if we want to win THE WAR WITHIN!

Strenuous Exercise:

Don't misunderstand me! Exercises do increase the free radical load in our body but that does not mean that you should stop exercising. Side effects of sedentary lifestyle are even more dangerous. Excessive strenuous exercise is harmful - is the message here. Moderate amount of antioxidants, which we get from our diets and supplements suffice the protection against the moderate exercise, which is desirable. The athletes, on the other hand, need to balance their diet so that significant amount of anti oxidants must be available to neutralize the free radicals they produce.

Stressful Life:

As with exercise emotional stress significantly raises the free radical levels in our body. More the stress, the more we produce them. You must have noticed how sickly you feel after any kind of emotional stress or heard about someone who had a heart attack following prolonged stress at work or elsewhere!

Air We Breath:

Today's city atmosphere is another major factor for increasing the free radical load in our body. The counterpart of us, who are in villages are much less prone to heart diseases or, other chronic degenerative diseases than us.

Air pollution contains ozone, nitrogen di oxide, sulphur di oxide and several hydro carbon molecules. They all genarate free radicals. Air pollution is responsible for asthma, chronic bronhitis, heart attacks and even cancers.

Another aspect of air pollution is occupational exposure to different chemicals like mineral dust, asbestos fibres etc. These cause host of occupational diseases like asbestosis, lung fibrosids, and even deadly cancers.

Smoking:

One of the greatest cause of oxidative stress is SMOKING. Smoking active or passive is associated with a host of diseases. To name a few are bronhial asthma, chronic bronchitis, emphysema, lung cancer, cardio vascular diseases. Smoking releases various amount of toxins, those in turn produces plenty free radicals not only in the lungs but through out our body, each time we smoke. No other addiction harm our body like smoking does.

Water And Food We Consume:

To be frank, unless you are drinking distilled water, an impractical practice, you are at risk of increasing free radicals in your body.

The municipal water, or the tube well water we are getting in our country, India are not only contaminated with bacterias and viruses but also contaminated with host of other chemical agents and heavy metals even arsenic! The totally unregulated market of mineral water also offer to guarantee of protection.

What about the food? We are adding thousands of new chemicals each year in the form of herbicides, fungicides, pesticides to increase the crop yield; but at the cost of our health. Everything we consume be it fruits, vegetables, or grains are loaded with them and are responsible for our oxidative stress.

Medicines Are Not Innocent! :

Each chemotherapeutic agents, like antibiotics, anticancer drugs, radiation work by creating oxidative stress within the causative organisms or cells, thereby killing them. While doing these the damage also is transmitted to the normal cells of our body. Every drug you consume is actually a foreign material to your body and your body's all organ like kidneys, liver has to work hard to metabolize and eliminate them. This process produces plenty of free radicals and our body is under oxidative stress!

The War Within - Behind the line force

It will be easier for you to enjoy the article, if you quickly go through the previous post with the heading - The war within..

Every organized army need to have a behind the line supply system, so is our body's defense.

Only the soldiers cannot win the battle unless they have adequate supply of arms and ammunition, food, water, clothes etc. Similarly only having antioxidants in our body may not be the final answer of our defense. They need sufficient antioxidant minerals like copper, zinc, manganese and selenium. They aid in the chemical reactions of the antioxidants, so that they can do their job efficiently.

Other kind of supplies required for an army like mechanics, fuel tanks, engineers. In our body they are co factors, primarily the B factors like Vit B1, B2, B6 and B12.

The battle ground is really complicated. The number of free radials, that will be produced per day is never known to our body and this depend on various factors, fortunately most of which we can control !

my next few posts will be regarding the factors by which we increase our enemies, the free radicals in our body.

Stay connected.

The War Within - Defense Force Of Our Body

From my previous posts you read the story of the war. If not, I will request you to go through them quickly, so that you can appreciate our defense.

God did not leave us defenseless against the onslaught of the free radicals. It is amazing, how beautifully our body is made, that we have our own army of antioxidants, which neutralize the free radicals and render them harmless.

If you remember the example in my earlier post of a fireplace; antioxidants are like the glass door or, fine wired mesh place in front of the fireplace preventing the cinders to fly on your carpet.

Antioxidants are the substances, which the unruly free radicals the electron, they are missing and make them neutralized and disciplined. You don't have to remember the names, but these are three major antioxidants produced inside our body - i) superoxide dismutase, ii) catalase, and iii) glutathione peroxidase.

Our body cannot produce all the antioxidants we need, but we must provide required to protect our body in the form of food and supplements, if we want to win the war within. As long as there is sufficient antioxidants available in our body to neutralize free radicals our body is safe. When the ratio alters towards the free radicals our body comes under oxidative stress. If such situation persist for long, we are prone to develop different chronic degenerative diseases, losing the war within.

The antioxidants we get from vegetables and fruits. The most common antioxidants are Vitamin C, vitamin A, Vitamin E, and beta carotene. The other antioxidants, which we get from our food are Co enzyme Q10 (CoQ10), alpha lipoic acid, and the colorful bioflavonoid antioxidant.

Like well organized army, different antioxidants has different role to perform and at different sites of our body. Some of them has ability to regenerate other antioxidants, so that they neutralize more free radicals. Vitamin C, being the water soluble vitamin is best antioxidant to target the free radicals in the water compartment of our body, blood and plasma. Vitamin E, on the other hand is fat soluble fights within the cell membrane, an area rich in fat. Glutathione works within the cell itself. alpha lipoic acid works both in the cell membrane and plasma. Vitamin C and alpha lipoic acid has the ability to regenerate Vitamin E and glutathione, so that they are recycled and used again.

In summary - The more the antioxidants we will have in our body, more strong will be our defense system. Our goal is to achieve a balanced army of antioxidants in sufficient amount to neutralize all the free radicals produced in our body and WE MUST WIN THE WAR WITHIN.