Arthritis


 
 
 
 
There are more than 150 types of Arthritis, the most common are Osteoarthritis and Rheumatoid Arthritis.

RHEUMATOID ARTHRITIS

DESCRIPTION: An inflammatory disease that affects the entire body, and is not limited to the joints. The main effect is inflammation (swelling and redness) of the smooth moist synovial membrane that lines the inside of joints. Those most affected are the hands and feet.

CAUSE: An autoimmune disease in which the immune system is triggered off inappropriately, and the body starts to reject its own tissue. Tends to run in families from one generation to the next, and the onset may be triggered by a viral infection of stress. Occurs in one in every 100 people, and females are three times more frequently affected than males. Usually between 20 and 40 years of age.

SYMPTOMS: Initial symptoms are very mild, with early morning stiffness in the small joints of the hands and feet, loss of weight, a feeling of tiredness and being unwell, pins and needles sensations, sometimes a slight intermittent fever, and gradual deterioration over many years. Occasionally the disease has a sudden onset with severe symptoms flaring in a few days, often after emotional stress or a serious illness. As the disease worsens, it causes increasing pain and stiffness in the small joins, progressing steadily to larger joints, the back being only rarely affected. The pain becomes more severe and constant, and the joints become swollen, tender and deformed. Other organs may also be affected.

INVESTIGATIONS: Diagnosed by specific blood tests, X-rays, examination of joint fluid and the clinical findings. The level of indicators in the blood stream can give doctors a gauge to measure the severity of the disease and the response to treatment.

TREATMENT: Requires constant care by doctors, physiotherapists and occupational therapists. The severity of cases varies greatly, so not all treatments are used in all patients, and the majority will only require minimal care.
In acute stages, general physical and emotional rest, and splinting the affected joints are important. Physiotherapists undertake regular passive movement of the joints to prevent permanent stiffness developing, and apply heat or cold as appropriate to reduce the inflammation.
In chronic stages, carefully graded exercise under the care of a physiotherapist, is used. Medications for the inflammation include aspirin and other anti-inflammatory drugs. Steroids such as prednisone give dramatic, rapid relief from all the symptoms, but they may have long-term side effects (eg. Bone and skin thinning, fluid retention, weight gain, peptic ulcers, lowered resistance to infection, etc), and their use must balance the benefits against the risks. In some cases, steroids may be injected into a particularly troublesome joint. A number of unusual drugs are also used, including gold by injection or tablet, antimalarial drugs (eg. Chloroquine) penicillamine (not the antibiotic), and cell-destroying drugs (cytotoxics).
Surgery to isolated, painful joints can be useful in a limited number of patients.
 
COMPLICATION: Additional effects can include wasting of muscle, lumps under the skin, inflamed blood vessels, heart and lung inflammation, an enlarged spleen and lymph nodes, dry eyes and mouth, and changes to cells in the blood. 
 
PROGNOSIS: There is no cure, but effective controls are available for most patients, and the disease tends to burn out and become less debilitating in old age. Some patients have irregular acute attacks throughout their lives, others may have only one or two acute episodes at times of physical or emotional stress, while others steadily progress until they become totally crippled by the disease.

OSTEOARTHRITIS

DESCRIPTION: A degeneration of one or more joints that affects up to 15% of the population, most of them being elderly.
CAUSE: Degeneration of the cartilage within joints, and inflammation of the bone exposed by the damaged cartilage, which is aggravated by injury and overuse of joint. There is also a hereditary tendency.

SYMPTOMS: Usually mild at first, but slowing worsens with time and joint abuse. The knees, back, hips, feet, and hands are most commonly affected. Stiffness and pain that are relieved by rest are the initial symptoms, but as the disease progresses, swelling, limitation of movement, deformity and partial dislocation (subluxation) of a joint may occur. A crackling noise may come from the joint when it is moved, and nodules may develop adjacent to joints on the fingers in severe cases.
 
INVESTIGATIONS: X-rays show characteristic changes from a relatively early stage, and repeated X-rays are used to follow the course of the disease. There are no diagnostic blood tests.
 
TREATMENT: Avoid any movement or action that causes pain in the affected joints, such as climbing stairs and carrying loads (obese patients should lose weight). Paracetamol, aspirin, heat and anti-inflammatory drugs may be used to reduce the pain in a damaged joint. Physiotherapy, acupuncture and massage have also been found to be useful. Sugery to replace affected joints is very successful. The most common joints replaced are the hips, knee and fingers. Surgery to fuse together the joints in the back is sometimes necessary to prevent movement between them, as they cannot be replaced. Steroid injections into an acutely inflamed joint may give rapid relief, but they cannot be repeated frequently because of the risk of damage to the joint.

COMPLICATIONS: Severely damaged joints may dislocate.

PROGNOSIS: Depends on the joints involved and the disease severity. Cures can be achieved by joint replacement surgery, while other patients achieve reasonable control with medications. The inflammation in some severely affected joints can sometimes ‘burn out’ and disappear with time.


Traditional Oriental Medicine (Traditional Chinese Medicine)

Oriental medicine uses a multidimensional approach in treating arthritis. The steps involve:
1. Determine the "type" of arthritis. Oriental doctors use terms such as Xing Bi and Tong Bi to classify different types of arthritis.
2. Treat with herbs and spices, diet, acupuncture, "ear acupuncture" and other therapies, as necessary depending on the type of arthritis and the symptoms.
Types of Arthritis from Oriental Medicine Perspective
Xing Bi. With this "migratory" arthritis, the pain moves around the body. It's caused by wind, dampness and cold invading and obstructing the chi (energy) and blood circulation. The patient is often thin, dislikes wind and has a white coating to the tongue.
Tong Bi. In this "painful" type of arthritis, severe pain stays in place at one or more joints. It's caused by excessive cold, which slows the circulation of chi and blood. It's made worse by cold and lack of movement, but feels better with heat. There is typically no inflammation or redness at the afflicted joint.
Zuo Bi. This is a "fixed" type of arthritis characterized by dampness and internal stagnation, in which the afflicted parts of the body become heavy and numb. The tongue typically has a greasy white coating, and the pain is worse on rainy and cloudy days.
Re Bi. Caused by the conversion of pre-existing problems into heat, this "hot" arthritis produces swelling, tenderness and sharp pain in one or more joints. The patient's tongue is typically covered with a dry yellow coating, and the pulse is "slippery" and fast.

 
Treatment
After determining the "type" of arthritis, the Oriental medicine practitioner tries to relieve the symptoms and to strengthen the body. A combination of herbs and spices, diet, acupuncture, "ear acupuncture" and other therapies, are used, as necessary.
Herbs and Spices
A variety of herbs and spices are used. The actual herb used and the quantity and frequency will depend upon the condition of the person being treated. Dried ginger is a popular herb in oriental medicine. It is a hot substance that warms the intestines while toning the stomach, lungs and spleen.
Very often combinations of herbs are used. Some of the herbal formulas that are useful to treat arthritis include:
Chen Pu Hu Chien Wan
Feng Shih Hsiao Tung Wan
Guan Jie Yan Wan
Herbal Formula for those with a robust constitution (strong, loud voice, and thick tongue coating):
4 parts chaparral leaf 2 parts devil's claw root 2 parts sassafras root bark 2 parts dried gingerroot 1 part black cohosh root 1 part burdock root 1 part prickly ash bark
Herbal Formula For Individuals who are weaker and more deficient (frail, pale, little or no tongue coating, introverted personality):
4 parts suma root 4 parts motherwort 4 pans prickly ash bark 4 parts oshaaigusticum root 2 parts angelica root 11/2 parts Siberian ginseng 11/2 parts cinnamon bark

Diet
The following foods are useful for arthritis:
Black soybean - increases blood circulation. Useful for rheumatoid arthritis.
Cherry - useful to treat rheumatism.
Grape - Increases energy while strengthening the lungs, spleen and kidneys.
Papaya - Useful for rheumatoid arthritis
Royal jelly - Useful for rheumatoid arthritis.
See Also: Acupuncture for Arthritis
Acupressure for osteoarthritis
Acupressure for rheumatoid arthritis
Acupuncture Infocenter in Holisticonline.com
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Osteoporosis

DESCRIPTION: Common bone condition (one quarter of women over the age of 50 affected) in which the basic constituent of bone, calcium, drops to a dangerously low level. The bones soften and may bend, break or collapse.

CAUSE: Calcium is found in al dairy food (particularly cheese), sardines, shellfish, beans, nuts and tripe. Adults require up to 800mg of calcium, and children and pregnant women up to 1400 mg a day. The structure of bones is being constantly renewed