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PHYSIOTHERAPY IN MANAGEMENT OF OSTEOARTHRITIS

Osteoarthritis in Ayurvedic texts is described as Sandhigata Vata. It is one of the most common forms of joint disorders. It damages the joint through wear and tear. It can be painful and depressing. There is no cure in modern medicine, but there are ways of managing the condition and making the life easier. Physiotherapy is an important part of that management.  

Causes of Sandhigata Vata (OA): Sandhigata Vata is vatik disorder, so that aggravating factor of Vata can be considered as aetiological factors of Sandhivata. As mentioned earlier Vata particularly vyana vayu has a close relationship with sandhi. So its aggravating factors are also to be considered.
Symptoms and signs: Recurring pain or tenderness in a joint. Stiffness, particularly early morning stiffness, swelling in a joint, Heberden's node and Bouchard's node, obvious redness or heat in a joint, inability to move a joint.
Ayurvedic types of Sandhigata Vata (OA): The Sandhigata Vata is Vata nanatmaj Vyadhi so that bheda of Sandhi Vata are not described in Ayurvedic texts. Sandhivata can be classified in following ways :
1. On the basis of Samprapti
(a) Vata Vardhak Ahar-Viharjanya Sandhivata
(b) Avaranajanya SadhiVata.
(c) Dhatukshayajanya Sandhivata.
2. On the basis of Doshas
(a) Nija - Due to vitiation of Vata by Vata vardhak ahar-vihar, dhatukshya and Avarana etc.
(b) Agantuja - Due to traumatic injury
Types According To Modern View.
There are two types of osteoarthritis:
1. Primary osteoarthritis
2. Secondary osteoarthritis
Primary osteoarthritis is a chronic degenerative disorder related to but not caused by aging. Secondary osteoarthritis is caused by other factors or diseases.
Diagnosis: Diagnosis is normally done through x-rays. This is possible because loss of cartilage, subchondral ("below cartilage") sclerosis, subchondral cysts, narrowing of the joint space between the articulating bones, and bone spur formation (osteophytes) show up clearly on x-rays. Plain films, however often do not correlate well with the findings of physical examination of the affected joints.
With or without other techniques, such as MRI (magnetic resonance imaging), arthrocentesis and arthroscopy, diagnosis can be made by a careful study of the duration, location, the character of the joint symptoms, crepitus on local examination and the appearance of the joints themselves. As yet, there are no methods available to detect OA in its early and potentially treatable stages.
How Physiotherapy Can Help
Physiotherapy can:
1. Reduce pain.
2. Improve movement and posture.
3. Strengthen muscles.
4. Improve independent function.
5. Assess and treat biomechanical problems that may exacerbate the pain and loss of function.
How you can help yourself:
1. Avoid over-stressing joints.
2. Avoid jerky/sudden movements.
3. Don't overload joints.
4. Take care with lifting.
5. Watch your weight.
6. Improve your body alignment to take stress off arthritic joints.
7. Use splints or walking aids as advised.
8. Don't overdo activity or exercises.
Exercises - how do they help? : Exercises for people with osteoarthritis should be individually prescribed. Your physiotherapist can devise a programme of exercises to suit your condition. As a general rule remember if any exercise hurts then don't do it. Recent physiotherapy research has consistently shown exercise to be effective in management of osteoarthritis of the knee.
Exercises help by:
1. Maintaining or increasing movement.
2. Improving joint lubrication and nutrition.
3. Restoring muscle balance.
4. Improving circulation.
5. Improving strength and stability.
6. Improving poor posture.
Don't forget to maintain your general fitness level - this helps you feel better and retain your healthy joints. Gentle regular exercises such as swimming, exercising in water (hydrotherapy), walking or cycling are recommended.
Rest : Whilst rest is an important part of managing your osteoarthritis, it is usually balanced with exercises and activity. In particular rest is required when joints are hot swollen or painful.
Summary and conclusion: Sandhigatavata (Osteoarthritis) is a type of arthritis that is caused by breakdown of cartilage, with eventual loss of the cartilage of the joints. Osteoarthritis can be caused by aging, heredity and injury from trauma or disease. The most common symptom of osteoarthritis is pain in the affected joint(s) after repetitive use. The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function. Physiotherapy helps to achieve the goal of treatment of osteoarthritis.