Arthritis is a term derived from “ARTHRON” means Joint and “ITIS” means Inflamation
Inflamation of joint and surrounding tissue is called ARTHRITIS
Its a general term used to describe pain swelling of joint and its surrounding tissue.
When one joint is involved its called Monoarthritis and when more than one joints are involved its called Polyarthritis
Different types of arthritis have different causative factors like
- Lifestyle and Evironmental factors
Though each factor has contribution in certain degree in every type of arthritis; Still it can broadly be classified into 4 major category based on the predominant factor responsible for their Pathophysiolohy/Pathogenesis :
- Mechanically mediated type
- Immunological mediated type
- Metabolical mediated type
With Genetics Lifestyle and Environment as Contributory factors in each type.
Further various major subtypes are described in detail in following link:
HOMOEOPATHIC MEDICINES and MANAGEMENT OF ARTHRITIS
Homoeopathic Arthritis Management depends on individualisation of the patient based on present symptoms, past history, family history and constitution of the patient.
In arthritis cases it is necessary to take into account the following points (with constant search for underlying miasm and constitution type):
- When it started, that is since how long its been there.
- How was the onset when it appeared first time.
- Wether the complaints had incidious progression or it was sudden.
- Which joint is involved, wether its single joint or multiple, wether its bilateral and symetrical or diagonal.
- Particulars like which part was affected first, which side it started first and how much time it took for progression to other side or other joints, sequence in which joints were involved.
- How and when it gets triggered, aggravation pattern morning stiffness , aggravation on rest/ motion, relation to climate winter/monsoon/summer, relation to heat and cold, aggravation to any particular type of food.
- Wether its constant or intermittant.
- The joint is warmer than rest of the body or not.
- Wether there is swelling around the joint or not.
- Nodes or nodosities on or around any joints. or any other signs of disfigurement.
- Movement or other disability in joint.
- Patient has fever or not or h/o fever before or during the episode of joint pain started.
- Presence of any concomittants or accompanying symptoms and wether those symptoms are of Psychotic, Syphilitic or Psoric nature.
- Wether he has any other systemic complaint especially any other autoimmune or metabolic disorder.
- History of injury, surgery especially affecting neurons or musculoskeletal structure.
- Nature of work the patient does , postural habits, structural anomalies disfigurements.
- Diet sleep and exercise routine water intake should also be noted carefully.
- It is important to note family history of patient wether first degree relative had any autoimmune or metabolic disorder.
- Wether patient was or is under any long term medication.
A careful history of all communicable ailments should be recorded in sequence as they had been contracted by patient, as it helps us evaluate when and how was the vital force deranged in past and wether the present condition is manifestation of some past ailment, that is any deep seated miasm, also it helps to establish wether its some inherited genetic condition or its acquired condition also it helps differentiate between
- Vector borne conditions like post viral arthralgia/arthritis and Group A streptococcal borne post pharyngitis systemic autoimmune condition AND
- Other Systemic autoimmune conditions like Rheumatoid Arthritis SLE psoriatic arthritis.
These basic question will lead you towards a broader vision in the case and will let you reach upto some conclusion that under what category of arthritis it should be classified and will lead you towards some understanding of miasm and constitution.
As I have mentioned in my other arthritis articles that basically I divide all types of arthritis into four major categories based on their pathogenesis.
After being diagnosed and classified the disease condition from one of the above group we can go further on how to manage each type of case.
Once established that its an immune mediated arthritis its necessary to rule out any damage to other organs like heart, liver, kidney, pancreas, eyes etc, as in most cases autoimmune arthritis is found to involve other system and organs or it is a part of broader systemic autoimmune condition and it is all the more necessary to find out miasmatic background, constitution and individualising symptoms, as such types of arthritis are deep seated having its own sets of aggravating and ammeliorating factors, furthermore its also observed that mental stress and emotional fluctuations have much impact on intensity and frequency of aggravations in almost all types of immunologically mediated arthritis, so its of utmost importance to take proper account of patient’s mental emotional past and present including likes and dislikes aversion and cravings, which helps us to individualise the case.
Once the we have derived constitution , miasmatic background and individuslised the case then comes medicine selection process,
I strongly recomend to go by constitution of patient in immunologically mediated arthritis rather than going theraputic remedy selection.
and it should be kept in mind that the selection procedure of medicine should correspond to degree of mental PQRS , degree of systemic PQRS and degree of musculo-skelatal symptoms of the person in disease should match the degree of pathogenic action on various sphere of the specific medicine.
Though during acute exacerbations of disease it becomes necessary many a times to administer short acting acute medicines theraputically where the new symptoms desnt fall into sphere of the constitutional medicine thats been administered.
Many a times only a single dose of similimum medicine selected may suffice to cure the case but all patients are not the same each has a different constitution and miasmatic background and severity of ailment and other external inimical factors, so in many cases it may take series of medicines one by one as per case demands during progression of treatment before the case is cured. It all depends upon how well the physician is able to find out the similimum and type of case and its requirement.
Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.
In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised remedy selection for complete annihilation of condition; if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.
In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.
Again this type of arthritis is a deep seated genetic in nature and they might accompany other metabolic syndromes and requires a careful case taking to get a broader picture of the person in disease, all aother systems and organs should be evaluated to understand sphere of disease pathology its extent and severity so it helps us to select the most similimum homoeopathic remedy.
The approach in such cases again remains constitutional , miasmatic and remedy should be selected only after proper individualisation of case and repertorisation.
In septic arthritis pt needs to be administered short acting acute remedies theraputically with support of deep acting constitutional remedy which can be administered intermittently or after the acute symptoms are ammeliorated to rearrange the deranged vital force.
Commonly Used Homoeopathic Medicines for Arthritis and its symptoms and indications:
RHUS TOXICODENDRON Usefull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system, rheumatic joint affections, sprain and injury on joints etc
ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
ACTEA SPICATA Pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
BRYONIA ALBA Stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
LEDUM PALUSTURE Gouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
HYPERICUM PERFOLIATUM Degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
BELLIS PERENIS Soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine, sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
COLCHICUM Gouty arthritis , increased Serum Uric acid and tophus formation in joints. typical pain in great toe aggravated at night, sudden gripping cutting pain with much burning comes at night waking patient up from sleep
CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
BELLADONNA red hot inflamed joint with much pain and swelling
ACONITUM NAPELLUS Acute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.
NATRUM SULPH a very good remedy for gouty diathesis.