Table of Contents
Introduction
The knee joint is the strongest and largest joint in the body which is made up of the lower end of the femur, upper end of tibia, fibula, and patella. The ends of the three bones where they touch are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones as you bend and straighten your knee. The meniscus is two wedge-shaped cartilages that are tough and rubbery to help cushion the joint and keep it stable. The synovial membrane covers the joint and inside it has synovial fluid which lubricates the joint.
Osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis are the common types of arthritis that affect the knee joint.
- Signs and symptoms of Arthritis knee
- Causes of Arthritis knee
- Diagnosis of Arthritis knee
- Treatments of Arthritis knee
- Prognosis of Arthritis knee
- Complications of Arthritis knee
- Sandhigata vata in Ayurveda
- Nidana- Causes of Sandhigata vata
- Samprapthi (Maturation) of Sandhigata vata
- Lakshana of Sandhigata vata
- Chikitsa (Treatment) of Sandhigata vata
- Commonly used medicines
- Home remedies and Diet
- Yoga
Signs and Symptoms
The signs and symptoms vary based on the type of arthritis that affected the joint.
Osteoarthritis: This is the most common type of arthritis affecting the knee joint. The symptoms include,
- Pain, stiffness, and tenderness of joint
- Painful movements
- Swelling
- Grating sensation
- The joint stiffness is predominant in the early morning or after being inactive
Rheumatoid Arthritis: The signs and symptoms include
- Warmth around the joint
- Stiffness of joints especially in the morning and cold season
- Instability and weakness of the joint especially on weight-bearing
- Difficulty in movements
- Crackling or popping noises on moving joints
Post Traumatic Knee Arthritis: The signs and symptoms includes,
- Joint swelling, stiffness, and pain
- Redness and warmth in the joint
- Decreased range of movements
- Crunching sensation on moving the joint
- Weakness or buckling in the knee
Causes and pathophysiology
Osteoarthritis is caused when the cartilage cushions the ends of bones in the joint. It is often known as wear and tear disease.
Rheumatic arthritis is caused when the immune system attacks the synovial membrane around the joint resulting in the thickening of the synovium. Gradually the cartilage inside the joints gets damaged resulting in symptoms.
The injury caused by sports, accidents, or any physical trauma causes wearing out of the joint which results in post-traumatic arthritis.
Diagnosis
The diagnosis can be done by
- Local examination of the knee joint for swelling, redness, warmth, and tenderness. Pain and stiffness of joints on movements were also assessed.
- Laboratory tests: The blood is tested for ESR, C-reactive protein which is raised in inflammatory conditions. Also, check for Rheumatoid factor and anti-cyclic citrullinated peptide (CCP) antibodies.
- Imaging techniques:
X-rays to check for cartilage damage, bone damage, and bone spur formation.
Computerized tomography is used to create cross-sectional views on internal structures of the joint. CT can visualize both bone and surrounding soft tissues.
Treatments
Arthritis of knee joint can be managed by,
- Reduce bodyweight
- Exercises to strengthen the muscles
- Anti-inflammatory and analgesic drugs like acetaminophen(Tylenol), ibuprofen (Advil, Motrin), or naproxen sodium (Aleve)
- Hyaluronic acid or corticosteroid injections into the knee joint. Steroids act as strong anti-inflammatory drugs and hyaluronic acid is lubricating to the knee joint
- Topical application of analgesic creams
- Knee braces to support the joint
- Physiotherapy
- If medication fails to relieve symptoms, then surgery is done
Prognosis
There is no complete cure for arthritis, but treatment can relieve symptoms, slow the progress of the disease, and reduce the risk of complications. In severe cases, surgery can be done to replace the inflamed joint.
Complications
A stress fracture is a complication of osteoarthritis of the knee joint. Joint deformities like knock knee or bow legs happen in advanced disease. Osteoporosis and rheumatoid nodules are also seen.
Disease and Ayurveda
In Ayurveda, Sandhigata vata is a condition affecting joints that closely resembles the symptoms of Arthritis of a joint.
Nidana- Causes
No specific nidana is said for the development of Sandhigata vata. But the factors like excessive dry, cold food, cold regimen, improper exercise, body postures, lack of nutrition, and less intake of food, etc. which vitiate vata can lead to the condition. Excess exercise and injuries also cause the disease.
Purvaroopam- Premonitory Symptoms
No premonitory symptoms are described.
Samprapthi -Maturation
Due to indulgence in etiological factors, the vata gets vitiated which further vitiate tissues like asthi (bone), majja (bone marrow) and gets localized to joints causing symptoms.
Lakshana Signs and Symptoms
The clinical features include,
- Swelling of the joint
- The pain of the joints in flexion and extension
- Crackling sound
- Degeneration of the joint
Prognosis
It is difficult to cure because it usually affects aged people and the knee joint is a vital point (Marma Sthana). Also, the asthi and majja like deeper dhatus (tissues) are affected.
Chikitsa – Treatment
The treatment aims at alleviating the vitiated vata dosha and strengthening sleshmaka kapha which acts as protection to the joint. The treatment procedures include,
- Snehana (oleation)
- Swedana (sudation)
- Mridu sodhana (mild purgation)
- Vasthi (enema)
- Ayurvedic Medicines and regimen which can reduce the aggravated vata dosha.
Commonly used medicines
- Shaddharana choornam
- Rasnasapthakam kashayam
- Rasnapanchakam kashayam
- Rasnerandadi kashayam
- Maharasnadi kashayam
- Yogaraja guggulu
- Kaisora guggulu
- Dhanwantharam thaialm
- Sahacharadi thailam
- Kattamchukkadi thailam
- Pinda thailam
- Dasamoola hareetaki lehyam
Brands available
- Dabur India
- Emami Ltd
- Baidyanath
- Aryavaidyasala Kottakkal
- Vaidyaratnam Oushadasala
- SNA Oushadhasala
- Dhootpapaeswar
Home Remedies
- Hot and cold compression- this relieves pain and stiffness
- Epsom salt bath relieves pain
- Topical application of creams and ointments
- Knee joint support like braces
- Ginger, turmeric, etc. are potent to reduce the pain in arthritis
- Daily exercise and stay active always
- Maintain healthy body weight
Diet
- Green tea is having anti-inflammatory action and hence can be used
- Omega 3 fatty acid-rich fish like salmon, walnuts
- Berries that are rich in antioxidants, vitamins, and minerals
- Leafy vegetables like Broccoli, spinach
- Include garlic, ginger, etc. in food
- olive oil may have a favorable effect on arthritis symptoms because it has an anti-inflammatory effect
- Avoid foods and beverages like highly processed food, fried foods, drinks rich in sugar, red meat.
Yoga
Yoga is very beneficial in the Arthritis of the knee joint because it helps in maintaining body weight and makes the movements of joints easier. So, beginning yoga is a wonderful idea. The postures advised includes,
- Padahasthasana
- Gomukhasana
- Ardhamatsyendrasana
- Merudhandasana
- Pavanamukthasana
- Sooryanamaskara
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