It is a disordered Condition when there is inflamation of one or more joints, Characterised by pain, redness, swelling and heat with restricted motion, Harrison says that over 80 diseases may cause arthritis including rhematoid arthritis (R.A), gout, osteoarthritis, tuberculosis and other infections. Exact diagnosis is assested by examination of the pattern of affected joints, x-rays, examination of synovial fluid by aspiration of a swollien joint. Any disease that involves synovial membrane(s) can cause degeneration ofthe cartilage and resultant arthritis. Cervical / lumbar spondylites/spondylosis, pain in wrist, shoulder (frozen shoulder), elbow (Tennis elbow), Hips, knees, ankles, feet etc are simply varied forms of arthritis
Osteo-arthritis (O.A)
It is a disease of joint cartilage, which is associated with secondary changes in the underlying bone that may cause pain and impair function, mainly ofthe weight-bearing joint (like Hip, knees and feet), Such a Condition results from overuse of the affected joint. Hence joint space is narrowed and there is difficulty in performing even of normal activity due to restricted and painful movements. The patients should reduce pressure on the affected joint but Continue moderate activity, despite pain. But when there is swelling, no movement should be performed and rest given to the joint. In chronic state, total chauge of the affected part is the only option but all cases do not improve, even after joint replacement. The patient should use stick or Clutches or walker to reduce weight on the affected joint
Rheumatoid Arthrites (R.A)
Incidence of R.A is next only to O.A. In R.A. joints of wrists, fingers, feet and ankles, hips and shoulders are involved. The joints are symmetrically affected and there is a considerable range of severity. The causation can be ascertained and diagnosed by a blood test which shows the presence of Rheumatoid factor, and X-rays reveal typical changes (Called-Rheumatoid erosions) around the affected joints. The Condition often responds to antiinflammatory analgesics and also undergoes remission of symptoins
Rheumatism
This is a wider term which simply denotes aches and pains in the joints and muscles. Here only large joints are involved, whereas small joints are affected in gout but the causes are different
Gout
It is a disease of difective uric acid metabolism, that is when an excess of uric acid and its salts (urates) accumulate in the blood stream and joints.
Gouty Arthritis
In this Condition there is chronic destruction! of the joints and deposits of urates (Toplie) in the skin and Cartilege, especially of the ears. Excess of urates also damages the kidneys in which stones of urate-origin may form, and ultimately the patient looks like a living skeleton. Treatment with Allopururol slows the formation of urates and also their excreton through urine’
Treatment: It is a multifaceted approach that is, by means of
1. Drgs (Fororal use only)
2. Non-steroid anti-inflammatory drugs like Aspirin, Indomethecin, Paracetamol, Ibuprofen, Neproxin, Phenyebutazone, oxyphenbutazone, Analgin, Phenacetin, Acetomenophen, Metoclopramide, Tenoxicam, Piroxicam, Declofenac sodium, Nemesulide can be used according to specific symptoms, taking the cautions, drug interactions, side effects, and non applicability factors into consideration.
2. Muscle Relaxants (For local use only)
These include Dicyclomine, Chlormezanone, Chlorzoxazone, Orphenadrine etc which are used in Combination with Paracetamol / Analgin / lboprofen /Diclofenace sodium Some companies can combine Diazepam (2.5 mg generally) to enhance the effect and soothe the agitated mind.
3. Topical Analgesics (For local application only) These topical analgesics are available in various forms which include Menthol, Mephensin or/and one or more than one ingredients out of methylsalicylate, Histamine, Capsicum, camplor, diclofanac sod/ Ketroprophen, Methyl Nicotinate, Eucalyplus oil, Piroxicam, Ibuprofen, winter green oil, turpentine oil etc in various concentrations, depending on a company’s clinical formulations out ofthe given list of drugs
Treatment (Except For Gout)
Hereunder only brand/trade names of most Commonly used drugs are given Oxyplenbutazone, analgin are not now used as those have been replaced by better drugs which have a less side-effects
(1) Asprin is still the first drug of choice Take a 500 mg tablet thrice daily
or (2)Tab Combiflam -1 tablet thrice daily
or (3)Tab Relaxyl/voveren – 1 tablet thrice daily
or tab Relaxyl/Vovern S.R. – one tablet once a day
or (4)Ultraflam – one tablet thrice daily
or (5)Unofen MR – one tablet 2-3 times daily
or (6)Nimulid/Slid (100) mg – 1 tablet trice daily
(7) Mobizox/spontrel/Magadol / wingesic plus/Magadol-SP Frenac-MR – anyone tablet once a day only.
Note: Drugs/Drug Combinations meantioned in No (7) should be taken only in severe painful swelling, stiffress of joints when mobility is restricted and shouldn’t be continued for more than 3-4 days, except when medically advised.
All the medicines, mentioned above, may cause burning, diarrhola flatulence or any other dyspeptic problems, hence do not use for 4-5 days at a stretch whereafter give a gap of 5-7 days and then restart if complaint still persists. Some ofthe patients may even develop immunity or resistance to a pellicular drug, if used for a prolonged period. Consult your doctor if there is no response or some new symptoms surface or there is any other complication.