Osteoarthritis:- Beware patients! Wrong guidance by most of the doctors. Know the facts.

Osteoarthritis:- Beware patients! Wrong guidance by most of the doctors. Know the facts.

It is the most common disease of the joints, with an associated risk of disability and wrong medication and advice by most of the busy doctors.

Causes

The exact causes are not known, there are many factors promoting the disease. It may occur at any age but people above 50 years are more commonly affected; more common in women after menopause; runs in families, genetic inheritance; accidental deformities or injuries may promote the disease and overweight does play a role.  But you may find thin skinny people are suffering with equal regularity.

All the parts of any synovial joint are affected, the bones, the cartilage, the joint capsule, the synovial membrane and even ligaments.  There are changes in the structures and functions of these parts and the end result is the mechanical failure of the joints. The joints get painful, swollen and all the movements become restricted. The joints of knee, the fingers, toes, hips and spinal column can be involved.  The joints of lumbar spine  may cause back ache, and cervical region joints can cause cervical pain or pain in the head or the arms or in the back of shoulders.  The most common presenting symptoms of the patients are of knee joints.

Myths and Facts

Myth:

It is caused by the wear and tear of the joints.

Fact

It is similar to any inflammatory disease, but exact cause is not known. It should involve all the athletes who use their joints more frequently and there could be more wear and tear of the joints, but it is not a fact. It is seen in women and men who had not run a single kilometer in their life time.

Myth:

Avoid exercises and stress to the joints by running, sitting, squatting and fast walking.

Fact:

This is absolutely funny advice and is harmful to the patients in the long run. I had been fighting the battle alone with no support from any known quarters. Innocent and lovable patients keep reporting and relating the pieces of advice they got from the doctors. And the common advice is not to do exercise, not to move the joint and for knee joint the patient is asked not to walk fast or run and not to sit or squat on the floor. The patients of this age are more prone to heart diseases , hypertension and diabetes, and the result is the patient may not have any relief from joint pains but there is every likelihood of contracting all these diseases.

Myth:

The use of anabolic steroids is recommended.

Fact:

No use and the use may cause gain in weight, increased blood pressure and worsen the diabetes.

Myth:

The use of cervical brace to support the spinal segment of the neck for curing the cervical spondylitis or very commonly given spinal jacket to cure the severe back ache.

Fact:

It is harmful advice without any benefit to the patients.  You would be surprised  to know that comparatively young patients of 25 to 35 years  were given  spinal jackets and cervical braces or collar to cure these patients. And when they approached me, the first thing I did was to remove these harmful supports.  And all of them reported relief within next few days.

As a matter of fact, the braces or immobility by any method is going to weaken the muscles, ligaments and bones.  The bones would get osteoporosis and weakened, and weakness of supporting muscles would make the patient invalid quickly, than the natural process of the disease.  This is very painful fact for me to digest and I feel impelled to do anything to safeguard the interests of gullible patients.   This is not only disinformation which can ruin the  future of patients but it is criminal negligence also.  That is the basic reason to put up this article in the web page so that people who are in touch with the mission get better informed.

[Note:- I must add here that I am not a orthopeadic surgeon, but I  come across more such patients in my voluntary service in the Sarab Rog Ka Aukhad Nam Mission Trust, Ludhiana, than many of the orhtopaedic surgeons.  We get those patients who had had their treatments from the hospitals and known reputed doctors but did not get any relief and then they gravitated to me. I have to work hard to know about the latest treatments and I do advise them how to go about it. And I have seen many patients who were advised by other doctors not to sit on floor or do any exercise. And I had advised as per the latest scientific thinking to do exercises and not to use jackets. Practically, I have seen all these patients had immense and immediate relief without exception. Some of the patients were advised knee replacement surgery. With prayers and exercises these patients were fully cured. More information about these cases can be had on request.

I am writing in context with my friends in India only and I am not exposed to doctors in developed countries. I suppose they are better disposed off, owing to strict laws and huge compensation being paid in case of wrong treatment.]

Myth:

The medicines can stop and modify this disease.

Fact:

No such medicine is known to cure the disease  Some of the disease modifying drugs are found very harmful but still being used in really desperate rheumatoid arthritis cases where the small joints of the fingers are affected and the patients find helpless, then temporary relief is provided but no cure is possible.

Please don’t follow the ayurvedic or homeopathic treatments, these systems are no match to allopathic system of cure. You would be offering your body for testing unproven and untested and even harmful medicines.  There is no strict system of checking the uses and side effects of these drugs. So choice is yours.

Myth:

Alendronate and Glucosamine  are being commonly  prescribed  to strengthen the bones.

Facts:

Alendronate can cause jaw necrosis and is not useful at all. Glucosamine can raise the risk of strokes and causes raised cholesterol and many other very serious side effects. I don’t know, why my friends are still prescribing these harmful and useless medicines?

Treatment

  1. Education,

  2. Weight loss, if more,

  3. Physical Therapy. Motion exercises, muscle strengthening, and stretching and soft tissue mobilization.

  4. For instability of knees and deformities, Bracing and shoe wedges may be useful.

  5. The medicines may be used to the bare minimum level. The medicines can give just a little comfort and solace. The best option is paracetamol, and the maximum dose upto 4 gms/ per day

References:

  1. Bailey & Love‘s Short practice of Surgery,  24th Edition.

  2. Osteoarthritis, BMJ , South Asia Edition, August, 2006 By David J Hunter and David T Felson.

 

The Role of Exercises

        The exercises are must for normal maintenance of the bones, muscles and other vital organs, like the brain, the lungs and the heart.  It is natural for the infants to keep moving all the parts of the body even in bed. That body activity is a must for normal healthy growth of the child. Once we grow up, we have to make efforts to keep all the organs fit and fighting by moving all the joints as the small child does, under the direct supervision of God.

  One must differentiate between exercise and walking.  The walks are also needed to tone up the entire body and the exercises are meant to strengthen the particular group of muscles.  Some parts of the body are not used or moved in routine; the arms are not raised above the  head and the neck is not rotated in all directions and similarly you keep yourself very active by using stairs and not using lifts but how many times you try to bend your waists or turn side ways.  You would be surprised to find that most of the younger people suffer from cervical spondylitis, and muscles of the back  are sprained by sudden forward bending of the spine as may be required in lifting  some heavy object from the floor. The logic is simple that these muscles had become wasted and weakened and could not withstand the sudden pressure to work for us and the result is tearing of the muscles and ligaments and hence pain and disability.

  The exercise is a food for the body, when the doctors ask the patients not to sit or walk fast, it amounts to more damage to the already damaged joints. In all these cases the active exercises can play a very key role. It would strengthen muscles, ligaments, cartilage and the bones of the joints and it would certainly delay the progress of the disease.

 

 How to do exercises

       The sole objective is to move all the parts of the body, in their full range of movements.  When the movement reaches the full extent, then the particular part of the body should be kept at the same stretched state for 8 to 10 seconds. This simple trick would help the muscles and bones get stronger and powerful. If the movements are made against resistance then the whole process becomes more useful. For example you want to exercise the muscles of neck by making the neck move to the left side what needs to be done in this particular case is that  you push your head from the opposite to the right where as your muscles of the neck are moving your head to the left. The use of dumbles  and other methods of exercise do give resistance to your muscles and are more useful than without the help of these implements.

   You can start with eyes, move the eyes in all directions, this would certainly help your eye sight. Then please come down to the neck, it is the most important part of the body and often ignored.  The exercises of the neck even without spondylitis  would abort such attack in future and provide relief to the pain around neck and head.  This simple act would improve the cerebral circulation and in return would help the hearing, the speech and other many related functions of the brain. It would help in delaying the onset of aging on the brain. These simple exercises help in venous return and better circulation to the brain.

  The joints of shoulder, the arm and the forearm should be exercised. And especially for the forearm muscles one has to fix the upper arm along the side of the body and bend the elbow then only muscles of the forearm can be excercised. Don’t forget to exercise the wrist joint. And similarly the upper spine and lower spine can be exercised and more important is the hip joint and muscles of the lower back. Side bends , bending your thighs and legs can be done even on bed or otherwise standing also. You must ensure all the joints are moved. You would feel fresh and more energetic to work for the day.

 

Advantages of the exercises

It improves the circulation of the blood in the area and even new blood vessels are laid and the existing blood vessels open up. Normally all the existing blood vessels do not open up and air entry into the lungs is also restricted. The exercise puts the demand on body for more oxygen and that is the stimulus for the organs to work more and  as a result the heart starts beating faster, the respiratory rate increases and the blood pressure rises up to supply the increased demand and blood vessels of the skin open up  to cool the body and there is sweating and you feel thirsty as the demand for  water also increases. The entire body gets rejuvenated.

And the value of exercises for the joints is much more, the increased blood supply removes the waste metabolic products from the bones and muscles. There is increased venous return from the muscles and bones, and these organs get the fresh blood supply and nourishments and much required micronutrients.  The result of all these actions is quite obvious, bones get more calcium and trace elements which are needed for the healthy bones and similarly all the parts of the joints stand to gain. The bones get stronger and the osteoporosis stops, muscles become stronger and ligaments get better.

An important cause of pain in any part of the body is the lack of blood supply.  The usual complaint is the pain in angina and muscle pain in legs due to reduced blood supply caused by atherosclerosis. The body in entirety stands to gain. The exercises should be graduated and there should be step wise increase in the strain or stress on muscles. Any body, in any situation can do exercises and the physiotherapy is much more refined to suit the requirements of particular parts of the body.  So the help of physiotherapist can be sought, but I am afraid who would go to the therapist against the orders of the surgeons. So key to the whole problem is better informed doctors.

I hope, my humble effort would be understood, it is not against any doctor, it is an endeavor  to make it possible for the doctors to appreciate the need to keep themselves updated with the latest in their respective fields so that every body is benefited. 

The prayers can cure any disease, you can know more from our website> gurunankhealing.com.  The prayers, without disease would abort the attack of so many diseases, if you are not well the prayers help you to decide the best option for you and you would get quicker and sure relief in a short time. No body loses anything in the prayers. 

Dr. Balwant Singh,

M.B.B.S.; Ex Capt,AMC,

Sarab Rog Ka Aukhad Nam Mission Trust, Regd., Ludhiana, 141002

 e-mail; info@gurunanakhealing.com

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