Rheumatoid arthritis is an auto-immune chronic disorder that might cause abnormal swelling in the joints when the joint tissues are attacked by the human immune system. The more frequently used body joints, such as the knees, fingers, shoulders, wrists, elbows and hips commonly get affected by the disease. Rheumatoid arthritis can also occur in the ligaments or tendons and might affect areas such as the kidney, bone marrow, eyes, lungs, and heart.

If rheumatoid arthritis is not diagnosed on time, it might lead to future complications, such as blood cancer in the lymph regions, osteoporosis (a medical condition resulting in the weakness of the bones), infections, stiffening of the arteries and dry mouth.

What exactly causes the disease is not known, but a significant damage to the immune system might cause the inflammation of the joints, resulting in this condition. Obesity, a family history of this condition and other lifestyle habits such as smoking tobacco put one at higher risks of this disorder.

The symptoms of rheumatoid arthritis might vary among people. The most common symptoms of rheumatoid arthritis are;
1. Severe pain in the morning
2. Episodes of mild fever with severe pain
3. Redness and inflammation of the joints which might cause intense pain
4. Stiffness in the joints
5. The pain might increase in low-temperature conditions
6. Acute lethargy and weight loss

Treatments
The treatment of rheumatoid arthritis includes a prescribed dosage (depending on the intensity of the condition) of non-steroidal anti-inflammatory drugs such as ibuprofen, anti-rheumatoid drugs such as methotrexate and steroid drugs such as prednisone to reduce the swelling and the subsequent pain. Performing regular exercises in order to retain the flexibility of the joints with appropriate consultation from the physiotherapist might cure rheumatoid arthritis. 

Persistent Stiffness in Joints - Can it be a Sign of Rheumatoid Arthritis

Proper rest and a sound sleep are prerequisites for keeping the physical and mental health in good shape. Difficulty to fall asleep or having a disturbed and interrupted sleep day after day can be a nightmare. In addition to the immense physical exhaustion and fatigue, insomnia can leave a person stressed out mentally which is bound to have an impact on their professional as well as personal lives and commitments. Over the last few years, incidences of insomnia have been rising at an alarming rate.

Insomnia does not always exhibit similar symptoms in all the affected individuals. In some, the condition may be short-term, lasting for a few days or weeks (Transient Insomnia). In some, the problem may appear on and off (Intermittent Insomnia). In extreme cases, insomnia and the associated discomfort may continue for months (Chronic Insomnia). In some instances, insomnia appears as a symptom associated with health conditions such as diabetes, Alzheimer's disease, Parkinson's disease, heart ailments, GERD, to name a few. Severe stress and anxiety along with unhealthy dietary and lifestyle habits are also known to play a pivotal role resulting in insomnia.

The goodness of Unani in treating Insomnia
Unani is one of the ancient forms of medications that has gained immense worldwide appreciation due to its effectiveness in treating various threatening and complicated health conditions including insomnia. In case of Insomnia, the Unani treatment involves a combination of Dietotherapy, Regimental Therapy, and Pharmacotherapy. The main aim of the Unani treatment is to treat insomnia by restoring the balance between the four humors namely, Blood (Dum), Yellow bile (Safra), Phlegm (Balgham), and Black bile (Sauda). It is these four humors that not only nourish the body and the vital organs but also keeps the various health conditions at bay.

With Dietotherapy or Ilaj Bil Ghiza, the aim is to bring the necessary dietary changes to deal with insomnia. The daily intake of banana, walnuts, kale, lettuce leaves, sweet potatoes, herbal tea (especially Chamomile), grapefruits, turkey and red meat (in moderation), whole grains, go a long way to improve the condition of insomnia. People with insomnia should, however, try and avoid processed foods, cheese, pork, aerated, caffeinated and alcoholic drinks, as much as possible. Unani also suggests that the dinner should be light and taken at least 2-3 hours before going to sleep.

Pharmacotherapy or Ilaj Bil Dawa involves the use of Unani medicine to alleviate the discomfort. Some of the medicines often used in treating insomnia includes:

Rogan Kaddo
Rogan Badaam
Hareera Magaz Badaam
To treat insomnia, a Unani specialist will also carry out a detoxification of the body, known as Regimental Therapy or Ilaj Bil Tadbeer, the detoxification is brought about through

Exercise (Riyazat)
Massages (Dalk)
Leeching (Taleeq-e-Alaq)
Venesection (Fasd)
Turkish bath (Hammam)

Role Of Unani Medication In Insomnia Treatment

Ayurveda is something which is very potent and its efficacy has been proven over the years. Arthritis is painful and has the ability to make a person feel pretty much like his or her hands are tied! However, while not much can be done to liberate a person to his or her pre-arthritis level of ease, the issue can be controlled and Ayurveda can really work wonders!

When you prefer an Ayurvedic treatment to help a person who is suffering from arthritis to experience lesser pain in his or her daily life, it is important to correct anything which may be wrong with digestion. This is because digestion, which is not optimal, leads to a situation of a build-up of ama, which is a lethal side effect of low-quality digestion.

It is believed that correcting a person s food intake will reduce the amount of ama one has in their body and as a result of the same, reduce the inflammation and the consequent pain which a patient of arthritis has to put up with on a daily basis.
If a person does not suffer from other lifestyle issues such as diabetes, making the effort to fast in accordance with the guidelines which have been set out as per the Ayurveda knowledge bank can have great benefits for the problems faced due to having arthritis.
The Magic of Ayurveda!

There is a herb known as Guggul, which is quite helpful, especially if a person is diligent about its consumption. This would mean that it be taken by him or her twice a day, along with some warm water. The dosages are small and usually range between 1 to 3 gms.
Ayurveda is a symbol of natural solutions to the health problems of people. As a result, it is only reasonable to expect a lot of the field to be centred on lifestyle habits and more so around food, as it is true, in this case at least, that we are what we eat.
In order to ease the pains of arthritis, it is very important to avoid oily food items and prefer a fruit diet such as apples, papayas and oranges. Tea, coffee and alcohol consumption should be kept to a bare minimum.
Arthritis is something which is frustrating, for sure. But, as long as a person is taking steps in the right direction, the issue will be a lot easier to deal with!

Ayurvedic Management For Arthritis!

One of the most common diseases that afflict a large section of the population is arthritis. It is common among people who are above 40 years of age. Acute joint pain, difficulties in movement and weakened bones are among the most common symptoms of arthritis. Given the fact that it is a condition that has permeated into modern life so deeply is what makes arthritis one of the most feared illnesses of this time. Although there are multiple forms of arthritis, there are primarily two types, which are:

Osteoarthritis: This is characterized by a breakdown of the cartilage between the bones. It is mostly known to affect a person s joints.
Rheumatoid Arthritis: This is a form of auto immune disease that severely affects the lining within the joints of bones.
Causes
The causes of arthritis might vary from person to person. Some of them are discussed below:

Diet and nutrition habits: Some food items, especially red meat and products derived from animals can cause a rise in the level of uric acid thus, increasing the risks of arthritis as well as gout. Smoking also has been known to worsen this condition.
Genetic predisposition: Some people are more prone to develop arthritis as they are genetically predisposed to it.
Problem in the immune system: Rheumatoid arthritis is one condition which is caused by the attack of immune system on the lining of the joints within the body.
Risk factors for arthritis include:

Obesity: The joints are subject to excess stress because of the excess weight. This results in a higher risk of arthritis in obese people.
Age: The risk of arthritis increases with age.
Family history: It is possible for you to be vulnerable to this disorder if arthritis runs in the family.
Previous injury: People who have had a previous joint injury are more susceptible to arthritis.
Typical symptoms of both forms of arthritis are:

Redness in the affected areas
Stiffness in the joints
Pain in the joints of the body
Swelling in particular joints or most joints of the body
Decreased mobility either due to pain or stiffness

Can Poor Diet and Nutrition be a Cause of Arthritis?

Osteoarthritis is a common disorder that affects the joints in the body. It is characterized by wear and tear of the cartilage present in the bones which lead to pain and mobility issues. The disorder mostly affects the joints in the hips, spine, knees and the hands. This disorder can t be cured; the symptoms, however, can be managed.

Symptoms

The symptoms of osteoarthritis are progressive in nature and tend to worsen with time. You will experience pain in the affected joint, leading to limited mobility. Joint stiffness occurs when you wake up in the morning or when you have been inactive for a long period. You will also experience a grating-like sensation when the respective joint is being used.  

Causes

This condition occurs when the protective cartilage around the bones tend to deteriorate. The function of the cartilage is to allow the joints to move without friction. In this disorder, the surface of the affected cartilage turns rough, ultimately resulting in complete damage. This leads to loss of the protective cushion of the bone, making the bone rub on other bones. There are certain factors that make you prone to osteoarthritis, some of them are:

Aging increases the risks of this disorder.

Women are more prone to this disorder as compared to men.

Obesity puts added stress on the joints.

It might be hereditary as well.

Ayurvedic Treatment

Ayurveda is a holistic system of medicine that balances the different energies in the body to keep you healthy. Ayurveda believes in the fact that a disorder in the body occurs when there is an imbalance in the respective doshas   Vata, Pitta and Kapha. The idea is to get the doshas in order in order to get relief from the symptoms of this disorder. Osteoarthritis, or for that matter any disorder occurs due to the imbalance of the  Vata dosha . The Ayurvedic treatments for this condition is Pachkarma therapy.

Panchakarma is the elimination of doshas from the body. It is one of the peculiarities of Ayurveda. Since according to Ayurveda, disease is the result of imbalance of doshas, when the increase of dosha is in a large quantity the best way to get cured faster is expelling the doshas out. These procedures (Karmas) are five (Pancha) and hence they are described as Panchakarma i.e. five procedures. These are to be performed not only by the patient for getting them cured but even by healthy persons for maintaining the health. 

Vamana: This is the elimination of doshas by the process of emesis. This is particularly useful for diseases arising from kapha and also from pitta. Diseases like chr. bronchitis, asthma, skin diseases, allergies, herpes, diabetes, sinusitis, osteoarthritis, hyperacidity are best dealt with this procedure. The best season for doing this procedure is   Spring  or even  Autumn .
Virechana: In this procedure, loose motions are produced to eliminate the doshas. This is very useful in diseases caused by pitta dosha e.g. Hyperacidity, herpes, gulma (Type of tumor) jaundice, osteoarthritis, anemia, skin diseases etc. The best season for this procedure is  autumn .
Basti: The procedure is important for the Vata dosha mainly, but can be used for Kapha and pitta and for all sorts of diseases also. In this procedure enema with herbal decoction, oil, honey and salt is given. Since it has a direct action over the large intestine, which is the main site of Vata dosha, it acts instantaneously. The procedure is especially useful for all kinds of diseases caused by Vata Dosha e.g. back ache, arthritis, osteoarthritis, dystrophies, multiple scherosis, muscle waisting etc. The best season for this procedure is the rainy season.

Ayurveda For Osteoarthritis

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

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