The knee is the joint where the bones of the lower and upper legs meet. The largest joint in the body, the knee moves like a hinge, allowing you to sit, squat, walk or jump.
The knee is vulnerable to injury and to the development of osteoarthritis.
The knee consists of three bones:
• femur - the upper leg bone, or thigh bone
• tibia - the bone at the front of the lower leg, or shin bone
• patella - the thick, triangular bone that sits over the other bones at the front of the knee, or kneecap.
The ends of the bones are covered with a layer of cartilage, a slick, elastic material that absorbs shock and allows the bones to glide easily against one another as they move.
Between the tibia and femur bone are two crescent-shaped pads of cartilage that reduce friction and disperse the weight of the body across the joint.
The bones are held together by a joint capsule, which consists of two distinct layers – an outer layer of dense connective tissue and an inner membrane, called the synovium, which secretes a fluid to lubricate the joint.
The outer layer of the capsule is attached to the ends of the bones and is supported by these ligaments and tendons
Two groups of muscles support the knee.
• Hamstrings - muscles on the back of the thigh, which run from the hip to just below the knee and work to bend the knee.
• Quadriceps - four muscles on front of the thigh that run from the hip to the knee and straighten the knee from a bent position.
Arthritis of the Knee
Arthritis is inflammation of one or more of your joints. Any joint in the body may be affected by the disease, but it is particularly common in the knee.
Osteoarthritis (OA) is the most common chronic disorder that affects the joints. OA of the knee happens when the cartilage, or cushion, between the knee joints breaks down. This can cause pain, stiffness, and swelling. It is a degenerative,"wear-and-tear" type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too.
Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people.
In Ayurveda, osteoarthritis is considered a disease of malnutrition that tends to affect vulnerable joints (due to previous injury or infection, congenital reasons etc). When Agni (the ‘digestive fire’ ) is not working properly, wastes or toxins known as Ama are produced instead of useful nutrients for the tissues. These toxins accumulate in the gut and at the same time, Vata (Air/Ether) accumulates in the colon.
Causes of Vata aggravation include: eating excessively cold, dry, rough, bitter, astringent or pungent foods; irregular meal; excessive travelling; constant multitasking and rushing around; high stress; lack of proper sleep; excessively cold or dry environments; a physically or mentally traumatic event; change or shock; excessive movement.
Aggravated Vata along with Ama (toxins) move from the gut into the channels of circulation, find places in the body that are weak or vulnerable (in this case the joints) and settle in. Ama can block the channels supplying nutrients to the joints causing further malnutrition. The deterioration and subsequent irritation in the joint causes inflammation, stiffness, swelling and pain.
In both cases of arthritis (Rheumatoid and osteoarthritis) strengthening Agni and removing Ama is the immediate concern.
This is achieved by the following:
Regular exercise under proper guidance can help:
The herbs boswellia, turmeric, dashmool,ashwagandha, ginger, triphala, guggulu, and shatavari have all been shown to decrease inflammation by interfering with the production of inflammatory chemicals in the body
Virechan: Induced loose motions in scientific method for removal of vitiated Pitta, Vata and Kapha.
Basti: Removal of toxins by using medicated oil or herbal decoction enema. It is the best treatment to pacify vitiated vata.
Panchtikta KshirBasti is also helpful in the condition of osteoporosis
Snehan (Abhyanga): Whole body massage or local massage.
Janubasti: Keeping warm medicated oil on the knee joint. It is helpful in knee joint pain, Arthritis.
Swedan: Steam or fomentation is bringing out sweat by applying heat. Snehan and swedan are also done as pre-treatment before Panchakarma
Pind-sweda: Steam by hot rice mixed with medicinal decoction or milk. It is also helpful in local pain management
Patra-pottali swed : Fomentation by heated bundle of specific fresh herbal leaves warmed with medicated oil. It is very helpful in arthritis.
Nadi-swed: Fomentation with vapours generated out of medicated decoction. Moist heat proves good technique for local pain management e.g. Arthritis and low backache.
Udvartan: Massage with the help of medicinal powders. It is helpful to loose weight.