Winter is tough on Arthritis but a combination of medication and physical therapy helps to alleviate pain and stiffness. Pioneer Health reports

Arthritis

Arthritis, osteoarthritis & joint pains are a result of inflammation. This results in wear and tear of the cartilage leading to more pain. The number of knee replacements that took place in the country in 2017 stood at around 1.5 lakh, up from about 80,000 in 2007. If the number of hip, back and shoulder joint operations is added to this figure, the total number of joint surgeries would be staggering. The number of elderly, who live with joint pain, for whatever reason, is several times of the number of people who opt for surgery, to say the least.

— Dr Prabhu Mishra, co-founder & CEO, StemGenn Therapeutics

Types of Arthritis

Osteo-arthritis

Also called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) can affect any joint, but most often the ones in the knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe. In this condition, there is a breakdown of cartilage which leads to pain, swelling and problems in moving the joint.

In the absence of timely treatment, the condition can become worse, causing bone or cartilage to chip off and float around in the joint. OA is more common in people older than 65.

However, some other risk factors include excess weight, an injury, overuse of the joint, weak muscles, and family history of the condition.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease in which the body's immune system attacks the joints creating inflammation that causes the tissue lining the inside of these joints to thicken. Over time, this leads to swelling and pain in and around the joints.

If not detected in a timely manner, the condition can cause damage to the cartilage and the bones leading to joint deformity. RA mostly affects joints of the hands, feet, wrists, elbows, knees, and ankles. It is also called a systemic disease because it affects the cardiovascular or respiratory systems as well.

— Dr Maiya

Symptoms

Some general symptoms of Arthritis include pain, tenderness and stiffness around joints, reduced movement and function, inflammation, redness, and weakness in the muscles. While there are over 100 different types of arthritis, each with various causes and treatment methods, osteoarthritis  and rheumatoid arthritis are the most common.

— Dr M Udaya Kumar Maiya, medical director, Portea Medical

Causes

The firm but flexible connective tissue called cartilage in the joints protects the latter by absorbing the pressure and shock created during any movement. Arthritis is caused when there is a reduction in the normal amount of this cartilage tissue.

The causes of this condition can range from age-related wear and tear to chronic infection, severe injury or lack of nutrients. While arthritis most commonly develops in adults over the age of 65, it can also occur in children, teens, and younger adults.

Studies indicate that women are more prone to developing this than men because they have a high erythrocyte sedimentation rate (52.07 per cent) and Rheumatoid Factor (13.08 per cent).

— Dr Maiya

Care tips

The best way forward is to combine medication and physical therapy. Some tips to alleviate pain & stiffness, and manage symptoms are as follows:

• Applying heating pads and ice packs can provide some temporary relief from the pain.
• Some people are also advised to use mobility assistance devices such as canes or walkers, which can help in taking pressure off the sore joints.
• Try simple physical activity such as brisk walking, aerobics, cycling, and swimming.
• Opt for methods that require you to avoid taking painkillers. For those with acute arthritis, cold or hot fomentation can help.
• Aim at losing excess weight as this will take away the pressure from the joints. A healthy weight will also reduce some of the existing symptoms.
• Consume a diet rich in antioxidants, such as fresh fruits, vegetables, and herbs, to reduce inflammation. Avoid fried and processed items, dairy products, and high intake of meat as far as possible.

— Dr Maiya

Stem cell therapy vs surgery

Surgery is a procedure whereby the damaged bone and cartilage is cut and an artificial joint is inserted made of metal alloys, plastic and polymers, new-age tested therapies like platelet-rich plasma (PRP). Stem-cells are using patient’s stem cells to repair, stimulate regenerative properties and reduce inflammation of damaged tissue in case of injury, disease or any other health-related conditions.

Instead of replacement, patients can opt for regeneration which uses the healthy cells of the body to heal injuries and cure backache, Arthritis and hip pain. When the body has a limited reserve, it tends to lose its ability to regenerate healthy cells limit recovery.

Under stem cell therapy, a few cells from the body are taken and then cultivated to be later re-injected into the body in a higher volume to replenish and boost body’s reserve. By helping the body to repair and regenerate cells and reduce inflammation, the ability to recover from various inflammatory conditions goes up considerably.

This also takes care of the problems associated with surgery. Some are prone to vein thrombosis or blood clots after surgery. But stem cell therapy uses patient’s resources and no new object or material is inserted, the chances of reaction are done away with.

For people who have knee Arthritis, the most invasive treatment is total knee replacement. Doctors are also testing other injectable therapies, including PRP, hyaluronic acid and steroids.

There is a long recuperation period in case of joint surgery which is also associated with unbearable pain. There is a complete rehabilitation process. In stem cell therapy, there is no such requirement and the diet is fairly simple. 

Consumers who decide to try stem cell treatments for achy knees should research their doctor and the specifics on the stem cell treatment. It's crucial to ask the clinic where the stem cells come from and if they will retrieve them from your own bone marrow or fat tissue, or if they will come from donors. Donor cells and tissues to be tested for communicable diseases. There is no consensus on which source is best, but most doctors use stem cells from fat or PRP.

- Dr Prabhu Mishra, co-founder & CEO, StemGenn Therapeutics