The Almighty gave us legs to walk on gave us mobility; to carry us from place to place and gave us hands to be creative, to perform the daily chores of life and to carry the burden of mankind.

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INTRODUCTION
The Almighty gave us legs to walk on gave us
mobility to carry us from place to place and
gave us hands to be creative, to perform the
daily chores of life and to carry the burden of
mankind.
Primitive hunting man used to walk miles to hunt
food for himself and his family. He had to have
strong legs to do this day in and day out. Since
there was never any certainty where he would go
and what he would find, his limbs were tuned to
work that extra mile or two if the need arose. In
those days, limbs or rather the joints served man
faithfully for really long number of years and
most mortals were mobile till death.
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But then came the Industrial Evolution and Man
had to develop different faculties. The joints
were used less and less till life became almost
sedentary From Home ? elevator ? car ?
Office ? elevator. The only exercise people
indulged in is climbing walls and jumping to
conclusions! The joints now had to be prescribed
exercise by doctors, as a must for maintaining
mobility and good health. As a result of
disuse joints stiffened, synovial fluid dried
up, joints started degenerating earlier. Every
which way you looked at it, the joint refused to
cooperate. What more can you call spondylitis in
early 30s and sever OA knee in mid 40s?
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JOINTS Definition It is a junction between two
o more bones or cartilage. It is a device to
permit movements. There are more joints in the
child than in an adult.
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Classification of Joints
Functional 1) Synapthrosis -
Immovable It. 2) Amphiarthosis -
Slights movable 3) Diarthrosis
- Freely movable

• Structural Classification
• Fibrous Joint
• 2,Cartilaginous Joints
• Synchonorosis or Hyaline
  Cartilage Joints.
• It B/w Epiphysis and diphysis of a
  growing long bone.
• Example
• Spheno Occipital Bone.
• Costochondral and Coststernal Joint.
• Symphysis or fibro cartilaginous
  Joints.
• Example Symphysis pubis
• Manabrio sternal joint

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• 3. Synovial Joints or Diarthrodial Joints
• Also k/s Freely movable joints
• The ends of tow bones are held together by joint
  capsule, with ligaments and tendons
  inserted at the outer surface of capsule.
• A synovial joint has a fluid filled cavity. The
  fluid is known as synovial fluid (produced)
• Synovial fluid acts as lubricant.
• Most of the disease of Joints affected
  Diarthrodial or Synovial Joints.

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Types of Synovial Joints their movements

• 1 .Plane or Gliding movement
• Example- Intercarnel Joints
• Inter tarsal joints
  
• Joints b/w bertebras
• Movements Gliding movements.

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• Hinge Joints
• Uniaxial Joints
• Movements are limited in one plane.
• Example - elbow joint
• Ankle joint
• Interphalangeal joints
• movements - Flexion extension

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• Pivoto Joints
• Uniaxial Joints
• Example - superior and inferior radio
  ulnar.
• Median Atlanto axial
  joints
• Movement - Rotation only

• Condoyle Joints
• Joints permit movements mainly in one plane
  around
• transverse axial
  but
  partly in another plane around vertical axis.
• Movement possible Flexion extension
  limited
• 
  rotation.
• Example - Knee joint
• 
  right left Saw joints 260

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• Ellipsoid Joints
• Biaxial Joints
• Free movement are permitted around both the axis.
• Movements Possible Flexion, Extension
• abduction,
  adduction and circumduction.
• Example - wrist Joints
• 
  Metacarpophalengeal joints.

• Saddle Joint (Seller)
• Multiaxial Joints
• Move possible-- Flexion, Extension, adduction,
  abduction
• and conduct
  rotation.
• Example ? Sternoclavicular joint
• Calcaneocuboid
  joint

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• Ball and socket Joint (Spherodial)
• Multiaxial joint
• Movements occurs around and
• indefinite number of axes which have
• common centre.
• Movements-Flexion, extension,
• abduction, adduction,
• medial rotation,
• Lateral rotation and
• circumduction.
• Example - Shoulder joint
• Hip joint
• Talocalcaneonavicular joint

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• Factor maintaining stability of joint
• Muscles
• Ligaments
• Bones

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• Aging Joints
• With aging, a decrease in synovial fluid,
  thinning articular cartilage and decrease
  flexibility ligament occur.
• Most individual experience some degeneration
  is the knees, elbows, hips and shoulder due to
  aging presses.

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• ARTHRITIS
• It is a form of Rheumatism in
• which joints have become
• inflamed and painful
• Characterized by
• Inflammation, Pain
• and stiffness and moving
• usability
• Arthritis affects about 10
• people of world Population.
• Most common in older Aged
• people due thinking of
• particular cartilage and
• decrease in
• synovial fluid

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• Also due to injury, Truma, Allergy and infections
  disease spread such as
• Tuberculosis.
• Gonococcal
• Syphilitic etc.

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• Important cause of Arthritis
• Diffused connection tissue disease such as RA
• Degenerative joint disease such as OA.
• 3.Metabolic and endocrine Disease
• such as Gouty Arthritis.

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• CLINICAL MANIFESTATION
• Arthralgia - Pains in Joint
• Chondritis - Inflammation of Cartilage
• (3 Synovitis - Inflation of a Synovial
  membrane.
• in
  joint.

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• CLASIFICATION OF
• ARTHRITIS
• 1. Rheumatoid Arthritis and its variants such
  as
• Arthritis with psoriasis
• Juvenile rheumatoid arthritis
• Rheumatic spondylitis
• Reiters syndrome
• Arthritis due to rheumatic fever.
• 3. Osteoarthritis.

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4.Arthritis associated with known infectious
agents e.g. Gonococcal, Tub
erculoses most common Involve spine,
hip join
Knee
joints Tuberculosis of spine is
termed as POTTS
DISEASE Spondylitis. Syphilitic
Pneumococcal, etc.
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• Associated with metabolic or bio-chemical
• or endocrine abnormalities -
• Gout, hemoglobinopathies, onchronosis,
• acromegaly, etc.
• 6.Traumatic arthritis
• 7.Neuropathic arthritis
• 8.Allergy and drug reaction.

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9. Arthritis with blood disorders 10. Connective
tissue disease S.L.E.
Polyarhteritis nodosa,
Dermatomyositis. 11. Miscellaneous Disorders -
Amyloidosis Erythema multiform,
Ulcerative colitis, Sarcoidosis
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• OSTEOARTHRITIS (O.A) Also called as
  Osteorthrosis or
• Degenerative Joint Disease
• Result from a combination of aging,
• irritation of joints, wear and abrasion.
• Commonly known as wear and tear
• arthritis and
• leading cause of disability in older
• individuals.
• Most common form of chronic
• disorder of synovial joints
• particulars weight bearing joint

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In Older Age. The Articular cartilage show
Degenerative changes in CENTRE (Fibrillation of

cartilage)
And Proliferative change around the
edges (Osteophytes )
It is characterized by
Degeneration of the cartilage with associated
over growth of bone at the margin of joints
And Changes
in synovial membrane Affect up to 10 of world
population
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IT COMMONLY INVOLVES
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• The distal IP joints of the fingers- to form
• bony swelling The Heber den nodes.
• The proximal Interphalangeal finger
• joints to form bony swelling
• The Bouchard nodes

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The lumbar spine lumbar
spondylitis
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• The cervical spine
• cervical spondylitis.

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• The large joints
• including Hips and Knees.

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• PRIIMARY OESTEOARTHRITIES ?
• Occur more commonly in women than men .
• Progress begin by end of 4th decade.
• Pathogenesis
• Wear and tear with repeated minor trauma,
• heredity AND obesity.

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Secondary Osteoarthritis ? -May appear at any
age. -Results from any previous injury, fracture
inflammation and congenital dislocation of
the hip. Clinical manifestaslation Joint
stiffness. Diminished mobility, pair etc. The
symptom are prominent on walking up
from the Bed in morning. .
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The degenerative changes in the
interphalenges joints lead to hard bony and pain
less modules at the base of terminal. Its
phalanx called as HEBERDENS NODES.
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HEBERDENS NODES
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Pathos Physiology of secondary osteoarthritis
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Most marked in weight bearing
region.
Initially
Loss of
cartilaginous matrix
Resulting
Progressive loss of normal metachron
Focal loss of chondrocytes
Causes
Loosening, flaking and fissuring of Articular
cartilage.
Resulting
Breaking off of pieces of cartilage.
Developing of Osteophytes.
Thicking of jointCauses swelling.
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MACHINICAL SYMPTOMS ARE CHARACTERRIZED
BY Pain The pain is usually relieved by rest.
Night pain may be a feature. Pain on weight-
bearing, if the lower limb joints are
involved. Stiffness after rest usually lasting
less than 5 minutes with the patient loosening
up quickly by moving the joints. Morning
stiffness is not a prominent feature and short
lived if present at all. Swelling is usually
bony rather than soft tissue in character.
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• Risk factors
• Age
• Obesity
• Repetitive stress injury / trauma to joints.
• Sex Female are more frequently involved (101)
• Genetics this is a problem often seen within
  families.
• Other diseases causing cartilage damage
  resulting in
• secondary osteoarthritis.

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X RAY OF NORMAL KNEE JOINT
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X RAY OF OSTEORITHRITIC KNEE
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OSTEOARTHRITIS OF KNEE
Most commonly affected joints found
in clinical practice. Joint space narrowing with
Osteophytes (new bone formation) and loose bodies
are seen. The patellofemoral
articulation is the most commonly affected with
medical tibiofemoral compartment being second.
In early disease, spiking of the
tibial tubercles and marginal Osteophytes are
seen.
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OSTEORTHITIS OF THE HIP JOINT This is the second
most affected joint in the body. Secondary
osteoarthritis following Congenital
dysplasia. PERTHS DISEASE congenital
dislocation, slipped epiphysis, Aseptic necrosis
etc is more common than primary
osteoarthritis. Joint space reduction and
marginal osieophyisis are seen. The femoral head
migrates either superiorly or medially. A-P views
of the hip usually provide adequate information.
In certain cases, a CT scan show
areas of subaiticular crescents as in aseptic
necrosis or geode formation in advanced cases.
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NORMAL X RAY OF THE HIP JOINT
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OSTEORTHITIS OF THE HIP JOINT
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OSTEOARTHRITIS OF THE HANDS In osteoarthritis,
the distal interphalageal joints are most
commonly affected with joint space narrowing and
large peripheral osteophytes resulting in the
clinically evident Heber dens nodes
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X RAY OF ARTHITIS OF THE TOE JOINT
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RHEUMATOID ARTHRITIS Definition A systemic
connective tissue disorder which affects
predominantly the synovial joints, hence the
term rheumatoid disease. Its systemic
manifestation include hematological, pulmonary,
neurological CVS abnormalities
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• Etiology
• Age any age, majority Between 20-40.
• Sex more in females than males 51
• Climate in temperature climate.
• Familial tendency.
• Genetic factors.
• Sex hormones more in female than in
• males.
• 7.Psychological factor Physical
• 8.Exposure to cold wet.
• 9.Trauma
• Arthritis may
  start in a joint which
• has been the
  seat of trauma and
• other joints
  subsequent get involved.
• 10.Environmental triggers.

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• EITIOPATHOGENISIS OF REHEVMATOID ARTHERITIS
• IMMUNOLOGIC FACTORS
• (II) GENETIC FACTOR

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Genetic susceptibility
( MHC Class II )
Antigenic stimulation
( By
infections agent )
CD4 T Cells Cytokines
( TNF a, INF ?,
IL -1)
Activate Activate Activate
B Cells Endothelial Cell Macrophages Anti
IgG antibody Release of
adhesion Cytokines
(Rheumatoid factor) molecule Protease
Formation of immune complex, Inflammatory
Cells,
Inflammatory damage to synovium, small vessel
collagen
Destruction of cartilage bone fibrosis,
ankylosi
joint Deformities
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Types of Presentation- 1.Classical
Pain, stiffness and swelling of small
joints of head,
wrists. 2.Palindromic
Pain, swelling and redness usually of a
single joint, followed
by rapid return to normal after several
days. 3. Systemic - Weight loss, Pleurisy and
pericarditis but minimal joint
involvement. 4. Polycyclic -
Plain and stiffness in shoulders and hips with

subsequent synoptic. 5. Monoarthritic -
Single joint involvement usually the
knee. 6. Acute Onset - Sudden overnight onset
with stiffness and pain. 7. With generalized
lymphadenopthy.
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• Clinical Features -
• In early stage
• Joints are warm, swollen and tender.
• Weakening of joints, capsule and tendon along
  
• with ligament damage.
• Instability, subluxation, dislocation.
• Severe joint damage may lead to fibrous or body
  ankylosis

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secondary degenerative changes.
1.Hands - Tenosynovitis (inability to
appose the palms) Rupture of
flexor/ extensor tendons with weakness
of grip. 2.Legs - Knees synovial
effusion Ankles Valgus
deformity 3.Cervical Spin -
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1.Skin - Palmer erythematic Rashes
Psoriasis. 2.Myositis - Muscle wasting
around inflamed
joints 3.Bone - Generalized
osteoporosis 4.Eye - Keratoconjunctivitis
scleritis 5.Heart - Pericarditis Myocardit
is Rheumatoid Vulvulitis. 6.Blood -
Anemia (mild normocytic
norm chromic anemia) G.I.
bleeding by Aspirin and other
Analgesics. 7.Respiratory-
Pleurisy and ale Ural effusion Rheumatoid
nodules Pulmonary hypertension
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8.Nervous System - Neuropathy
Nerve root compression
Pain
Numbness or Paraesthesiae 9.Kidn
ey - Proteinuria
Microscopic heaematuria 10.Investigation
- E.S.R. (elevated)
R.A. Factor S.L.E. 11.Radiology
- Reduced of joint space
X-ray bone
Deformity
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X-RAY bone Deformity
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GOUTY ARTHRITIS In Gouty Arthritis, sodium
create crystals are deposited in the soft tissue
of the joints. The crystal irritate and erode the
cartilage causing The person who suffers from
govt. either produce excessive uric acid or is
unable to excrete as much as normal. Result in
building up uric acids in the blood. Uric acid
sodium ? Crystal of Sod. Ureate
? Deposited in the soft tissue of the joints.
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DIAGNOSIS OF ARTHRITIS
1. PHYSICAL EXAMINATION

• Whenever a patient presents with a problem joint,
  the primary care physician has to picture All the
  structures that makes up a joint. Any one or more
  of the following may be involved
• Trauma
• Degenerative changes
• Infection both acute and chronic and
• Neoplastic

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• If a Patient is looking with pain in joint
• the pain can be of three things.
• Bone
• Muscle
• Nerve
• Examination of Swelling /Edema
• Tender
• Redness
• Any eruption
• Tortuousness of veins
• Hot/cold ( temperature )
• Movement
• Sound (cracking )

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To complete the list, metabolic
(gout) Neoplastic causes also have to be kept
in mind. On the other hand the joint
may be affected as part of a widespread systemic
disease Rheumatoid arthritis and other
seronegative spondyloarthropathies. When a
patient presents with any joint pain, it is the
duty of the physician to assess the entire
locomotors system
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• ESTABLISH THE EXTENT OF ABILITY OR DISABILITY
• To carry out routine, day-to-day chores.
• Eg in rheumatoid arthritis can he open / shut a
  zip or unbutton her blouse what are the
  activities which are not possible now and
• should be our first target at improvement.
• Ask the patient
• Can you climb stairs?
• Can you dress normally?
• Are you free from any muscle stiffness any
• where in the body?
• If the answer is No. go into details an
• if the answer is yes, it is unlikely that the
• patient has any significant involvement
• in affection of a joint / muscle group.

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OBSERVATION Ask the patient to disrobe as much as
is comfortable for both the physician and the
patient. Ideally patient should be in
undergarments. Stand away from the patient and
observe closely as the patient carries out your
instructions. Observe the patient from behind
to Assess the buttocks, shoulder, Para spinal
muscles. Are they symmetrical? Is there any
deformity or swelling? Is the spine straight or
tilted/ curved to one side? Observe from side Are
cervical and lumber curvatures normal? Ask the
patient to touch the toes. Is the flexion of hip
and spine normal? (ie whether he can touch the
toes)
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• From the front
• TOUCH head both ways checks lateral flexion of
  the neck.
• Open and close the mouth Temporo-mandibular
  joint.
• Ask to put hands behind the head tests
  gleno-humeral and sterno clavicular movements.
• Ask to hold arms straight tests elbow
  extension.
• Ask to supinate and pronate the hands.
• 6.Ask to spread the fingers and show you the
  hands-look for any wasting, deformity or swelling
  (s).
• 7.Ask to put thumb and index finger together
  checks pincergrip

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1. Closely observe the lags quadriceps bulk, any
   deformity or swelling.
2. Knee joint- any effusions by patellar tap?
3. Observe feel any deformity? Any callosities?
4. Ask to walk around- is the gait normal? Are the
   amis swinging while walking?
5. Is the strike of heal on the ground as well as
   lift of toes from the ground normal?
6. Can he turn quickly and normally?

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• LAB . INVESTIGATION OF
• ARTHRITIS
• BLOOD INUESTIGATION
• ESR
• RA- FACTOR
• ASOTITER
• SLE

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X-RAY REPORTS OF ARTHRITIES
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• C. T. SCAN
• MRI
• SYNONICAL BIOPSY
• URIN TEST

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• OTHER MODE OF TAEATMENT
• ALLOPATHY
• Anti inflammatory
• Pain killer
• Relexacent
• Sedatives
• Local application
• Hot fomentation
• AYUERVEDIC
• UNANI
• NATUROPATHY
• YOGA

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• Homeopathic Mode of Treatment
• Examination Physical and LAB Investigation
• Case taking
• Constitution
• History weather patient had any trauma
  
• or accident in the
  past
• Miasm psora , syphilis or sycosis
• Diathesis Rheumatic or Gouty
• Mental
• Location Hand , Wrist , Knee, Cervical
  spine
• or Hip joint
• Ailments (Cautions)

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HOMEOPHATHIC REMADY
FOR ARTHRITIS, RHEUMATISM GOUT
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•            ABROTANUM
• Especially for ANKLE JOINT
  WRIST JOINT
• For OSTEOARTHRITIS
• Rheumatism
•     For excessive pain before the
  swelling comens  
• From suddenly checked Diarrhea
  or other Secretion,
• Alternate with Hemorrhoids,
  with dysentery
• Aggravation - at night and from cold
• Amelioration - by motion

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ACTAEA SPICATA Special Affinity for Smaller
joints  

Wrist, Fingers
Ankles toes
Rheumatism  
Swelling aching in joints after a slight
exercise.   Affected joints are swollen
and in affected limbs great
weakness.   Right arm and right wrist are
specially affected. Pain Are
violent tearing and drawing character
Aggravation - At night motion and change of
weather.
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3)ARNICA MONTANA Especially for Traumatic
Rheumatism or Arthritis. Rheumatism       
  Ascending type of rheumatism.        
Patient cannot bear pain         Great fear of
being touched or struck. Pain
? in the back and limbs as if bruised or
beaten. ?
cannot walk erect on account of pain in
pelvic organ.
Aggravation At rest when lying down from wine
Amelioration From contact Motion
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BENGOIC ACID Especially for GOUTY ARTHRITIS
In a person who have History of Suppressed
Gonorrhea, Syphilis. Gouty concretion arthritis
Affects all the joints, especially knee joint
Cracking on motion Nodositis Urine dark
brown And The urinous odor
highly intensified Pain tearing, stitching ,
in large joints, Pain aggravates in
night
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 BRYONIA ALBA ? For Articular Rheumatism ?
Allumina is chronic of bryonia ? Great
dryness of all mucus membrane. ? Great
thirst for large quantity of cold water
at long interval Pain Stitching, tearing,
worse at night. Aggravation from slight
motion, exertion, touch,
Suppressed discharges of any kind,
at 9 pm Amelioration Complete rest,
lying on painful side
pressure, cold.
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CALCAREA CARB For Gouty Nodos ties about
fingers Arthritis nodosa deformans.
Aggravation cold air wet weather, cold water in
morning. Amelioration Lying on painful
side.   CAULLOPHYLLUM For Arthritis Deformam
in womens. Affinity for smaller joints.
Pain Severe drawing, tearing pain.
Pain is of flying nature migrate from
one place to another. Pain
in fingers and wrist. Fingers are very stiff.
Aggravation in open air and coffee
Amelioration By emission of flatus.
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  CAUSTICUM For Rheumatoid Arthritis For
Chronic Articular Rheumatism Rheumatism Of
joints with stiffness and contraction
of flexor tendons,
Shortening of muscles.
Aggravation in clear weather Amelioration
In damp weather and by warm air.
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CMICIFUGA (Actaea recemosa) Articular
rheumatism of lower limb. Joints commonly
affected are lumbo-sacral region
and Big Joints. Rheumatism        
Good remedies for muscular rheumatism.        
Especially affects the bellies of muscles of
neck and back.         Joints commonly
affected are those of
LUMBO-SACRAL REGION and big joints.        
Uneasiness, restlessness, aching in the limb
with pain in lumbar and sacral
region.         Rheumatism alternates with
mental symptoms. Aggravation        
from using arm in sewing , type writing,
piano-playing.         From cold damp
weather and during menses. More
severe the flow, greater the sufferings.
Amelioration from warmth
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COLCHICUM AUTUMNALE Valvular Disease or
pericrditis following rheumatism. Acute
Rheumatic fever. Action more marked on Small
Joints Rheumatic pain Of the
clavicle, neck, shoulder, arms and back.        
In the elbow joint, forearm, waist, and ligaments
of the finger Joints, and of
great toes.         With lameness in the arm
which make it impossible for the patient to
hold lightest thing.         Flying pain in
the Hips,         Tearing pain in thighs and
knee joints with swelling.         Tingling pain
in Toes.         Pain has tendency to move from
one joint to another from one side
to other , from below to upwards or from above to
downwards. Aggravation From cold damp
weather, by motion, during Autumn
Amelioration from warmth, by rest, and lying
down.
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FERRUM MET ELLICUM For
Neuralgic and Rheumatic Pain.
Rheumatism of LEFT SHOULDER      
Tearing and stinging nature of pain.       
Rhematic Pain in Deltoid muscle.      
  Violent pain in muscles and along the
nerves. Aggravation From cold and rest
Amelioration slowly moving
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KALI BICHROME Rheumatism     
For Syphilitic Arthritis     
Tearing sensation in the tibia, with swelling and
stiffness of joints.     
Rheumatism alternates with gastric symptoms.
Pain       In small spots, which
can be covered with TIP of finger.      
WONDERING PAIN, Aggravation from cold
and motion.
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KALMIA LATIFOLIA For Acute Rheumatic fever.
Rheumatism-    Caused by chill,
exposure to cold    Right-sided
affection.    Sensation of numbness,
coldness, weakness, in the limbs. Pain
WANDERING PAIN, changes place suddenly,
goes from one joint to other.
Pains are sticking darting, pressing,
shooting in the a downward direction.
Joints are hot, red, painful and
swollen. Þ   Heart complaint alternate
with Rheumatism. Aggravation from least
movement , becoming cold. Amelioration
continued motion
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LACHESIS For Rheumatic Carditis.
Sciatica, right side, better on lying
down. Pain In lower Extremities,
in Tibia, in Neck worse cervical region
Shortening of tendons.
Neuralgia of coccyx, worse rising from
sitting posture. Sensation of threads
stretched from back to arms, legs,
eyes, etc. Aggravation from warm bath,
pressure or constriction, hot drinks
Amelioration appearances of discharges warm
application
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LYCOPODIUM CLAVATUM Chronic Articular
Arthritis Right-sided remedy Rheumatic
Pain In ankle, and finger Joints,
Painful Callosilitis (CORNS ) on soles
All disease is worse in the
afternoon from 4 to 8 pm. Tearing in
shoulder and elbow joints. One feet
hot and other is cold. Chronic gout,
with chalky deposit in joints. Aggravation
Right side, from right to left, from above
downward. 4am to 8
pm. from heat Amelioration by motion. After
mid night
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NATRUM MUR Chronic articular
Arthritis. Based on History of Dyscrasia.
Symptoms are worse from sunrise to
sunset, especially from
10 to 11 pm. Painful contraction
of the Hamstring. Pain in back
with desire to support. Palms hot
and perspiring. Ankles weak and turn
easily. Cracking in joints on
motion. Aggravation from noise, music, lying
down, heat, and talking. Amelioration open
air, pressure against back. Lying on right side.
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RHODODENDRON Fibrous deposit is great
Toe-joint. Right-sided remedy.
Chronic Osteoarthritis Gout with
fibrous deposit in great toe joint.
Rheumatism-
Chromic Rheumatism affecting the
smaller joint Acute inflammatory
swelling of the joints. Pain.       
Drawing ,tearing pain in the limbs.       
Sometimes wandering from one joint to
other.        Pain in dorsal region,
extending to arm, in bone and
periosteum        Pain in the shoulder that
arm cannot be moved. Aggravation During
rest, before and during storm Amelioration
By warmth, wrapping up moving.
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RHUS- TOXICODENDRON
Right-sided remedy For
Osteoarthritis Traumatic and Articular
Arthritis. Rheumatism-     
Caused by lying on damp ground, summer bathing,
working in damp
place.      Great restlessness, anxiety
and apprehension.      Always want to be
moved, cannot remain in one place.
Pain.        As if Sprained,
As if muscle or tendon were torn from its
attachment.        As if bone were scrapped
with knife. Aggravation - After
midnight, in rainy weather,
" On first moving, and getting up
in morning." Amelioration - By walking,
and continued motion.
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SULPHUR Facilitates absorption of
serous or inflammatory exudates in
pleura joints Acute and Chronic
Rheumatism After the attack of acute Dyscrasia
Aggravation By standing, rest, heat,
bathing, changeable weather. Amelioration
By dry warm weather, lying on right side THUJA
OCCIDENTALIS Gonorrheal Arthritis Sycotic
Poison, Arthritis deformens Aggravation At
night, at 3pm and 3 am, form cold damp air . Etc
Amelioration In open air, by movements,
pressure, rubbing
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• MANAGEMENT
• The concept of joint protection is vital for the
  
• patients with OA. Especially where
  large
• joints are involved.
• Protection from overuse is important.
• Assistant devices to reduce weight bearing joint
  pain
• ie canes.
• Reduce impact exercise like jogging.
• Increase non weight bearing exercise
• ie swimming / cycling.
• .

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• Good quality footwear, when walking
  recreationally.
• If any leg length discrepancy, ensure it is
  corrected.
• Weight reduction is crucial especially in obese
  patients
• with large joint problems on weight bearing.
• Physiotherapy will maintain joint protection
  through
• optimizing the strength of adjacent
  supportive
• muscles.
• Heat and ultrasound may relieve muscle spasm.a

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• General Measures
• Diet
• One has to avoid the following items.
• Tea, Coffee, Fried things,
  Salt, Chilly, Spices and condiments milk and
  milk products. Heavy digestive Dal , Rice ,
  Pickles Alcohol an d Non- veg diet .
• 2. Yogic therapy include
• Yogasanas, Pranayama, rest
  and other arthritic
• exercise
• Rest - Both mental and physical
• Exercise- morning walk, running etc.
• 5. Correction of Anemia
• 6. Avoidance of cold, dampness and draughts.
• 7. Removal of focal infection

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1. Exercises for arthritis

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CORRECT YOUR POSTURES 1.Correct postures of
sitting, standing and walking make a difference
in patients of cervical spondylitis. Wrong
postures, even temporary, can result in strains
on the joints and bring diseases.
There should not be any hump in the back when the
child learns to sit, stand and walk
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3.When we sit, stand, walk or drive a vehicle,
do not bend spine
Car drivers not keeping their backs straight also
get neck pains. The seat of the car should be
adjusted nearer to the steering wheel and if
there is space between seat back and upper hips
area. A small pillow should be placed in
between.
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Sleep, bed and pillow Both neck and back pain
have a definite bearing with the type of bed
7. Sleeping posture. Those who suffer from
cervical spondylosis should try to sleep on the
left or right side instead of continuous sleeping
on the back. While sleeping on the sides of the
body, one should lie with the legs slightly
flexed or bent at the knees towards the abdomen.
This offers great relaxation to the muscles
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Standing postures during parties In most of the
parities, the fashion is to stand for a long lime
at one place.
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13. Working on computers need more care for neck
pain. The table should match your height. Roughly
your elbows and table top should be at same
level. Your eye level should be in alignment with
screen of computer continuously for hours
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Case-

• Patients Name- Mr. Bhagwan Lal Patel
• Address- Arnodh (Dist.-Indore)
• Age- 68yrs.
• Occupation- Farmar
• Date- 14/11/08
• Mobile- 99009245062

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PRESENT COMPLANTS

• Pain Swelling in both Knee Ankle Joints
  (Since- 4 Months)
• Allergic Rashes on Neck Face taking
  antiallergic.
• Difficulty in Breathing.
• Pain worse when goes to upstairs down stairs.

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Personal history

• Thermal Relation- chilly Pt.
• Thirst- 10 to 12 glass per day.
• Appetite- decreased.
• Aggravation- when goes upstairs, down stairs
  cold wet weather.
• Amelioration- warm application.
• Stool- Clear
• Urine- Scanty

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MENTAL GENERAL

• Restlessness.
• Fearful
• Irritable

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General Examination

• Built- N
• Skin- Rashes on Neck Face
• Toung- Red Cracked
• B.P. 130/80 mm/hg

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1ST Prescreption

• Rx
• Rhus. Tox. 200 1 drm
• T.D.S. for 7days

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Second prescription

• C/o
• Slightly relief in pain swelling
• Rashes disappears
• Rx
• Plc 2001/2 dm
• B.D. for 7 days

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• C/o
• Pain swelling as it is.
• Sneezing coryza.

• Rx
• Rhus. Tox. 2001/2 dm
• B.D. for 5 days

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• C/o
• Pain Swelling worse.
• relieved in coryza sneezing.
• Stiffness in neck.
• Pain in both shoulder

• Rx
• Rhododendron 200 1/2 drm
• T.D.S. for 3 days
• Plc 200 B.D for 5 days

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Advise

• Avoid sour things, fatty food high rich protein
  diet.
• Do some mild exercise

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• C/o
• Much relief in all complaints
• mentally feel well

• Rx
• Plc 200 1 drm
• B.D for 8 days

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• C/o
• No further relief
• Complaints are as it is

• Rx
• Medorrhinum 1M 1dose
• Rhus tox 200 1drm
• B.D. for 7 days