Arthritis

The etymology of word Arthritis

  • Athron meaning joint
  • Itis means inflammation

Definition of Arthritis

Arthritis is the swelling or inflammation of one or more joints. It is a disorder that affects your joints. Moreover, it involves degeneration or inflammation of joints.

or

If you feel pain, stiffness in your body, or have trouble moving around, you might have arthritis. Most types of arthritis cause pain and swelling in your joints.

Bones provide support to the body and aid in movement. Joints are places where two bones meet such as your elbow or knee. They may be immovable, slightly movable, or freely movable. A synovial membrane surrounds the movable joint. Inside the membrane, synovial fluid is present that lubricates the joint and also nourishes the cartilage. In addition, articular cartilage is tough slippery cartilage on the end of the bone which allows smooth joint movement  Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs such as your eyes or skin.

Pathophysiology of Arthritis

The pathophysiology of different types of arthritis varies accordingly. Arthritis refers to a range of musculoskeletal diseases where cartilage is damaged and joint function is impeded.

Rheumatoid arthritis

is an autoimmune disorder. The trigger for the onset of rheumatoid arthritis is largely unknown. However, genetics, hormones, and environmental factor play an essential role. Indeed, instigation of immune response causes antibodies and cytokines to cause inflammation of the joint lining (synovium). Thus, it also results in pannus formation.

 

Psoriatic arthritis is also immune-mediated response of musculoskeletal body parts. It is also related to skin psoriasis.

Types of Arthritis

Major types of arthritis include:

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It is often related to aging or to an injury. It is mostly a degenerative disease that generally affects the hand, knees, hips, and spine. Moreover, females have more tendency than males. A Female with overweight has a joint injury or fracture that causes osteoarthritis. However, osteoarthritis causes pain and limited movement of joints. Yet, there is no cure for osteoarthritis but the combination of treatment prevent further damage. Osteophytes occur within osteoarthritis. Osteophytes is the growth of tiny bones. The joint is stretchable and may lose its shape.

Rheumatoid Arthritis

It is the most common form of this kind of arthritis. The joint that is commonly affected is the wrist, hand, knees, ankles, and feet. It typically occurs at the same joint on both sides of the body. Moreover, it can also affect the other organ of the body such as the eyes, skin, heart, lungs, kidney, nervous system, and digestive tract. Autoimmune arthritis happens when your body’s immune system attacks healthy cells in your body by mistake. Rheumatoid arthritis is an autoimmune disorder, thus the body itself attacks joints and organs. Biochemically, the white blood cells release chemicals that attack the synovial membrane. These chemicals cause the synovial cells to release other destructive substances. Due to this, a pannus develops that destroy cartilage and bone

Chemical in the fluid can damage the bone and joint.

Juvenile Rheumatoid Arthritis

It is a form of the disease that happens in children. The symptoms may include the triad of spiking a high fever of more than 104 degrees. Semen-colored rash in the chest and salmon-colored rash in the abdomen.  If we study biochemical structure, there is a decrease in albumin and red blood cells while an increase in white blood cells and anti-nuclear antibodies.

Infectious Arthritis

It is an infection that has spread from another part of the body to the joint. The infection usually occurs because of bacteria. Generally, it affects one of both knees. Conclusively, it is a painful infection in the musculoskeletal part (joints mainly). Joint redness and swelling may occur with intense pain in the joint. Sometimes, it may also carry with chills and fever. The infected joint is unable to move. Mostly, staphylococcus aureus (staph) bacteria may cause the infection.

Septic arthritis can develop when an infection spread through your bloodstream to the joint. Certain laboratory tests are conducted to know more about the infection and then further treatment is suggested accordingly.

Psoriasis arthritis

It affects people with psoriasis. It usually develops within 10 years of skin-changing conditions. Moreover, it occurs in middle age but can also occur at any age. It causes red, scaly rashes and thick pitted fingernails. Generally, it tends to have fewer joints as compared to rheumatoid arthritis. Often, you find swelling joints, fingers, and toes. In addition, you may also find pain and swelling in the knees, ankles, feet, and hands. Yet, the cause of psoriatic arthritis in fingers or any other body path is unknown. An imaging test is generally conducted for the test or diagnosis of psoriatic arthritis.

Gout

Most painful type of arthritis that happens when too much uric acid builds up in the body. It often starts in the big toe. typically the painful swelling that occurs due to inflammation.

Tips to get relief: generally, the healthcare professional may recommend non-steroidal anti-inflammatory drugs (NSAIDs).  At home, you may apply ice to the affected area. Try to drink plenty of water. Contact your healthcare professional if the situational get worsens and self-medication is not recommended.

 

Spondyloarthritis

Spondyloarthritis is the arthritis that occurs in the spine (vertebra), thus causing pain and swelling in the joints of vertebrae.

Symptoms:

●     Low standing back pain

●     Heel pain

●     Change of color in the skin and nail colo

●     Back pain

●     Fatigue

Ankylosing spondylitis

Ankylosing spondylitis is the fusing of the spine (vertebra) that can pain and inflammation.  

Warning signs:

●     Headache

●     Loss of bladder control

●     Muscle spam

●     Back pain

●     fatigue

Symptoms of Arthritis

Various arthritis symptoms include:

Stiffness of Joint

Any type of arthritis first causes stiffness of joints. You find difficulty in movement or standing straight. Due to arthritis, the inflammation of the joint occurs resulting in stiffness. Generally, you may find stiffness in movement during the morning. However, the tendency of stiffness may vary from person to person. Yet, there is a difference between rheumatoid arthritis and osteoarthritis symptom. Rhematoid arthritis has rapid onset while osteoarthritis gets worsens over time. Osteoarthritis appears in one of the joints

Swelling & rashes on joints

Swelling and rashes on joints may occur in arthritis. Natural deterioration of cartilage may occur in arthritis. In most cases, redness or scaly rashes may occur with or without swelling. The condition may vary according to the types of arthritis.

Fatigue

One of the earliest warning sign of arthritis is carried out with fatigue. You may also feel tingling and numbness in your joints. More often, you are unable to move or have difficulting moving or standing straight.

Pain in joints & other body parts

Pain is one of the earliest symptoms that arise after arthritis. The pain in joints or bones is commonly characterized by arthritis. The site or tendency of pain may vary according to the types of arthritis. Some types may have swear pain while others have tingling pain. We have discussed the tendency and site of pain as well.

Symptoms_of_Arthritis

Decreased range of motion

Due to arthritis, your joint may have slight movement. The freely movable joints are less likely to move. It feels that you’ve restricted movement. It may also result in difficulty in the daily tasks such as walking, exercise, and writing sometimes.

Arthritis is a disorder that occurs due to inflammation, and non-inflammation infection that causes swelling and stiffness of joints.

One more definition by Ibn e Sina

Arthritis is a clinical condition of pain with or without stiffness in specific joint or more than one joint caused by accumulation of rutubat ghariba (foreign humor) in the joint.

 As per Jurjani’s point of view

When pain and inflammation are in the smaller joints of hand it is called Waja-ul- mafaasil khas

(Rheumatoid arthritis)

 The inflammation or pathological change in joints occurs due to the derangement of humor. Thus, the rearrangement of humor may result in arthritis (waja al mafasil).

Etiopathogenesis of Waja al Mafasil (Arthritis)

Unani pathophysiology of arthritis is subdivided into two categorises:

  • Asbab e failah: Pathology of articular region that result in pain and swelling.
  • Asbab e Munafailah: Pathology which indirectly affect the articular region and make the joint vulnerable to accept the morbid material with their subsequent accumulation. On addition, it result in organic and functional change in joint.

Asbab e Failah

It is generally occur due to

  • Sui e mizaj (derangement of temperament), and
  • Mawad al fasida (morbid material)

 

Asbab Munafailah:

The causes which are related to the structure of the organ, affecting them indirectly with a consequence of susceptibility to the disease.

  • Dilation of the natural passage which may be congenital or acquired.
  • Development of a new unnatural passage due to movement, tahallul (dissolution) and takalkhul (rarefaction) which may be congenital or acquired.
  • The affected organ become the cause of occurrence of the waja al mufasil
  • Stable derangement of temperament particularly barid (cold derangement)
  • Dufa al Udwu khilqi (congenital weakness) which is not related to the temperament.
  • Intensive absorption of heat particularly when it is supported by movement, other types of pain and external factors.

As a result of the other organs being normally situated lower than other organ the morbid material move actively towards it that is the cause of its great incidence in legs and the hips

Etiology of arthritis (Waja Al Mafasil)

The causes are classified according to the type of humor. Therefore, causes of arthritis are as follows:

Waja al Mafasil Sada

The pain is of less duration and diagnosed by the absence of congestion (imtila) and swelling symptoms. The pain is relieved by cold or hot exposure.

Waja al Mafasil Damvi

Generalized and localized symptoms are present. The unani practitioner may diagnose sanguine predominance (ghalba e dam). Affected part will be reddish, edmatous and tender. The pain and symptoms are relieved by cold exposure and venesection.

Waja al Mafasil Safrwi

The symptoms are generalized and local that lead to the discoloration of yellow with red tinger are present. The deposition of ghalba e safra (bilious predominance) occur. Joint swelling is small as compared to waja al mafasil damvi but the pain, throbbing and inflammation are more in magnitude. Syndromes are relieved by cold exposure.

Waja al Mafasil Balghami

General and localized symptoms of ghalba e balghami (phlegmatic predominance) are present. Affected site will be whitish, swollen, and cold on touch. The warning signs are relieved by hot exposure.

Waja al Mafasil Saudawi

Generalized and localized symptoms of ghalba e sauda (melancholic predominance) are present. Affect joints are dusky hard and cold on touch. Pain and throbbing are minimal. Symptoms are relieved on hot exposure.

Unani-terminologies-for-arthritis-

Waja al Mafasail Reehi

Joint swelling is nominal with lightness in affected organ. Pain is fleeting and shifting in nature.

Waja al Mafasil Middi

Affected joint is extremely hot with having itching, tickling and burning sensation. Symptoms are exposed by cold exposure and worsen by hot exposure or treatment.

Waja al Mafasil Murakkab

Various accumulated humor can cause pain. Symptoms are relieved either by cold or hot treatment.

Unani treatment for Arthritis (Waja Al Mafasil)

There are various ways to treat arthritis but the most suitable way to arthritis is unani treatment. Principle unani treatment for arthritis are as follows:

  • Regimental Therapy (Ilaj Bil Tadbeer)
  • Diet Therapy (Ilaj Bil Ghiza)
  • Pharmacotherapy (Ilaj Bil Dawa)

Regimental Therapy for Arthritis

Regimental therapy involves the healthy changes in daily lifestyle and physical procedures to treat the illness. Arthritis is an inflammation that may treat accordingly.

Venesection (Fasd)

Venesection is the process of bloodletting that reduce the number of red blood cell and excessive iron or morbid material from the body. Participants may also feel less fatigue and more relaxed than before. Thus, it may also remove the morbid material and treat the derangement of the temperament of the body for the arthritis treatment.

Acupuncture

Acupuncture is the practice of penetrating the skin. Certainly, acupuncture is a form of complementary therapy that involves inserting very thin needles into the body. Therefore, it essentially relieves the pain and eliminates the morbid materials from the body.

Thus, the physical insertion of arthritis leads to curing many inflammatory diseases including joints.

Moderate Exercise

Exercise is one of the best regimental therapy. But you need to consult with your health care professional before opting for any exercise or regime. However, one can do moderate exercise if one faces arthritis. The physiotherapist may guide accordingly.

Hijama

The cupping therapy as known as hijama is a great regime for improving the overall health the well-being. Basically, it is a technique in which cups are applied over the skin to create a vacuum and suck morbid material. There are various types of cupping therapies and the unani practitioner may suggest according to your health condition.

Irrigation (nutool)

Irrigation is a popular regime in the unani system of medicine which refers to the pouring or dripping of drugs on body parts. It is a technique in which water, essential oil, or medicated decoctions are poured from a specific height in order to irrigate the targetted or affected organ.

Thus, it may treat any kind of arthritis.

Diet therapy (ilaj bil ghiza)

We need to take the dietary intake that reduces morbidity and disability of the affected organs. Generally, a diet plan is followed in order to treat any disease. For arthritis, there are certain dietary recommendations and restrictions

Dietary Recommendations

Your health care professional can suggest a specific diet plan for arthritis. However, a general dietary recommendation for arthritic patient are as follows:

 

Unani dietary recommendations: wheat, pulses, especially bengal gram, indian millet, big bean, french beans, palak, piyaz, chuqandar, carrot, red chilly, black pepper, injeer, badam, akhrot, khajoor, apricot, angoor, aaloo, pur ghee, methi, shaljam, makka, and papita.

Dietary Restriction

Nightshade vegetables such as tomatoes called solanine. It may cause arthritis while sometimes it has proven beneficial to arthritis.

Try to avoid sugar if you have arthritis. Sugar sends the message of releasing cytokines that causes inflammatory cell which eventually results in arthritis.

Avoid the intake of high saturated fats. Food with high fats may cause inflammation which may result in arthritis. Moreover, it also causes heart disease and many other chronic conditions.

 

Pharmacotherapy (Ilaj Bil Dawa)

The most precious and suitable treatment for waja al mafasil is ilaj bil dawa. Ilaj bil dawa is further comprised of

Single herb

Unani compound

Single Herbs

There are various single herbs used for arthritis. Oral administration for a single drug is as follows

Surajan (colchicum luteum L.)

Essentially, there are two types of suranjan 

  • Suranjan Talkh (Bitter variety)
  • Suranjan Shirin (Sweet variety)

Suranjan aids in treating arthritis, gout, rheumatism, and constipation. Although suranjan is a included in the list of toxic plants. However, there is certain procedure from which we can get therapeutic dose of suranjan. Moreover, it also has anti-inflammatory, antitumor and antigout properties. In addition, it is beneficial for the digestive health as it is a carminative and stimulanat. Suranjan can be the active ingredient of hypnotic and sedative medication. While at a certain amount, it is toxic and can be used as a poison.

Asgandh (Withania Somnifera L.)

Withania Somnifera also known as asgandh has proven traditionally beneficial for the treatment of various illnesses. The chemical constituents of asgandh include anti-inflammatory, aphrodisiac, antiarthritic, and anti-oxidant properties. Thus, it may prove therapeutic for asgandh.

Filfil Siyah

Filfil siyah commonly known as black pepper has a scientific name as piper nigrum l. According to clinical research, it has proven beneficial for arthritis. Moreover, it has antiarthritic, anti-inflammatory, and analgesic properties.

Tip: Grind whole pepper and add into balsamic vinegar and oil to create a dipping sauce for bread and various meals. It not only develops a great aroma but has a therapeutic effect as well.

Zanjabeel

Ginger also known as zanjabeel has zinigiber officinale as a botanical name. The constituent of ginger has anti-inflammatory, carminative, antiarthritic, and many other therapeutic effects on the human body. This potent plant has been clinically proven to treat rheumatoid arthritis. Allopathic medicines can treat the symptomatic cause of the illness while ginger treats the root cause of the illness.

Sana Makki

Sana makki also known as Senna has traditionally been used for its therapeutic effect. Folks always employ senna leaves in their diet and daily meal as it has multiple health benefits. In addition, it is a strong laxative and treats an anti-inflammatory effect as well.

Unani Compounds

Generally, the following unani formulations have been used for arthritis (waja al mafasil). Usually, the unani compound is categorized into

  • Local administration
  • Oral administration

Local Administrating drug

  1. Roghan e surajan
  2. Roghan e Malkangani
  3. Roghan e mafasil hakim ajmal khan
  4. Roghan e zaitoon
  5. Roghan e badam
  6. Roghan e satawari

Oral administrating drug

  1. Majoon suranjan
  2. Safoof suranjan
  3. Habbe asgandh
  4. Habbe suranajan
  5. Qurs mafasil
  6. Jawarish jalinoos.

View of CONCEPT AND MANAGEMENT OF WAJA‘AL-MAFᾹSIL (ARTHRITIS) IN UNANI SYSTEM OF MEDICINE (2022). Available at: http://jddtonline.info/index.php/jddt/article/view/2699/1983

● Surender Singh, Y. (2011) “Antiarthritic activity of Majoon Suranjan (a polyherbal Unani formulation) in rat”, The Indian Journal of Medical Research, 134(3), p. 384. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193721/

Asgand | National Health Portal of India (2022). Available at: https://www.nhp.gov.in/Asgand_mtl (Accessed: 18 May 2022).

Filfil (Safaid/ Siyah) | National Health Portal of India (2022). Available at: https://www.nhp.gov.in/Filfil-Safaid-Siyah_mtl (Accessed: 18 May 2022).

● Al-Nahain, A., Jahan, R. and Rahmatullah, M. (2014) “Zingiber officinale A Potential Plant against Rheumatoid Arthritis”, Arthritis, 2014, pp. 1-8. doi: 10.1155/2014/159089.

Senna (plant) – Wikipedia (2022). Available at: https://en.wikipedia.org/wiki/Senna_(plant) Senna (plant) – Wikipedia (2022). Available at: https://en.wikipedia.org/wiki/Senna_(plant)

 

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