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When pain affects life

Some prefer painkillers while others go for ayurvedic medication or yoga. Aparna Karthikeyan on the treatment options

OH! THIS PAIN Osteoarthritis commonly affects the knee-joint

The only ones who perhaps don't enjoy Chennai's mild, ephemeral `winter' are arthritic patients. For, the agonisingly crippling disease, characterised by painfully stiff, swollen joints, certainly affects their quality of life, wherein walking, climbing stairs, why, even getting out of bed become Herculean tasks. Unfortunately, the conflicting opinions and free-advice from family and friends are bewildering at best (gargle that oil, apply this one, check out that diet, do this asana, apply ice, try hot-water fomentation... ) While some swear that popping painkillers is the easiest way out, others vouch by the long-term benefits of yoga and Ayurveda; then again, unable to conform to the prescribed exercise and strict diet regimens, they imprudently discontinue them mid-way, unfairly faulting a whole system. We therefore thought it fit to throw some light on the various options available to arthritic sufferers — as outlined by an orthopaedic surgeon, yoga and Ayurveda practitioners.

Two types

Dr. S. Sivamurugan, orthopaedic surgeon, Soundarapandian Bone and Joint Clinic, explains that there are two basic types of arthritis — osteo and rheumatoid. Blood tests, x-rays and clinical examinations help in diagnosing whether it is the common `wear-and-tear' a.k.a. osteoarthritis, or the rarer, rheumatoid arthritis, caused by a systemic disorder. Arthritis typically affects the elderly, but some factors such as obesity and sports injuries result in even younger people suffering from it.

Dr. N. Chandrasekaran, Director for Cikitsa (Therapeutic yoga) at Krishnamacharya Yoga Mandiram, explains that yoga addresses not just the body, but the mind as well. It's a comprehensive, holistic healing process, dealing with both the cause and effect. Each patient is offered a specific tailor-made treatment plan, after assessing them completely.

According to Dr. P.L.T. Girija, Ayurvedic practitioner, Dr. Girija's Sanjeevani Ayurveda Centre, by examining the patient, the vaidya can find out what `doshas' are aggravating the problem. We then help them understand what caused it and what changes they need to make in their lifestyle and diet. The choice of drugs and treatment varies for each person.

Treatment

All forms of medicine have but one aim — to rid the patient of the excruciating pain and put them back on their feet. Dr. Sivamurugan says that treatment depends on the severity and type of arthritis (he warns against bundling osteo and rheumatoid arthritis together). "In India, osteoarthritis commonly affects the knee-joint. With weight reduction, physiotherapy, and medication, mild-arthritic patients usually feel much better," he says. Dr. Chandrasekaran adds, "the yogasanas are modified to suit each individual. In winter, gentle asanas are prescribed — when the joints are less stiff, the patient feels much better."

Dr. Girija explains that the patient is initially subjected to Panchakarma (cleansing) treatment, and then the medicines are administered. Once the doshas are eliminated from the body, the medicines are better absorbed, controlling the disease. But she cautions that not all karmas are suitable for everybody and only a vaidya should prescribe him or her. She says that the treatment provides not only symptomatic relief, but also relief from the disease itself. Moreover, there are no side effects. According to Dr. Chandrasekaran, the object is to reduce pain, followed by restoring functional ability so that the patients can get on with the normal routine. And then, we look at strengthening the structures around. As far as possible, we try and prevent any recurrence; but age-related problems are not reversible.

Dr. Sivamurugan agrees that there is no remedy for age-related problems. "Arthritis also tends to run in families. However, if there is a complete loss of articular cartilage, there is no option but to go in for joint-replacement surgery, which will give patients a better quality of life," he says.

Combining therapies

An alarming number of people tend to follow different treatments and trends, sometimes all at once. Do these systems of medicines lend themselves to be combined with others? Dr. Chandrasekaran says that when the pain is severe, the patient might need allopathic or ayurvedic medication, in addition to yoga. "Yoga is best used as a complementary medical system," he reasons. Dr. Girija adds that yoga and Ayurveda go hand-in-hand. "Since our theories are the same - both dealing with vatha-pitha-kappa - there is no conflict,." she says.

Finally, it's left to the individual to choose what they're comfortable with. Each system has a unique approach and treatment plan. Each has its own staunch followers, whose lives have improved post-treatment.

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