Abstract: Osteoarthritis commonly referred to as OA is the most common joint disease and one of the most widespread of all chronic conditions managed in General Practice. Whilst its prevalence increases with age, a significant number of adults experience symptoms of OA earlier in life. Most cases of OA are not extraordinary, yet the individual experiences of the affected can help a health practitioner to fully understand the impact of the diseases in the overall population.
This case report was triggered by a patient who was eager to tell her story and also reach out to the others suffering from OA- as to how a simple Ayurveda drug helped her to manage her long term pain effectively. As the importance of narrative medicine is increasingly being recognized to have a positive impact on patients and also helps clinicians to strengthen their practices, a summary of this case highlighting the use of Trailokya Vijaya Vati was made.
Introduction
Osteoarthritis occurs when the cartilage that cushions the ends of our bones in our joints gradually deteriorates.
OA has often been referred to as a “wear and tear” disease. But besides the breakdown of cartilage, OA affects the entire joint. It causes changes in the bone and deterioration of the connective tissues that hold the joint together and attach muscle to bone. It also causes inflammation of joints.
The pain and limited mobility in OA occurs as a result of destructed cartilages. Left bare of their padding, bones rub painfully against each other – particularly in the hands, spine, knees and hip.
For years, there have been very limited treatment options available for OA. The treatments include pain management, steroidal injections, physiotherapy and surgery as a last resort. Out of these pain management is the best sought treatment as PAIN itself is a major symptom in this condition.
Case Report
Patient description
A 48 yr old female was presented with complaints of pain in both knees for 8 years, since the last 3 months the pain had aggravated from moderate to severe to highly intolerable which was leading to increased anxiety and also restless sleep. The pain would increase on an activity like walking or climbing up the stairs and would be relieved by rest.
Case history
The patient has no history of fall or trauma. She walked without a walking aid but requires support when there is a peak in pain.
She has been on analgesics since when she doesn’t exactly remember, taking periodic physiotherapy sessions as advised by the doctor. She took Intra-articular injections a couple of times but the relief was temporary (6-8 months). She was recently advised bilateral knee replacement by her doctor and she decided to give it a last go through an alternate option! The pain was her only concern.
Recently the severity of the pain was so intense that it was impossible for her to use stairs and she is sedentary most of the time.
Physical Examination
- BMI – 30 (Obese)
- Gait – Antalgic
- Fell – Mild crepitus is felt upon moving both knee joints.
- ROM – Restricted and Painful
- Blood Results – ESR and CRP raised
Treatment plan
Medicines to be used – Trailokya Vijaya Vati. After a thorough clinical examination, she was prescribed with Trilokaya Vijaya Vati with one tablet two times a day for a period of seven days initially.
Expected outcome of the treatment plan
The expected outcome was to relieve her of the pain and that the patient should get a sound sleep.
Actual outcome
Within a week, she began to notice a distant difference in her pain.
Discussion
The treatment was focused on effective pain management as that was the only factor troubling the patient at this given point. The patient was not ready to undergo surgery thou she was counseled that she might need one over a period of 5 years or so.
She was also prescribed other drugs effective on OA and mild exercises. Trailokya Vijaya Vati not only helped the patient with pain but also gave her a sound night’s sleep. The patient also reported being less cranky throughout the day.
Conclusion
For years, treatments for OA have majorly being planned on physiotherapy, steroidal injections, and joint replacement surgery. But as pain management is now emerging as an individual branch, there has been an increased focus on pain management in the treatment of OA.
Unlike Rheumatoid Arthritis, OA hasn’t had any major breakthroughs that have dramatically improved its medical treatment. Drug development for OA has been slow because the disease itself follows a slow process.
Dr. Anirudha Mohite, Consultant Ayurvedacharya
