Arthritis

Agnes was a 48-year-old lady who came to see me with pain in her right knee, which was swollen and hurt whenever she walked and more when she went down some steps. She had been told that she had arthritis and would probably soon need a knee replacement. When I examined her, I found a mild clicking in her left knee and no sound at all of movement in her right knee. When I felt the inside of her knee, there was a lot of tenderness on pressure but no pain on movement. I could feel a bulging of the cartilage of the knee, which is called the medial meniscus. The X-ray of her knee showed a clear and smooth surface on the bones that made up the knee. The only indication of a problem was the reduced joint space inside the knee. 

I gently manipulated the cartilage into place, and a few minutes later, she was pain-free in the right knee. The left knee did show early signs of osteoarthritis, which I treated with acupuncture for 2-3 days, and the clicking disappeared. Over the next week, the swelling in both knees subsided. I advised her not to twist her knees, to walk for an hour daily, and to see me again after three months. When she returned a few months later, she was happy and smiling and said, " Bless you, doctor, for taking my pain away. Since I started walking, I have lost 3 kg."

 One of the most common problems I treat at my clinics is Joint pains. Many of these patients come to me with a diagnosis of arthritis, and many of them have been advised of surgery.   Most of them can return to an active, pain-free life with my non-surgical treatment. Muscle or ligament spasms or injuries can cause joint pain. Joint pain may also result from falls, which can cause injuries or sprains, incorrect diet, food allergies, and poorly designed or fitting footwear. 

These factors can cause imbalance around joints, which may have varied effects. Joint pain often arises from injuries to the spine, and treatment usually leads to miraculous results. Spinal problems at the 2nd or 4th lumbar vertebra commonly cause knee pain. There are four or five different types of arthritis, but the acupuncturist typically sees only two kinds. Arthritis constitutes 20% to 40% of the patients seen by an acupuncturist. Of these, roughly 75% have Osteoarthritis, and the balance has Rheumatoid Arthritis. 

Osteoarthritis usually affects large joints like the knees and hips. It may also occur in other joints, primarily those operated on or injured. Any injury to a joint, either by way of trauma or surgery, predisposes to Osteoarthritis in that joint in 5-20 years. About 40% of these people have Osteoarthritis, which implies wear and tear on the joints. These patients usually have had joint pains for at least 20 years. The cause of this problem is usually cartilage and joint displacements in the knee or the ankle, which predisposes to wear and tear on the joint surfaces by making the joint surface irregular. Many of these patients are overweight, and the increased weight increases damage to a joint not suitably buffered by the shock-absorbing cartilage.

 The rational treatment is to restore the cartilage to its proper alignment and teach the patient about the correct use of that joint. The knee joint is a hinge joint that functions well when used in one plane only. Twisting of the knee joint can lead to displacement of the knee cartilage. Rheumatoid Arthritis can affect any joint and usually affects multiple joints, such as the fingers, toes, elbows, ankles, knees, and spine. A significant number of people with joint pain are erroneously diagnosed as having arthritis when, in fact, the problem is not arthritis at all. Displacements and tears of the knee cartilage may cause swelling and knee pain.

 OSTEOARTHRITIS 

Osteoarthritis treatment is usually fast and effective, with most patients needing between ten and thirty treatment sessions to be entirely free of pain. Depending on the severity of the arthritis, the patient can expect a pain-free interval of two to twenty years. Whenever the problem recurs, the patient is advised to return for treatment as early as possible if the patient returns within the first few weeks of the recurrence of his pain. He may require as few as three to four sessions to be pain-free again. 

The following is a typical example of a patient with Osteoarthritis. Ms. Daniel, a large lady in her late sixties, came to see me with an eight-year-old complaint of pain and creaking in her knees when she walked. At first, she had been able to keep moving with the help of painkillers, but now, even with the tablets, she was unable to move without pain. 

Arthritis in the knees is due to joint cartilage wear and tear, which usually follows an injury 15 to 20 years earlier. The injury causes the growth of new bone, which wears away the cartilage opposite the injured area. Gradually, over the years, the cartilage completely disappears and is replaced by bone. At this stage, movement is excruciating and restricted. The body secretes an excess of lubricating fluid to minimise the pain and facilitate movement, leading to joint swelling. This swelling is harmless and tells us the body is trying to help itself. 

Ms. Daniel wanted to know how acupuncture would repair the damaged knees. When a person has pain in a joint, the muscles around it contract to restrict movement. This pulls the joint surfaces closer, increasing friction and damaging the joint surfaces. Acupuncture removes the pain and relaxes these muscles. The joint can move freely, and this vicious cycle is broken. Gradually, nature takes over, and the damaged cartilage often regenerates. Glucosamine and chondroitin sulphate, when taken for 6-8 weeks after treatment, can significantly aid the regeneration of the joint cartilage. Keeping the joint moving is essential in arthritis. 

Walking and simple knee-bending exercises are all required to keep the knee mobile. Heat in a hot water bag is helpful, effective, and safer than infrared or short-wave diathermy, which you may receive in a physiotherapy department. A hot water bag is beneficial in cold or damp climates where arthritis often plays up. Ms. Daniel received acupuncture treatment for about fifteen sessions and was pain-free. Her arthritis did not recur for the remaining 18 years of her life. 

RHEUMATOID ARTHRITIS 

 Rheumatoid arthritis responds to treatment slower than Osteoarthritis. This inflammatory process involves the joints and other parts of the body. The causes of the inflammation must be addressed if the treatment is to be effective, commonly food allergies and heavy metal poisoning.

The patient is treated every day until he has had ten sessions, after which he is given a week's break. He is treated again daily for ten sittings and a further week's break. This process is continued for three to four courses of ten sessions each until the patient is entirely pain-free. The patient’s ESR (Erythrocyte Sedimentation Rate) is monitored regularly to assess the progress of the rheumatoid activity. With treatment, the ESR should start to fall and should continue to fall even after the treatment is over until it reaches normal levels. The standard value of the ESR by the Westergren Method in a male is up to 10 mm, which falls in the first hour, while in ladies, the accepted value is up to 20mm.

The patient is advised to check the ESR periodically to monitor any increase in Rheumatoid Activity. The early deformities of Rheumatoid Arthritis can be reversed using Ultrasound and wax baths. Ultrasound therapy followed by gentle manipulation can make joints that have become stiff, loose and free and can prevent the deformities from becoming worse. After three to four courses of treatment, the patient has a pain-free interval of at least nine months. 

Whenever the pain, stiffness or swelling recurs. The patient is advised to return immediately for a course of treatment. The patient is treated for one or three courses of ten sessions until the pain, stiffness, and swelling subside. He can then expect a further pain-free interval of eighteen to twenty-four months before the pain returns. When the pain recurs, the patient is treated again, following which he should have a pain-free interval of four to five years. In many patients, the disease burns out, and I now have patients who have not had a recurrence for thirty years.