Knee osteoarthritis, often termed as degenerative joint disease, is a chronic condition characterized by the deterioration of the joint’s articular cartilage, the smooth covering that cushions the ends of bones. This wear and tear can cause the bones to rub against each other, leading to inflammation, pain, and stiffness in the joint. The progression of osteoarthritis can be gradual, often developing over a long period of time due to aging, obesity, joint injury, or other factors.
It is most common in elderly people. The intensity of the symptoms vary for each individual and usually progresses slowly. Common clinical symptoms include knee pain that is gradual in onset and worsens with activity, knee stiffness and swelling, pain after prolonged sitting or resting, crepitus or a cracking sound with joint movement with a reduced range of motion.
Case at VHG: A female patient named aged 74 yrs, visited the VHG, HRBR centre on 03/05/24 with the chief complaint of bilateral knee pain with crepitus of left knee for 15 days. Pain was associated with reduced range of motion of knee joint dominating more on left knee than the right knee. She also presented with pedal edema and hyperpigmentation of lower limbs since few months. Patient had history of Hypertension (BP noted at the time of consultation: 140/70mmHg) and was under anti-hypertensive medication for 11 yrs.
Treatment at VHG:
Treatment protocol followed for her was:
Janu pizhichil (warm oil streaming on both knees) + Upanaha for left knee + Acupuncture for 7 days (1st line) along with oral Ayurveda medicine.
She started her ayurveda treatment, Janu pizhichil with Ksheerabala oil and Dhanwantaram oil and Upanaha with Rasnadi churna and Jadamayadi churna along with Acupuncture on 04/05/2024. Prior to her treatment, she was administered the WOMAC OSTEOARTHRITIS INDEX Questionnaire and data was collected. She completed her 1st line of treatment on 11/05/2024. Post-treatment WOMAC OSTEOARTHRITIS INDEX Questionnaire data was collected and evaluated.
Janu pizhichil (bilateral knee) + Upanaha for left knee + Acupuncture for 7 days (1stline)
Pre-Treatment Patient Data (1st line) on 04/05/2024
| WOMAC OA INDEX | NRS | VAS | PAIN INTENSITY |
| 24 | 8 | 9 | 100% |
Post-Treatment Patient Data (1st line) on 11/05/2024
| WOMAC OA INDEX | NRS | VAS | PAIN REDUCTION |
| 3 | 6.5 | 7 | 60% |
The patient was asked to continue the same above-mentioned medication for a week and was called for follow up on 17/05/2024. With pain reduced by 40%, she was suggested for exercise therapy for 3 days with knee strengthening exercises and asked to apply Balashwagandhadi taila and Jadamayadi churna topically for pain relief on a regular basis and asked to continue the oral medicines.
Exercise Therapy for 3 days (2nd line)
Before starting exercise therapy on 18/05/2024, her gait and Range Of Motion (ROM) of both knees were evaluated manually. She was taught several knee-strengthening exercises for 3 days under guidance. She was asked to continue the same exercises for the next 15 days on a regular basis.
Pre-Treatment Patient Data (2ndline) on 18/05/2024
| Gait | NRS | VAS | ROM | PAIN REDUCTION |
| Limping gait | 6.5 | 7 | Restricted on left knee | 60% |
Post-Treatment Patient Data (2ndline) on 20/05/2024
| Gait | NRS | VAS | ROM | PAIN REDUCTION |
| A slight improvement in gait is seen | 3.5 | 3 | Little improvement in Range of motion is seen on the left knee | 65% |
After 15 days, on 03/06/2024, the patient claimed 90% pain reduction.
Conclusion: The Integrative Medicine treatment protocol using Ayurveda, Acupuncture and Exercise therapy aids pain reduction and improves mobility in Osteoarthritis of the knee joints
