Joint pain and inflammation - Arthritis is spreading worldwide as a complicated health problem. It is the main cause of disability among people over fifty-five years of age in industrialized countries. The word arthritis comes from the Greek word “arthron” means "joint" and the Latin word “itis” means "inflammation". According to WHO, about 0.8% of the population suffer from arthritis worldwide. In most of the countries it ranges from 0.3 to 1.0 %. It is much common in developed countries. In India more than 1% of the population suffers from arthritis but in Kashmir percentage of such patients is more. As per Unani doctrines, arthritis is more prevalent in cold regions like Kashmir where people above the age of 45 years are more suffering from this disorder particularly poor, malnourished persons or persons with sedentary life styles.
Arthritis involves inflammation of one or more joints. The major complaint by individuals who have arthritis is joint pain. Pain is often constant and may be localized to the joint affected. It is characterized by pain during walking. Along with pain there is swelling, stiffness of joints and fatigue. The conventional treatment options for this condition have improved in terms of effectiveness, the use of pain killers, surgeries and other medical interventions in order to relieve pain and prevent dysfunction of joints, have all been associated with adverse effects. However, conventional treatment cannot get total control over symptoms leading to great dissatisfaction and may be disabilities in some cases.
Because of this reason, patients suffering from arthritis are likely to seek alternative Unani or AYUSH methods for complete relief. Unfortunately some people are falling prey to “quacks” labelling themselves as ‘Hakeems’ or “Unani Doctors’ without any proper mandatory institutional qualifications (BUMS/MD -Unani) or registration from National Commission of ISM. Such private fake healers are mixing modern pain killers and allopathic steroids into unknown powdered drugs or capsules and providing patients without any labels or prescriptions.
Some malicious persons from neighbouring states are selling some steroids and pain adulterated drugs like hot cakes in Kashmir and labelling them as ayurvedic or unani medicines which should be controlled by drug controller or AYUSH department. In my suggestion patients have best choices to visit government AYUSH/Unani Hospitals or dispensaries and should insist either to get external massage oils or unani regimental therapies in milder arthritis or pure herbal prescription formulations along such therapies in chronic arthritis or joint pains to reduce burden of drug ill effects from quacks or over the counter pain drugs.
Unani system identifies and attributes diseases like Arthritis to a weak immunity and poor digestive system. It suggests several polyherbal formulations for the treatment of this condition and other joint disorders.
In the Unani context the arthritis is known as Waja-ul- mafasil which in broader terms means pain in joints. Waja-ul- mafasil is used to describe all kinds of joint disorders including pain, swelling, and stiffness. It has been described as Waja-ul- mafaasilaam (arthritis), Waja-ul- zuhr (back pain), Niqras (gout) and IrqunNisa (sciatica) etc.
Symptoms of Arthritis
Symptoms of arthritis include joint pain, swelling, fatigue and weight loss. Inflammation and stiffness in the fingers, arms, legs, and wrists in the same joints or on both sides, especially soon after awakening may also be present in extreme cases of arthritis.
Environmental factors and mental status of a person affects the internal balance of humours of the body. However, maintenance of the humour via six essentials of life is beneficial. Patients of arthritis are advised to control their weight as obesity may cause osteoarthritis. Regular exercise is very useful for such patients. Exposure to sunlight is very useful. The patients should avoid extreme exertion, mental stress, anxiety and depression. Positive thinking itself may minimise the symptoms of arthritis.
Keeping is mind the principle of “Prevention is better than cure”. Unani medicine emphasises Asbab-e- sitta zarooria (Six essentials of life) from which one can prevent the communicable as well as non-communicable diseases. These are
1. Hawa (Air).
2. Maakool wa Mashroob (Food and drink).
3. Harkat wa sukoon-e- badani (Body movement and rest).
4. Harkat wa sukoon-e- Nafsaani (Mental work and rest).
5. Naum waYaqza (Sleep and Wakefulness).
6. IstifraaghwaEhtabaas (Retention and Evacuation).
If these essentials are in equilibrium, occurrence of major chronic diseases can be avoided.
Management of Arthritis
The Unani literature and classic textbooks have detailed information regarding the disease and its management. As per Unani philosophy following modes of treatment are advised for complete relief according to the preference
1. Dieto therapy (Ilaj bil ghiza).
2. Regimental therapy (Ilaj bil tadbeer).
3. Pharmaco therapy (Ilaj bil dawa).
4. Surgery (Ilaj bil yad).
Foremost consideration is given to Regimental therapy along with dieto therapy. If it does not show results, then it is necessary to shift to pharmacotherapy. Surgery is the last intervention used for arthritis patients.
The regimental therapies include, fomentation, massage, leeching, cupping, turkish bath, diaphoresis, concoction and purgation as per requirement of the condition. All these therapies have alone and if required collectively given excellent results in controlling the symptoms and in the general wellbeing of patient and is freely available in major Govt. AYUSH hospitals.
As per Unani philosophy the basic principles followed for the management of the arthritis are:
• Maintaining humoral imbalance.
• Maintaining healthy environment and good hygienic practices.
• Expel out toxins from the affected joints.
• Use of proper diet to check the growth and complications of the disease.
• Improvement of digestion and appetite.
Some commonly used safe Unani drugs are available from branded companies like Hamdard which go through stringent quality control. Some famous Unani classical formulations are Majun Suranjan or its pills (habb) or Majun Azraqi or Majun Jograj guggul or their tablet forms.
And always visit qualified BUMS/MD/PHD (unani) doctors or Govt. AYUSH Centres or Govt Unani Hospitals/ Dispensaries and never fall prey to fake healers. Never use unani over the counter medicine without consulting valid Unani Doctor or Medical officer.
(Author is Medical Officer (Unani Medicine), AYUSH Unit District Hospital Pulwama. Feedback: firstname.lastname@example.org)
Box: As per Unani doctrines, arthritis is more prevalent in cold regions like Kashmir where people above the age of 45 years are more suffering from this disorder particularly poor, malnourished persons or persons with sedentary life styles