H-Treatment Of Osteoarthritis
NATIONAL JOURNAL OF HOMOEOPATHY 1999 Mar / Apr VOL VIII NO 2.
Dr V P Bansal
'Rhus-t / Bry / Ruta / Caust / Kali-carb / Calc-carb / Sulp

How Is Osteoarthritis Treated?
Treatment aims at patient education, pain relief and optimising joint function, although patients usually want only pain relief.

Homoeopathic Remedies

1. Rhus-tox: The most commonly used remedy is Rhus-tox. Its pathology exactly simulates OA. Affects fibrous tissue, joints, tendons and tendon sheaths, producing stiffness and pain. Pains are tearing in character, especially in the mornings, better movement. Joints hot and swollen with numbness and tingling in hands and feet. Worse cold air, dampnees, sleep and rest and better by warmth, dryness and pressure. These patients are often sad and listless. It should not be forgotten that Rhus-tox has skin symptoms- vesicles, urticaria and cellulitis. The association with psoriasis is of interest.
   
   
2. Bryonia (which is derived from wild hops) affects serous membranes. The pain is stitch-like in character. Worse movement, pressure and warmth. They are better by rest and cold and like open air. Joint swellings- hot and erythematous. These patients often complain of dry mucous membranes and have lot of thirst. Bryonia is a useful remedy in the treatment of pleurisy and certain migraines.
   
   
3. Ruta: A remedy acting on the periosteum, cartilage and flexor tendons. Patients usually restless, debilitated and somewhat despairing. They have a sense of bruising and lameness. They complain that their legs give way under them. Pains in the neck and lumbar regions predominate. Their sciatica is often worse lying down and they often suffer from contractures and ganglia. The tendons are sore, especially the achilles tendon. AGG: lying down and in cold wet weather. Ruta is useful in tennis elbow and frozen shoulders.
   
   
4. Causticum is useful in long standing cases often affected with contractures. It affects the muscular and fibrous tissues. Joint pains are dull, tearing and drawing, well marked in elbows and hands. Often suffer from Lt-sided sciatica. Some of these patients complain of restless legs at night. Better for warmth, wet weather and dampness and worse for dry cold winds, walking and, it is said, the motion of carriages. These patients are often sad, but sympathetic to other sufferers. All complaints associated with drowsiness, faintness and general weakness.
   
   
5. Kali-carbonicum: The characteristic weakness of the Kali salts is seen in Kali-c associated with coldness, depression and a soft pulse. The pain is stitch-like-sharp and cutting, affecting the knees, hips and lumbar region. Complain that their legs are giving way under them. The knees are swollen and the soles tender.
   AGG: cold air, coffee and at 3 a.m. AMEL: warmth and movement.
   
   
6. Calcarea-carbonica is associated with apprehension and debility. The joint pains are sharp and stitching, feeling as if they had been sprained. They suffer from cold sweats both local and general, but especially marked is sweating of the feet and hands. The joints are often swollen, especially the knees. These patients are better in dry weather and worse for cold washing, prolonged standing and mental or physical exertion.
   
   
7. Sulphur: The great characteristic is heat, with special affinity for the skin, and is widely used in the Homoeopathic treatment of eczema. In joint problems- pain and stiffness in the neck and between the shoulders and tearing pains in the arms and hands. The knees and ankles are stiff and they are often stoop- shouldered. Associated with hot, sweaty hands and burning in the soles.
   AGG: at rest, standing, the warmth of a bed, washing and at11 a m.
   AMEL: in dry, warm conditions and for catnaps. Sulphur patients tend to be forgetful untidy and lazy.
   
   
8. Sepia derived from the cuttlefish, is a great remedy for women. Complain of weakness in the lumbar area. Coldness between the shoulders, stiffness in the legs and twitching in the limbs and pain in the heels. The legs and feet are often cold. Sepia patients can display an indifference even to their families and close friends. They are irritable, sad & weepy. They tend to be worse towards the evening from dampness, cold air, sweating and before thunderstorms; they are better for exercise, pressure, a warm bed and after sleep.
   
   
9. Pulsatilla: These chilly and weepy patients develop shifting pains in the joints, drawing in character with swelling of knees, shooting in the neck, between the shoulders and in the lower back. Often have catarrh and varicose veins. Pulsatilla patients prefer the open air and are thirstless. Worse by heat, fatty foods, evening and letting the feet hang down (venous congestion). Pulsatilla is, of course, one of the greatest constitutional remedies.
   
   
10. Aurum-met: Tearing pains in joints with oedema. Bones are sore especially at night, cold weather (especially in winter). These patients are often very depressed (it is in fact, a useful remedy for depression). The dreams are vivid.
    Two small remedies, in arthritis of small joints: Caulophyllum and Actea-spicata
    
    
11. Caulophyllum is often a female, has severe drawing pain and stiffness in the small joints of the fingers, toes and ankles. In minutes, pains move from one joint to another (like Pulsatilla). Thrush like vaginal discharge and menstrual problems. Caulophyllum is useful in the management of labour, and post-pill amenorrhoea.
    
    
12. Actea-spicata has tearing, tingling pains in the small joints, especially the wrist. The joints are swollen and red - worse for movement. The patients are fearful and often complain of widespread pulsations.
    
    
13. Apis-mellifica (the honeybee) is very useful in the control of joint oedema. Knees swollen, shiny and stiff with stinging pain. Very itchy joints.
    AGG heat, touch and often after sleeping;
    AMEL: in the open air and cold bathing.
    Apathy, stupidity and tearfulness can be present. Another remedy useful in the control of oedema is Urtica-urens (stinging nettle)
    
    
14. Ledum (marsh tea). Patients have a lack of heat yet feel worse for warmth. Better by cold. They get gouty pains in the small joints, which are swollen, hot but pale. The soles are painful.
    
    

General Management: by giving supplementary therapy in arthritis.

1. These patients are often tense, and suffer from poor sleep and should be given Valerian tincture or Passiflora. Regular interaction will relieve the anxiety.
2. Homoeopathic treatment will have to be worked out for each patient, especially as regards potency & repetition
3. For the overweight, weight reduction will benefit - through swimming, which allows working of arthritic knees and hips and without impact loading.
4. Muscle exercises to increase muscle tone and aerobic fitness benefit pain reduction and function even in the elderly.
5. Aids such as splints, walking sticks etc, can help in reducing the load on weight-bearing joints and also in post surgical rehabilitation.
6. Occupational therapy services.
7. Surgery now has much to offer in the replacement of severely affected joints, particularly hips and knees. The decision to replace a joint must be made taking into account the deformity, loss of functional ability and extent of the pain.

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