Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis with different causes.

Two of the most common types are:

• Osteoarthritis (OA)
• Rheumatoid Arthritis (RA

The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from a misdirected immune system (such as rheumatoid arthritis). While osteoarthritis and rheumatoid arthritis are the most common types of arthritis, there are many other types of arthritis.

Other types of arthritis include:

• Psoriatic arthritis
• Ankylosing spondylitis
• Reactive arthritis
• Types of infectious arthritis include septic arthritis and Lyme arthritis
• Self-limited forms of arthritis can occur in association with virus infections

Joint pain, stiffness and swelling are the most common symptoms of arthritis. The range of motion decreases and redness of skin around the joint may be experienced. The symptoms are worse in the morning.

Tenderness of the inflamed joint can be present with or without pain. When the large joints are involved such as the knee there can be loss of cartilages with limitation of motion from the joint damage.

When arthritis affects the small joints in fingers, there can be bone growth and loss of hand grip and grip strength of the hand associated with stiffness.

Arthritis of weight bearing joints can lead to difficulty in walking from poor joint function and arthritis pain.
Different forms of arthritis can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include :

• Fever
• Gland swelling
• Weight loss
• Fatigue
• Even symptoms from abnormalities of organs such as the heart, kidneys or legs

Cartilage is a firm but flexible connective tissue in your joints. It protects the joints by absorbing the pressure and shock created when you move and put stress on them. A reduction in the normal amount of this cartilage tissue cause some forms of arthritis.

Normal wear and tear causes osteoarthritis one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue.

Rheumatoid arthritis another form of arthritis is an autoimmune disorder. It occurs when your body’s immune system attacks the tissues of the body. This attacks the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints.

• Physical examinations to check the fluid around the joints (warm or red joints) and range of motion in the joints
• Extracting and analyzing inflammation levels in your blood and joint fluids can help determine what kind of arthritis you have
• Blood tests that check for specific types of antibodies like Anti-CCP (anti-cyclic citrullinated peptide), RA factor (rheumatoid factor) and ANA (antinuclear antibody) are also common diagnostic tests
• Physicians commonly use imaging scans such as X-ray, MRI and CT scans to produce an image of bones and cartilage. This is also to rule out other causes of symptoms such as bone spurs

Family history : Some types of arthritis run in families, so you may be more likely to develop arthritis if parents or siblings have the disorder

Age : The risk of many types of arthritis including osteoarthritis, rheumatoid arthritis, and gouty arthritis increases with age

Your gender : Women are more likely than men to develop rheumatoid arthritis, while most of the people who have gouty arthritis are men

Previous joint injury : People who have injured a joint are more likely to develop arthritis in joints

Obesity : Carrying excess pounds puts stress on joints particularly on your knees, hips and spine

Rheumatoid arthritis is an inflammatory arthritis in which all the major and minor joints are involved or associated with pain and stiffness. Women are 2-3 times more prone than men. It is an autoimmune disorder.

• Small joints of fingers, toes, hands and wrist are inflamed
• Morning stiffness more than 30 minutes or much longer seen with mild fever
• Stiffness or restricted range of movement
• Painful joints along with swelling
• Rheumatoid nodules are seen in posterior aspect of elbow and in sacral region
• More redness and ulcer in case of vasculitis

• Low hemoglobin count
• High ESR (erythrocyte sedimentation rate)
• Rheumatoid arthritis factor may or may not be positive
• ANA (antinuclear antibody) test will be positive in 20% of rheumatoid arthritis cases
• Anti CCP(anti-cyclic citrullinated peptide) is a confirmatory test

Osteoarthritis also occur secondary to injury and is commonly seen in obese individuals. Microscopic changes in structure and composition of cartilage is the cause. The pain increases on walking and it is a slow progressive disease.

• X-ray helps in understanding the intensity of damage
• Hemoglobin, erythrocyte sedimentation rate, rheumatoid arthritis factor and urine routine tests are needed to rule out other arthropathies
• X-ray correlates poorly with symptoms but MRI is useful

Treatment protocols:

• Ama pachana
  Any disease can present an avastha/ stage called aamam. Amavastha can be seen in rheumatoid arthritis, so here we do aama pachana and at the same time raktaprasadana too
• Dhaara
• Dasamoola ksheera dhara, dhaanyamladhara
• Snehapana
• Virechana
• Vasti
• Rasayana prayogam
• Administration of rasoushadhis

Treatment protocols:

• Samana snehapana
• Sodhanam
• Abhyangam
• Lepam
• Swedam
• Swedam