Leech therapy for osteoarthritis – Minimizing pain, optimizing function and reducing disability.
Osteoarthritis (OA) is by far the most common form of arthritis known today. It is strongly associated with ageing and is a major cause of pain and disability in older people. So, let’s learn about Leech therapy for osteoarthritis.
Pathologically, osteoarthritis may be defined as a condition of synovial joints which is characterized by focal loss of articular hyaline cartilage with proliferation (new growth) of new bone and remodelling of joint contour.
Inflammation is not a prominent clinical feature of osteoarthritis. OA preferentially targets certain small and large joints but is not a disease or a single condition.
OA is an important cause of disability and the second most common musculoskeletal problem in the world (30%) after back pain (50%). The reported prevalence of OA in rural India is 5.8%.
Risk factors in osteoarthritis
- Increasing age
- Female
- Obesity
- Smokers
- Occupational knee bending
- Physical labour
The disease follows a more severe course in women with greater symptoms, more extensive involvement, and increased prevalence of knee and hands joint involvement. In contrast, men have an increased prevalence of hip OA in western countries.
Joint trauma, malignancy, meniscectomy, and quadriceps weakness are important risk factors.
Clinical features of osteoarthritis.
The most important clinical features are a pain in or around the involved osteoarthritis joints is the cardinal symptom. Usually, it starts insidiously as an intermittent, localized, deep ache, often aggravated by joint use and relieved by rest, in an asymmetric fashion and then becoming symmetric.
The pain is persistent in nature and in advanced cases the pain during the night may be very disturbing. Knee joint involvement is typically associated with pain on descending or ascending stairs, squatting for the toilet, climbing into auto-rickshaws, rickshaws, buses, etc. There may sometimes be locking or buckling of the knee joint. Hip involvement causes problems of gait and pain in the groin or medial part of the thigh.
Stiffness in joints on first awakening (morning stiffness) in OA usually lasts 5 to 30 minutes (average 20 minutes). Stiffness occurring after periods of rest or inactivity (gelling) is frequent and lasts for a few minutes. Functional impairment in OA is variable and depends on associated muscle wasting, weakness, and on radiological severity of the disease.
Signs of OA include bony swelling, crepitus (sensation of bone rubbing against the bone on movement), restricted movement, and deformity of joints, muscle weakness, and muscle wasting.
Clinical signs for osteoarthritis
- Restricted movement due to capsular thickening, or blocking by osteophyte
- Palpable, sometimes audible, coarse crepitus due to rough articular surfaces
- Bony swelling (osteophyte) around joint margins
- Deformity, usually without instability
- Joint-line or periarticular tenderness
- Muscle weakness, wasting
- No or only mild synovitis (effusion, increased warmth)