Dr. Shreepad Khedekar MD (Hom) discusses his approach to this common, painful and potentially crippling group of conditions
Arthritis and rheumatism are among the commonest forms of chronic disease and, with an aging population, are set to become commoner still. Strictly speaking, arthritis means disease of the joints, while rheumatism is disease of the soft connective tissues which support and move the joints. In fact, the distinction is often artificial, since many of these conditions affect both the joints and connective tissues.
Osteoarthritis, the commonest of these conditions, is basically “wear and tear” of the joints. The root of the problem is wearing out of the cartilage, the tough, slippery “gristle”, which allows the ends of the bone to slide smoothly over each other and absorbs shocks. The joint becomes stiff and painful, and may creak as it is moved.
As the cartilage wears down, the bones on either side of the joint may react by forming small bony outgrowths called osteophytes. One of the sites where bony nodes can easily be seen is the last joint of the fingers. Spondylosis is a similar problem affecting the spine; here the main problem is degeneration of the disks which separate the vertebrae.
As one would expect with a degenerative condition the prevalence of osteoarthritis increases with age, it affects nine per cent of the total population but around 70 per cent of the over-70s. It is the commonest of all rheumatological conditions, and indeed probably the commonest of all chronic diseases, because many sufferers live with it for many years. Not surprisingly it tends to affect weight-bearing joints (eg low back, hips and knees). Joint injuries or overuse (for instance heavy physical work or professional sport) predispose to osteoarthritis later in life. Overweight is another important factor.
The other two main groups of arthritis and rheumatism are inflammatory arthritis, of which the commonest form is rheumatoid arthritis, and soft tissue rheumatism. Rheumatoid arthritis affects about one person in a hundred; it is nearly three times commoner in women than men (for unknown reasons). Its cause, too, remains frustratingly elusive. It tends to come on at an earlier age than osteoarthritis (typically in the 30s to 50s) and is more aggressive, running a more rapid course: about a third of sufferers are seriously disabled within ten years, although it is very variable. It particularly affects the small joints, especially of the hands and feet, causing a typical hand deformity where the fingers slant sideways. But it can affect almost any joint in the body, and also cause nodules under the skin and eye problems. There are many other forms of inflammatory arthritis, some of them associated with infections.
The final group is true rheumatism, affecting the soft connective tissues rather then the joints themselves. There are many forms, some with picturesque names. They include enthesopathies which affect the point at which tendons connect to the bones – the best known of these are tennis elbow, affecting the outer side of the elbow, and golfer’s elbow, which affects the inner side. Capsulitis – inflammation of the capsule of tissues that surround the joint – most commonly affects the shoulder, and may lead to a stiff “frozen” shoulder. Some of the more amusing names are reserved for bursitis – inflammation of the bursae, cushioning pads which overlie many joints. These include Housemaid’s Knee (also known as Clergyman’s Knee), from too much kneeling. But my favourite is Weaver’s Bottom – so called because it used to affect weavers who had to shuffle up and down long benches to tend their looms!
The most common form of soft tissue rheumatism, however, is fibromyalgia (which used to be known as fibrositis). It affects about two per cent of people and is much commoner in women than men. It is a controversial condition; some believe that fibromyalgia and chronic fatigue syndrome (ME) are varieties of the same condition, certainly there are similarities. The typical features are widespread musculoskeletal pain and aching with tender points at several specific locations. It is frequently associated with poor sleep and fatigue as well as other problems including migraine and irritable bowel syndrome.
There are many problems with current conventional treatment of arthritis and rheumatism. For instance, although osteoarthritis rarely, if ever, killed anyone, a group of drugs often used in its treatment, the non-steroidal anti-inflammatory agents (NSAIDs), including aspirin, Ibuprofen and Voltarol among many others, certainly has. There are some 12,000 hospital admissions and 2,000 deaths from these drugs every year in the Mumbai alone. Although the new generation of NSAIDs is safer, they are only glorified painkillers, which do not affect the basic disease process. Similarly for rheumatoid arthritis, a range of powerful drugs is available but all of these have long and alarming lists of side effects. Mostly cytostatic used in Cancer management are used and they have deadly side-effects.
WHAT HOMEOPATHY COSTS?
Your first consultation with a private homeopath will usually cost between INR 500 to INR 10,000. Further appointments usually cost less – about INR 500 to INR 5000 depending on the location of the place and experience of homeopath. It will also depend on the skill level of his staff or assistants who usually take the first case and prepare it for the main consultant.
Your remedy will usually be included in the consultation price, but do check this first. Homeopathic tablets or other products usually cost around INR 100 to INR500 if you need to buy them separately in India.
Dr. Shreepad A. Khedekar, BHMS, MD (homeopathy), a specialist for over 17 years, he has used homeopathy in his Switzerland, Belgrade and Mumbai practice for the last 17 years. He lectures in homeopathy at Switzerland, Croatia and at the Serbian Doctors Association (SLD) Teaching Centre in Belgrade and has a busy private practice in Dadar, Mumbai and at Shushrusha Citizens co-operative hospital, Mumbai and is the only Homeopath in their 60 year history.
Dr. Shreepad Khedekar is the Clinical Director, Imperial clinics Mumbai and Imperial clinics Belgrade, Consultant at Shushrusha Citizens Co-op Hospital Mumbai and Physician to several international stars and celebrities.
