Arthritis

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 and treatment methods. Two of the most common types are osteoarthritis (OA) and rheumatoid arthritis (RA).

The symptoms of arthritis usually develop over time, but they may also appear suddenly. Arthritis is most commonly seen in adults over the age of 65, but it can also develop in children, teens, and younger adults. Arthritis is more common in women than men and in people who are overweight.

What are the symptoms of arthritis?
Joint pain, stiffness, and swelling are the most common symptoms of arthritis. Your range of motion may also decrease, and you may experience redness of the skin around the joint. Many people with arthritis notice their symptoms are worse in the morning.

In the case of RA, you may feel tired or experience a loss of appetite due to the inflammation the immune system’s activity causes. You may also become anemic — meaning your red blood cell count decreases — or have a slight fever. Severe RA can cause joint deformity if left untreated.
- Crepitation with movement
- Deep, aching joint pain
- Grinding sensation
- Joint swelling
- Loss of muscle strength
- Muscle tenderness
- Reduced movement
- Stiffness
- Tenderness
How soft tissue injury leads to Degenerative Arthritis

Following a trauma, ligaments become sprained and relaxed. If left untreated, chronic joint instability and destructive joint motion occur with continued use of the joint, ultimately leading to extensive degenerative changes and osteoarthritis. Destructive joint motion and the degenerative process can be prevented with appropriate intervention through Prolotherapy, including traditional dextrose Prolotherapy, Platelet Rich Plasma, and Stem Cell Therapy. These regenerative treatments can be used for arthritic joints as well, but utilizing these options earlier can potentially save a lot of lost time and lifestyle adjustments due to pain.
New view of Pathophysiology of Osteoarthritis

Osteoarthritis, or degeneration of a joint or spine, starts with ligament injury; thus, treatment should start with Prolotherapy. Plain and simple. This view of osteoarthritis is the correct view and someday hopefully will be accepted by modern medicine and then the treatment of choice for chronic pain from degeneration would be regenerative injection therapy.
Ligament injury (laxity)
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Decreased tension on the bone at ligament-bone insertion site
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Altered joint mechanics (instability) – increased force on subchondral bone
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Subchondral bone sclerosis (thickening)
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Shock-absorbing capacity of bone is drastically reduced
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Shear stresses increased between bone-cartilage interface
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Cartilage fibrillation and subsequent joint degeneration worsens
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Cartilage breaks off (loose bodies) and bone spurs form to try to stabilize joint
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Bone on bone Stage 4 arthritis
Symptoms caused by Arthritis
- Crepitation with movement
- Deep, aching joint pain
- Grinding sensation
- Joint swelling
- Loss of muscle strength
- Muscle tenderness
- Reduced movement
- Stiffness
- Tenderness
Treatment
Early stages( Stage 1,2 and Early Stage 3) can be managed by Newer treatments for osteoarthritis focusing on regenerative injection technique Platelet Rich Plasma and Prolotherapy to stimulate repair and healh of ligaments, ligament-bone interface which is where the primary source of pain is located. Cartilage repair is also initiated. Emphasis is on increasing anabolic processes by stimulating repair.

Later stages( Late Stage 3 and Stage 4) are approached in a two-staged manner

Diagnostic genicular block with interarticular ozone infiltration

Cooled or Conventional Radiofrequency Ablation of the genicular nerves

These treatments are a part of a personalized treatment plan for the patient which includes:

MEDICAL MANAGEMENT

STRUCTURED PHYSICAL THERAPY

CLINICAL NUTRITION

LIFESTYLE ASSESSMENT – MODIFICATION

CLINICAL PSYCHOLOGY

People not amenable to any conservative line of management are advised for a Total Knee Replacement if they are medically fit for surgery.