How does a Normal Joint develop Arthritic Changes related to Gout?
In the last unit of Email training about Gout, you knew about Gout, its symptoms and how it affects men, women and obese persons.
Now, you will know about what kind of degenerative changes start in a normal joint and how it starts to turn into Gout. This insight will help you to take care of it with Ayurvedic herbs, home remedies and exercise.
The Normal and Healthy Joint
First, it is important to understand structure of healthy joint. Each Synovial Joint is made up of following structures…
- Two more more bones meeting in one place.
- The bony ends are made up of slippery cartilage tissue.
- Both bony ends are bathing in synovial fluid – a lubricating fluid and are covered with joint capsule.
- Surrounding structure like muscles, tendons, ligaments and bursa surround a joint.
A Healthy joint means that..
- Bones are in good condition, have adequate calcium and protein.
- Bony cartilage is intact and in healthy condition.
- Synovial Fluid is in sufficient quantity.
- Space between cartilage of two bones is adequate.
- Joint capsule and surrounding structures are in healthy condition.
Joint is a living part of body. All of its components – bones, cartilages, synovial membrane, synovial fluid and surrounding structures are constantly reprocessed – as all other living structures.
Gout Versus Osteoarthritis in Ayurveda:
Even though Gout is generally grouped under Arthritis, it is a metabolic disorder of Uric Acid. That is why it is grouped under metabolic disorders as well. The cause of Osteoarthritis is generally aging, wear and tear, injury and poor nutrition and lifestyle habits. Gout is primarily associated with high Uric Acid levels in blood (Hyperuricemia) that causes joints pain or arthritic symptoms.
The normal level of Serum Uric Acid is 3.5-7.2 mg / dl for men and 2.6-6.0 mg /dl for women.
Ayurveda and Gout or Hyperuricemia – What Causes It?
High Uric Acid levels in blood or Hyperuricemia is the universal factor present in Gout. When high blood uric acid is present without causing any symptoms, it is simply called Silent or Asymptomatic Hyperuricemia. At other times, high Uric Acid levels in blood causes different type of problems such as…
- Kidney Stones after deposition of Urate crystals. It is often recurrent in nature.
- Poor Kidney functioning, sometimes, it can cause failure of kidney as crystals block a number of tubules in Kidney
- Arthritis when Urate crystals gets deposited in joints and surrounding tissues.
Why do High Uric Acid level is present in blood in Gout?
Uric Acid is a normal byproduct of Purine (Protein) metabolism in body. Uric Acid is present naturally in body and in various foods such as organ meat, asparagus, mushrooms, meats, herring and anchovies – usually high protein foods with fat. You will be guided about dietary choices and home remedies in upcoming unit.
Normally, excess of uric acid passes through kidneys and body gets rid of it.
Sometimes, either body produces more uric acid or body is not able to get rid of it. In both conditions, the blood level of uric acid rises and cause these problems related with Hyperuricemia.
Ayurveda and Gout – Changes occurring in Gout:
Silent or Asymptomatic Stage: Here, there are no symptoms in body. Only high uric acid level is detected in blood. It can be the ideal time to start our Ayurvedic treatment program.
Kidney Stone or Recurrent Kidney Stone: It is better than Gout Arthritis and can be managed with our Ayurvedic treatment program. However, care has to be taken when there is only Kidney stones with high blood uric acid levels as it might be silent and not causing joints pain and redness. If not treated properly at right time, this might damage Kidney tubules and cause advanced condition of Gouty Arthritis in the backdrop.
Acute Attack of Gout or Flare Ups: It is sudden and acute attack of joints pain, redness and swelling caused when urate crystals get deposited in joints and surrounding structures. This condition lasts from few days to few weeks. When Gout persists, Acute Stage or Flare Ups are more frequent as well as more intense leading to Chronic condition without any resting phase of the condition.
Intercritical or Remissive Stage: This is the stage between Acute Stages. Usually these resting phase might be few weeks or months. Gradually, as these periods become less in duration and even some remnant disease (pain, swelling, redness and difficulty in movement) remains even in this stage.
Chronic Gout: It is a chronic and progressive disorder. It means that it is lasting and you can experience one or more acute episodes in a year when you will have intense pain.
Only High Blood Uric Acid Level
Asymptomatic Condition >7.2
Crystal Deposition in Joints
Recurrent & Chronic Gout
Bone Damage Present
sYMPTOMS OF Gout
acute flare up
Persistent or progressive gout
Chronic & Complicated
Blood Uric Acid
Normal / Slightly Raised
No / +
Between Acute Attacks
No / Less Duration
No / +
Redness in Joints
No / +
Swelling in Joints
No / +
Difficulty in Movement
No / +
Complications of Kidney
No / Rare
No / Rare
Complications of Joints
No / Rare
No / Rare
Ayurveda and Gout – The Healthy Joint – The Functional Integrity:
Ayurveda considers ‘Vata Dosha’ as responsible for all movements, pressure forces and impulses. “Rakta Dhatu” represents blood and associated metabolism. The Ayurvedic term for Gout is Vata-Rakta. It signifies the association of Vata disorder (joint pain) along with vitiated Pitta dosha and Rakta Dhatu.
This term has been used in Ayurveda for millennia and Charaka Samhita has described this disorder in good clarity. The classical symptoms of Gout do represent the truth behind the name – Vata-Rakta. Naturally, the other factor- Doshas and Dhatus – that make part of a joint are affected later on, with the progression of the disease.
Ayurveda and Gout or Hyperuricemia:
The understanding of modern medicine and Ayurveda is almost similar when considering the Gout or Hyperuriceamia. They diverge on the point of treatment and management of this disorder. You don’t find “Uric Acid or Hyperuricemia” in ancient Ayurveda.
However, you can find almost close or better presentation of symptoms that still are characteristic of Gout. Further, the name Vata-Rakta is self-explanatory from Ayurvedic point of view and gives hint toward its Ayurvedic treatment and management.
What Causes Enhances Risk of Gout or Vata Rakta?
- Diet, Herbs and Lifestyle that Vitiate Vata along with Piita and Rakta (Blood Tissue)
- Obesity, Diabetes, Hypertension or Other Lifestyle and Metabolic Disorders
- Specific Medical Drugs
- Surgical Procedures and Hospitalization
- After Organ Transplant Surgeries
Key Insight about Osteoarthritis Ayurvedic Treatment:
You could easily see that this condition becomes worse with passage of time. If you have any of the symptoms that relate with Joints pain or Osteoarthritis, it is always best to start with Ayurvedic treatment.
As time passes by and this condition becomes worse, the duration of treatment is longer and response is also poor.
Gout should be managed and taken care of even when in silent stage. Regularly get Serum Uric Acid level checked periodically.
Case Study of Gout
Mr. Sudeep had been 40+ years of age when he sought management of chronic Gout through Ayurveda. He got quick relief with earlier medical treatment but it relapsed again and again despite dietary restriction. The uric acid level in serum had been 9+, with ++ urates in urine accompanied by pain in big toe, ankle and knee in left leg.
He was put on Ayurvedic herbs for Comprehensive Joints Wellbeing that includes specific herbal products for Joints, Liver detox, body detox and gentle colon cleanse along with stress. The initial response had been poor compared to medical drugs.
After one month of use of Ayurvedic herbs, the recovery had been rapid. The duration of silent phase prolonged with little or no symptoms as well despite some hectic schedule.
About Next Unit:
In the next training session, you will learn about...
- Ayurvedic Treatment plan for Gout or Hyperuricemia adopted by Dr. Vikram Aditya Tomar
- How everything fits in generating a synergistic approach
This will help you to understand the landscape of Ayurvedic treatment and holistic management of Gout.
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