Essay on Diseases of Bone, Joint and Connective Tissues

Read this essay to learn about Diseases of Bone, Joint and Connective Tissues. After reading this essay you will learn about: 1. Acute Osteomyelitis 2. Osteoporosis 3. Osteomalacia 4. Olecranon Bursitis 5. Frozen Shoulder 6. Acute Rheumatism (Acute Rheumatic Fever) 7. Rheumatoid Arthritis 8. Osteoarthritis 9. Low Back Pain or Lumbago 10. Cervical Osteoarthritis or Spondylosis.

Content:

1. Essay on Acute Osteomyelitis
2. Essay on Osteoporosis
3. Essay on Osteomalacia
4. Essay on Olecranon Bursitis
5. Essay on Frozen Shoulder
6. Essay on Acute Rheumatism (Acute Rheumatic Fever)
7. Essay on Rheumatoid Arthritis
8. Essay on Osteoarthritis
9. Essay on Low Back Pain or Lumbago
10. Cervical Osteoarthritis or Spondylosis

Essay on Disease # 1. Acute Osteomyelitis:

A young person, after suffering a local injury, comes with severe pain and extreme local tenderness, starting near the end of a long bone, pus making its way to the surface under the periosteum with local swelling, redness and heat. There is a marked temperature around 104° F. The condition is ACUTE OSTEOMYELITIS.

Acute osteomyelitis is often due to coagulase-positive staphylococcus arising from the focus on the skin, in the tonsils or from the wound. At times pneumococci or H. influenzae is responsible. The infection is due to bacteremia. A small abscess is formed which makes its way up towards the surface under the periosteum or occasionally in the medulla of the bone.

Calcarea Phos:

Calcarea Phos suited to delicate and tall thin children, scrofulous and of gouty constitution. Bones are osteoporus, slow ossification, non-union of bones, rickets. This is typically tubercular constitution, and is prescribed on the constitutional expression.

Fluoricum acidum:

Fluoricum acidum it has an action on the long bones causing decay and necrosis and favours the expulsion of the necrosed part. Destructiveness is the key-note of this add and produces slow deep destructive effects. The patient is compelled to move about energetically. The tissues are puffy, indurated, and fistulous. Discharges are thin, foul, acrid, causing itching. Fluoric acid is hot patient and always better by cold.

Aurum metallicum:

Aurum is suited to sanguine people with syphilitic and mercurial traits when implanted on to scrofulous characters. Destruction of bones is like secondary syphilis. Pains in bones are mostly at night. Bones of head, lumps under the scalp, exostosis, decay of nasal, palatine and mastoid bones fall under its influence.

Soreness of the affected bones, better in open air, and are worse at night. Paralytic and tearing pains in the joints. There is cold foul sweat in the feet. Boring pains and burning stitches predominate.

Mezerium:

Mezerium it is a vegetable analogue and is most important antidote to mercurius. Mezerium affects the skin, bones, nerves, and mucous membranes and is very sensitive to cold air. Decay and exostosis of bones, periostitis, and bones seem enlarged. The secretions are acrid and has lot of pus.

Bones, specially the long bones are inflamed, and swollen, develop decay and exostosis; the pains are worse at night. Burning in tibia and in the long bones. From the eruption that develops over the osteomyelitic area, ooze acrid gluey moisture, often green in colour, form a thick crust, scabs with pus beneath. The ulcer is thick and hard and painful.

Silicea:

Silicea useful in diseases of bones and cartilages, decay and necrosis. Softening of bones. Silica can stimulate the organism to reabsorb fibrotic conditions and scar tissues. It is related to all pustulous borrowings — Felons, abscesses, boils, old scar ulcers. It promotes expulsion of foreign bodies. In osteomyelitis, the pus and the sequestrum formed by the decay and necrosis of the bone.

Gunpowder:

Gunpowder it is mixture of Carbon-sulphur-kali nitricum. Gun-powder is for healing the wounds which refuse to heal. Also is a very good remedy for acute infections, boils, abscesses and bites. It has antiseptic properties. Low potency of Gun-powder is used.

Essay on Disease # 2. Osteoporosis:

Post-inenopausal woman or an elderly man complains of low back pain which is occasionally more severe with a minor fall or an injury. The condition may be OSTEOPOROSIS. Osteoporosis is the reduced bone mass per unit bone volume.

This leads to reduced strength and increased risk of fracture often with even a minor trauma. The bone mass decreases with increasing age and osteoporosis is commonest in post-menopausal women as oestrogen prevents bone resorption. This group is more prone to fractures specially Colles, neck of the femur, and vertebral sites.

Calcarea carb, and Calcarea phos:

Calcarea carb, and Calcarea phos are two major remedies for this condition. This will promote the absorption of calcium from the food that the patient takes. But all the same it will be necessary to supplement large doses of calcium and vitamin D for early benefit. High consumption of milk is advised. Apart from this it is necessary to determine the constitutional remedy so that it can be given intermittently during the course of the treatment.

Essay on Disease # 3. Osteomalacia:

An adult presents with bone and muscle pain and tenderness, often due to sub­clinical fracture and the signs of proximal myopathy with a characteristic waddling gait. The condition is OSTEOMALACIA.

Asafoetida:

Asafoetida the pains in the limb, particularly in the tibia, are intolerable and are mostly at night. There is severe backache, preventing any work. Cold swelling around the ankle. Painful periosteum, swollen and enlarged. Decay of bones and deep ulceration producing thin ichorous pus. The pains are pressive, sharp, stitching and extending outwards, associated with numbness. Pains change place and are better by touch.

Mercurius vivus:

Mercurius vivus patient is very sensitive to cold. Bone pains deep or near the surface. Worse at night. Must go out and walk about. Trembling limbs, especially the hands, as in Parkinson’s disease. Lacerating pains in the joints. Dropsical swelling of the feet and legs. There is a sensation as if the knees are larger.

Disease Type # 4. Olecranon Bursitis:

Patient complains of sudden pain in the elbow after an history of repeated trauma with slight swelling and tenderness. The condition is OLECRANON BURSITIS. There are numerous bursae around the body and any of these can become inflamed.

They may appear for no obvious reasons or they may be secondary to trauma, repetitive injury, or arthritis. In many cases no treatment is required but only protection to the inflamed site.

Rata:

Rata is one of the chief remedies for injuries of joints, tendons, bones and bursae. Pains are bruised. Complains from straining flexor tendons, bursitis with cracking in joints; worsq, walking in open air.

Bellis perennis:

Bellis perennis muscular and joint rheumatism, post-traumatic and rheumatic myalgic pains. Joints are sore. Muscular soreness. Wrist feels contracted as from elastic band. Better from continued motion, cold application. Worse from cold and immobility, sprains and injuries.

Lycopersicum:

Lycopersicum intense aching, rheumatic pain in the muscles of all limbs, with lame and tired feeling. Sharp pain on the right deltoid and pectoral muscles, worse lifting arm upwards and outwards.

Bryonia:

Bryonia swelling of elbow, every spot is painful on pressure. Along with typical bryonia symptoms.

Essay on Disease # 5. Frozen Shoulder:

Patient complains of unilateral pain the shoulder, at times in both the shoulders, with radiation of pain to the arm, aggravated at night. The condition is FROZEN SHOULDER. It is a common condition occurring in adults at any age.

In most cases this condition appears without any obvious cause, but it can be occasionally related to overuse or injury. There is restriction in the glenohumeral movement. In a mild case simple exercises can correct the situation. Physiotherapy is the best solution apart from some minor medication. Patient should be encouraged to move the shoulder and some hot fomentation of short wave diathermy may be advised.

Ferrum met:

Ferrum met has cracking in joints, particularly in the shoulder, has an irresistible desire to bend the arm, with intense pain. Sudden cramps or tearing pain in the limbs. Rheumatic symptoms, especially of the left shoulder.

Thiosenaminum:

Thiosenaminum it is useful in torn ligaments, especially in the shoulder.

Rhus toxicodendron:

Rhus toxicodendron the joint is hot and painful swelling. The pains are tearing, and spreads over a large surface of the nape of the neck, better by motion. Limbs get stiff and paralyzed. Worse after midnight, blows, jar, riding, ice-cold drinks.

Ruta:

Ruta is one of the chief remedies for injured joints, tendons, bruised bones. Cracking of joints, worse walking in the open air. Tendons are sore aching pain. Worse from over-exertion injury.

Sanguinaria:

Sanguinaria rheumatism of the right shoulder. Cutting pain or stiffness in the right deltoid, worse on raising and turning arm. Pain is worse at night.

Essay on Disease # 6. Acute Rheumatism (Acute Rheumatic Fever):

A child or a young adult complains of acute pain and often swelling in several joints. As the inflammation subsides in these joints others are affected. The patient has high temperature and there may he cardiac involvement—endocarditis. The condition is ACUTE RHEUMATISM (Acute Rheumatic Fever).

There is usually a history of tonsillitis due to (haemolytic streptococcus) infection a week or two previous to the present complaint. The attack of acute rheumatism comes on with fever and joint pains appear within 24 hours. The usual accompaniment of fever present.

The joint pains are wandering and without suppuration. One by one the joints get affected with the resolution of swelling and pain of the previous joint. The joints are acutely painful on the slightest movement, warm and tender to touch and more likely to show effusion in adults.

Cardiac involvement is the most important; is less amenable to treatment and the permanent damage sets in. In children, mitral endocarditis sets in.

Aconite, Belladonna, Bryonia, Arsenic alb, Rhus tox: are those remedies which are normally indicated at the onset of the fever. If prescribed in time, chances are that the condition can be aborted. After the acute phase of temperature is over, the pains in the limbs and joints are experienced by the patient.

Colchicum:

Colchicum it affect markedly muscles, fibrous tissue, serous membrane, small joints, with stitching pains in the muscles, periosteum and the joints. These shift rapidly and the swellings are very minimal. Tingling, crawling. Pains are digging, drawing worse by mental exertion and emotions, slightest touch and vibrations.

There is anxiety in the region of the heart, oppression, better on walking. The pains are worse in the evening and warm weather. Joints become stiff and feverish, shifting rheumatism.

Kalmia latifolia:

Kalmia latifolia it has prominent action on the heart. The pains are neuralgic, and tingling numbness, trembling and paralytic weakness. Deltoid rheumatism is common, fluttering heart with anxiety. Pains along the ulnar nerve, goes into third or fourth finger.

The joints are red hot, tingling and numbness of the left arm. Neuralgia of the right side, wandering rheumatic pains, which travel from above downwards, tumultuous action of the heart and slow pulse.

Essay on Disease # 7. Rheumatoid Arthritis:

A woman complains of stiffness and later pain and swelling in the joints of the fingers. And later there is affection of the larger joints. This condition progresses and is associated with constitutional symptoms and some pyrexia. The condition is probably RHEUMATOID ARTHRITIS.

Rheumatoid arthritis (RA) is a chronic multi-systemic disease of unknown etiology. The characteristic expression of RA is persistent inflammatory synovitis, usually affecting the peripheral joints in symmetric distribution. But there is a possibility of variety of systemic manifestations.

Rheumatoid Arthritis usually presents with insidious onset of pain and stiffness, in the small joints of the hands and feet which eventually lead to characteristic bilateral symmetrical peripheral polyarthritis.

These pains are worse in the morning on waking up, and may improve with activity. Often there are pains in the night and sleep gets disturbed. The morning stiffness often lasts for long hours. Fatigue and general malaise are common. There are also non-articular symptoms present like swelling, caused by effusion, warmth, tenderness on pressure or movement. Deformities occur in the later stages of the disease.

Rheumatoid Arthritis is a multi-miasmatic disorder and all these miasmatic expression can follow one after the other or can be present at one time. Psoric inflammatory stage, proliferative sycotic phase, and destructive tubercular and syphilitic phase need to be treated at their phases in a case. Treatment will depend upon the constitution and the phase in which one receives the case.

Calcarea carb:

Calcarea carb it is an antipsoric constitutional remedy. Persons of scrofulous type, who take cold easily. Tendency to grow fat. Disorders caused by working in water. In the back there is pain as if sprained, can scarcely rise from over lifting. Vertebrae feel loose, painful on pressure. Rheumatism of the lumbar region with weakness in the small of the back. Neck stiff and rigid.

Faulty development of bones. Calcarea has cold clamy feet as if wet stockings are on, with lot of growing pains. Joints as if sprained. Rheumatoid pain as after exposure to cold. The joints look deformed, especially the knee.

Arthritic nodosities, cold, sour, swelling, perspiration, burning of soles of feet are some of the characteristics. While taking the history for RA apart from the local symptoms of the pains in the joint these characteristic qualities will be considered.

Calcarea fluoricum:

Calcarea fluoricum there are bony growths, exostosis, and deformities of bones. Cracking in joints and easy joint dislocation, and synovial swellings. Chronic synovitis of the knee joint. Joints are worse at the beginning of the movement.

Worse with the cold weather but always better in warmth. There is crepitation of joints from lack of synovial fluid. Piercing, darting, grinding pains in all joints. Cramps in muscles of legs.

Apis mel:

Apis mel it forms serous inflammation with-effusion, extreme sensitive to touch, great burning and stinging in the affected parts — worse from heat in any form. Rheumatic pains in the back. Stiffness in the back of the neck. Knees are swollen, sensitive shining sore with stinging pains. Any joint that is affected looks puffy and red, shining and sensitive to touch.

Formica rufa:

Formica rufa causes many rheumatic and gouty pains the pains — which appear suddenly and dart from place to place. Rheumatism comes on suddenly, with restlessness. Muscles feel torn from their attachment. Stiffness and contracture of joints.

Guaiacum:

Guaiacum tearing and stinging in the limbs. Contractions of the affected parts. Marked stiffness of the affected limb. Joints are swollen, puffy and hot. Cannot tolerate pressure or heat.

Colchicum:

Colchicum it is a cold damp weather remedy especially in spring and autumn. It acts on the fibrous tissue, on the periosteum, and synovial membranes of joints, especially the small joints. It does not tend to suppuration. The joints are swollen and puffy, sensitive to touch or jars. Large joints are intensely red and hot, small joints are swollen numb and stiff. Pains go from left to right. Stitches in the right shoulder.

Kali iodatum:

Kali iodatum useful in chronic periosteal rheumatism of syphilitic origin. The condition is aggravated at night and lying on painful side. Jerking of tendons, contractions, tendons are hard and stiff, drawn tightly to palms, chilliness predominates.

Pulsatilla:

Pulsatilla wandering pains shift rapidly from place to place, and ever-changing symptoms. Caused by getting wet in the rains or water and protracted hot weather.

Essay on Disease # 8. Osteoarthritis:

A middle-aged or elderly patient complains of progressive pain in one of the several joints; stiffness and grating are felt on movement but there are no constitutional symptoms. The disease is likely to be OSTEOARTHRITIS.

Osteoarthritis (OA) is degenerative joint disease. No predisposing factor is apparent. Pain is typically in the knees, hips or hands, they are worse in the evenings and aggravated by movement, relieved by rest. Initially the pains are intermittent. Morning stiffness lasting up to half an hour or so and stiffness after sitting.

Characteristic swelling hard and bony, sometimes associated with effusion. Crepitus on movements. Signs of inflammation, warmth in the knee, and erythema in the small joints of the hand. Limitations of the movement follow with wasting of muscles around the affected joint.

Bryonia alba:

Bryonia alba joints are painful red, swollen and hot, with stitches and tearing worse on least movement. Every spot is painful on pressure. Pains better by lying down and the same side of pain. Knees totter and bend under him while walking. Knee is stiff and painful. The muscles are sore and painful. Mucus membranes are dry and serous membranes are inflamed.

The modalities are characteristic. Better on lying on the painful side, by pressure, rest and cold things. Better from bandaging. Better by drawing knees up. Irritability of mind and tissues runs through the remedy. Dropsical swelling of the leg, sensitive to touch, joints are stiff and red, swollen, stitching pains with the slightest touch.

Kali carb:

Weakness is caused by all the salts of potassium, but Kali carb has these symptoms pronounced. There is weakness of the muscles of the heart, back of the limbs, including the weakness of the intellect. Fibrous tissues, ligaments of joints of uterus, of lumbar back are particularly affected.

Producing relaxation, joints give way, back feels .as if broken, and the patient feels compelled to lie down or lean on something. Sharp stitching pains, stabbing or catching pains are felt in various parts of the body joints, chest, muscles, head, lying on affected side. Back is stiff and paralytic feeling, with burning in spine. Lower back feels weak. Pain in the buttocks extends to thighs, even to the knees.

Rhus tox:

Rhus tox it affects the fibrous tissues, markedly joints, tendons, sheaths etc., producing pain and stiffness. It causes stiffness of the muscles and joints. He is always better in changing position. The ailments are from strain, over-lifting and getting wet while perspiring.

The pains are tearing, shooting, and stitching, worse at night and cannot rest in any one position — therefore restless. Rheumatic pains are in damp cold weather. Better by heat and hot bath, elevating the feet.

Ruta:

Ruta bursitis cracking in joints, worse on walking in open air. Pains and stiffness in the fingers and wrist. Knees give way while ascending and going down. Tendons are sore. Aching pain in the Achilles.

Kalmia lat:

Kalmia lat the pains of Kalmia are neuralgic. It is a rheumatic remedy. Pains shift rapidly, shooting outwards along the nerve. Deltoid rheumatism, especially at night. Pains from hip to knees. Kalmia pains travel from above downwards. Pains are worse from motion (Bry).

Phytolacca:

Phytolacca rheumatic pains worse in the morning, mostly in the shoulders, with stiffness, causing difficulty in raising the arm. Pains fly like electric shock;— shooting lancinating and shifting rapidly. Sharp cutting in the hips, legs are drawn up and cannot touch the ground. Aching of heels, relieved by elevating feet.

Hot painful swelling of the joints. Soreness of the condyles of the bone, limbs are stiff and paralyzed. Intolerance to cold fresh air. Rheumatoid pains develop about the joints, painful stiffness in the back.

Ledum palustre:

Ledum palustre it affects the fibrous tissue of small joints — ankles, tendons, heels, and skin. Rheumatism begins in the lower limbs and spreads upward, cramps over the hip joint, cracking of joints, worse on warmth of bed, heels are sore, can hardly step on them. Easy spraining of ankles and feet, tendon. Ankles are swollen and tender after injury, better by application of ice.

Manganum aceticum:

Manganum aceticum it has special affinity for periosteum of shin bones, joints, ankles and lower limbs. Inflammation of bones with nightly digging pains, growing pains and weak ankles. General soreness and aching, every part of the body feels sore when touched.

It has chronic arthritis, with infiltrated glistening joints. Suppuration of the skin around the joints. Shiny and red swelling of the joints, knee pain and itching, burning spots about the joint.

O AN (Osteoarthritic nosode):

O AN (Osteoarthritic nosode) it is made from the synovial liquid of arthritic joints. Pains are aggravated by the first movement, at night, better by prolonged movement. Worse right side. Pains are more marked in the Achilles tendon.

Essay on Disease # 9. Low Back Pain or Lumbago:

Patient, usually a tired housewife who has been gaining weight and whose spine is assuming faulty posture, experiences dull nagging pain in the lumbosacral area which aggravates after sitting in a chair in a flexed position, or while stretching the back with knees straight, especially after lifting a heavy weight. The condition is LOW BACK PAIN or LUMBAGO.

One should differentiate this condition from more frequently presented condition which sets in with sudden crippling pain, often spreading into one or both sciatic nerve, called Intervertebral Disc Lesion, and Osteoarthritis of the lumbar spine, and Ankylosing Spondylitis.

In fact it will be worth-while to refer to a repertory for these conditions since there are so many modifying symptoms which need to be considered. But most common remedies indicated will be discussed:

Rhus Tox:

According to Hahnemann, Rhus tox is is the most efficacious and a specific remedy for frequently fatal effects of over-lifting, inordinate exertions of muscles and contusions. His observation led to the most important symptom — bruised and sprain-like and stiffness in the back. There is stiff neck with painful tension when moving.

Pain and stiffness in the small of the back, better motion when lying on something hard, worse while sitting. The backache is constrictive, better on hard pressure or bending backwards. Rhus affects fibrous tissues—markedly joints, tendons, sheaths, producing pain and stiffness. Motion limbers up the Rhus patient and he, therefore, feels better for a time from change of position. Cold damp season is worse.

Tellurium:

Has restlessness and pains all over the body, very sensitive back. Afraid cannot bear to be touched on sensitive areas. Sacral and sciatic pains. Weak feeling in the back, pressing aches in the scapula, numbness in the nape and occiput.

Pain from the last cervical to the fifth dorsal vertebra, very sensitive to pressure and touch. Sensitive spinal column on coughing and sneezing, straining. The neck pain spreads into shoulder, and between the scapula. Lumbar pain spreads to the right thigh, ameliorated by walking.

Sepia:

There is weakness in the small of the back when walking, usually associated with uterine complaints. Collar feels tight, coldness between the shoulders, sudden pain in the back as if struck by hammer, worse on stooping, and kneeling. Back pain is better by belching, by pressing back against something. Hard stiffness of limbs; worse after sleep.

Cimicifuga:

The pain across the pelvis from hip to hip. Menses are with severe backache, more the flow more the pain. Useful in rheumatic persons. Plump, delicate, sensitive, nervous, chilly, women who complain of aching pain in the back, neck, here and there.

Rhematic pains in the muscles of back and neck. Stiffness and contractions in neck and back. Pain in the neck is worse sensitive and worse on pressure, which causes nausea. Pain in the lumbar and sacral regions, down thighs and through hips, crick in the back.

Aesculus:

There is a characteristic backache that incapacitates the patient and makes him useless for any work. Backache of sacrum and hips, worse on walking or stooping. Pains are lightening. Back feels weak. He has to make repeated efforts to rise from sitting position. Pains are so severe that it makes almost impossible to walk.

Essay on Disease # 10. Cervical Osteoarthritis or Spondylosis:

Patient complains of dull aching or burning pain in the occipital area or in the lower neck or in the arm, associated with paraesthesiae. The condition is CERVICAL OSTEOARTHRITIS or SPONDYLOSIS. It is usually due to poster lateral disc protrusion and, sometimes, to changes in the articular surfaces.

The result is narrowing of the intervertebral foramina by osteophytes. Between cervical C-3 -7, specially in the C5 and C6-7 area. Initially there is complaint of stiffness, and limitation of movement. Gradually this becomes more aggravated and causes compression of the cervical nerve roots.

Rhus Toxicodendron:

Rheumatic pains spread over a large area of the surface of the neck, better by motion. Soreness of the condyles of the bone, limbs become stiff and paralyzed. Cannot tolerate fresh cold air. After overwork there is pain in the limbs. Pains travel along the ulnar nerve. Loss of power in the hands and forearm with crawling sensation in the tips of the fingers.

Lachnantes tinctoria:

There is stiff neck and the head is drawn to one side, with rheumatism of the neck, the pain is as if dislocated. Tearing from the shoulder, extending to finger joint, thumb and index finger feel as if sprained.

Radium bromatum:

Sharp pains in the shoulder, arms, hand, fingers. Neck feels very hard and brittle and feels as if they would break on moving. Pain and lameness in the cervical vertebrae, worse on dropping head forward, better on standing or sitting erect.

Paris quadrifolia:

There is weight and weariness in the nape of the neck. Violent pain in both sides of the neck, extending down to fingers; worse on mental exertion. Neuralgia beginning in the left intercostal region and extending to the left arm. Arms become stiff, fingers clenched, fingers feel numb, and everything feels rough. It is a left-sided remedy but coldness is in the right side of the body while the left side is natural and hot.

In all these cases of lumbar spine spondylosis, more than the remedies physiotherapy will be very useful. A competent physiotherapist can give good and appropriate exercises so that the condition can be greatly eased quickly.