Introduction:
     Dr.Merlin Hazarika is doing her internship at Dr.J.K.Sakia Medical College,Jorhat Assam. She had presented many articles in scientific Journals. Here she discusses the scope of treatment in Osteoarthritis.

 Osteoarthritis
    Osteoarthritis is the most common type of arthritis, affecting many people in the world. The most commonly affected joints are the knees, the hips, hands, feet, and spine. The risk of developing the condition increases with age. It mainly affects people over the age of 40, and is most common among those over the age of 65. In fact, by the age of 65, around 50% of people have OA in one or more of their joints, and around 10% have some disability caused by it.

Pathophysiology
    Primary osteoarthritis is mostly related to aging. With aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates. Repetitive use of the joints over years irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of the cartilage cushion between the bones of the joints. Loss of cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility. Inflammation of the cartilage can also stimulate new bony outgrowths (spurs) to form around the joints. Osteoarthritis occasionally can be found in multiple members of the same family, implying an heredity basis for this condition.

    Secondary causes of osteoarthritis includes obesity, repeated traumaor surgery to the joint structures, abnormal joints at birth diabetes and other hormone disorders.Obesity causes osteoarthritis by increasing the mechanical stress on the cartilage. In fact, next to aging, obesity is the most powerful risk factor for osteoarthritis of the knees. Crystal deposits in the cartilage can cause cartilage degeneration. Heberden’s nodes in the distal phalanges gives valuble sign of oeteoarthritis. Hormone disturbances, such as diabetes and growth hormone disorders, are also associated with early cartilage wear and secondary osteoarthritis. Surgical removal of uterus and ovary results in more cases of osteoporosis now a days.

Symptoms
The symptoms of OA tend to gradually appear over months or years, and usually include:

Pain and stiffness in a joint or number of joints,

The affected joint becoming difficult to move or use, 

The joint ‘creaking’ or ‘cracking’ when moved,

The joint becoming larger than normal, or deformed.

    The symptoms of OA can vary significantly from person to person, and can range from mild and barely noticeable, to severe and disabling. Some may experience the worst of the pain in the morning when they get up, and for some it can be worst while exercising the joint or at the end of the day. Some people also find that damp weather causes more pain in the affected joint.

Diagnosis
     X-rays of the affected joints can suggest osteoarthritis. The common x-ray findings of osteoarthritis include loss of joint cartilage, narrowing of the joint space between adjacent bones, and bone spur formation. Simple x-ray testing can be very helpful to exclude other causes of pain in a particular joint as well as assist the decision-making as to when surgical intervention should be considered.

Treatment and management
    Miasmatic approach gives correct path in treating an oesteoathritic patient. The patients of this category falls predominantly on syphilitic miasm. Even though the degeneration is inevitable owing to aging process a suitable miasmatic remedy can balance the calcium metabolism and put a check to degenerative changes. By saving the patients in both aspects Homoeopathy serves best. Anti syphilitic Medicines like Aurum Met, Acid Fluor, Syphilinum may be used as main remedy.