Ozone therapy in Rhumatism and arthritis
Arthritis is Inflammation of a joint or a state characterized by inflammation of the joints. , There are more than 100 different types of arthritis, with osteoarthritis being the most common. Osteoarthritis is a degenerative joint disease, due to joint injury, joint infection, or age. Osteoarthritis tends to affect older individuals. Rheumatoid arthritis, psoriatic arthritis, gout, and some other autoimmune diseases are other forms of arthritis.
Patients with arthritis generally experience constant joint pain.
Arthritis can attack neighboring structures, such as the muscles, and even the liver, lungs, kidneys and heart.
Arthritis tends to be a chronic (long-term) disease. Chronic disability due to arthritis is the second most common from of chronic disability, after heart disease.
Rheumatism (or rheumatic disorder)
It is an Indefinite term applied to various conditions with pain or other symptoms of articular origin or related to other elements of the musculoskeletal system.Rheumatic conditions are generally classified as localized, where just a specific location is affected, regional, when a larger region is involved, and generalized, when many parts of the body are painful.
- Localized - bursitis, an inflammation of a small sac between the tendon and bone, or between the muscles.
- Regional - when perhaps there is chest wall pain
- Generalized - fibromyalgia
Common types of arthritis
Osteoarthritis. This is the most common type of arthritis, also called degenerative arthritis., affecting adults of age group above 40 yrs. Osteoarthritis affects both the cartilage, which is the tissue that cushions the ends of bones within the joint, as well as the underlying bone. In osteoarthritis, there is damage to the cartilage, which begins to fray and may wear away entirely. There is also damage to the bond stock of the joint. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips).
Common laboratory tests
Rheumatoid arthritis. This inflammatory disease of the immune system targets first the synovium, or lining of the joint, resulting in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical (occurring equally on both sides of the body). This symmetry helps distinguish rheumatoid arthritis from other forms of the disease. Usually associated with other autoimmune disorders
Juvenile arthritis. This disease is the most common form of arthritis in childhood, causing pain, stiffness, swelling, and loss of function of the joints. This condition may be associated with rashes or fevers and may affect various parts of the body.
Fibromyalgia. Fibromyalgia is a chronic disorder that causes pain throughout the tissues that support and move the bones and joints. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Patients also may experience fatigue and sleep disturbances.
Systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system harms the body’s own healthy cells and tissues. This can result in inflammation of and damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
Scleroderma. Also known as systemic sclerosis, scleroderma means literally “hard skin.” The disease affects the skin, blood vessels, and joints. It may also affect internal organs, such as the lungs and kidneys. In scleroderma, there is an abnormal and excessive production of collagen (a fiber-like protein) in the skin and internal organs.
Spondyloarthropathies. This group of rheumatic diseases principally affects the spine. One common form—ankylosing spondylitis—also may affect the hips, shoulders, and knees. The tendons and ligaments around the bones and joints become inflamed, resulting in pain and stiffness. Ankylosing spondylitis tends to affect people in late adolescence or early adulthood. Reactive arthritis is another spondyloarthropathy. It develops after an infection involving the lower urinary tract, bowel, or other organ. It is commonly associated with eye problems, skin rashes, and mouth sores.
Infectious arthritis. This is a general term used to describe forms of arthritis that are caused by infectious agents, such as bacteria or viruses. Parvovirus arthritis and gonococcal arthritis are examples of infectious arthritis. Arthritis symptoms also may occur in Lyme disease, which is caused by a bacterial infection following the bite of certain ticks. In those cases of arthritis caused by bacteria, early diagnosis and treatment with antibiotics are crucial to removing the infection and minimizing damage to the joints
Gout. This type of arthritis results from deposits of needle-like crystals of uric acid in the joints. The crystals cause episodic inflammation, swelling, and pain in the affected joint, which is often the big toe
Psoriatic arthritis. This form of arthritis occurs in some patients with psoriasis, a scaling skin disorder. Psoriatic arthritis often affects the joints at the ends of the fingers and toes and is accompanied by changes in the fingernails and toenails. Back pain may occur if the spine is involved.
Bursitis. This condition involves inflammation of the bursae, small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursae. Bursitis produces pain and tenderness and may limit the movement of nearby joints.
Tendinitis .This condition refers to inflammation of tendons (tough cords of tissue that connect muscle to bone) caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict movement of nearby joints.
Antinuclear antibody (ANA). This test checks blood levels of antibodies that are often present in people who have connective tissue diseases or other autoimmune disorders, such as lupus.
CCP (or anti-CCP). This test checks blood levels of antibodies to citrulline, a protein that can be detected in up to 70 percent of people in the early stages of rheumatoid arthritis
C-reactive protein test. This nonspecific test is used to detect generalized inflammation.
Rheumatoid factor. This test detects the presence of rheumatoid factor, an antibody found in the blood of most (but not all) people who have rheumatoid arthritis.
Other tests, Complete blood count (CBC). Creatinine. Erythrocyte sedimentation rate (ESR). Hematocrit (PCV or packed cell volume). Synovial fluid examination. Urinalysis.
Imaging Procedures, X rays provide an image of the bones, but they do not show cartilage, muscles, and ligaments. Other noninvasive imaging methods such as computed tomography (CT or CAT scan), magnetic resonance imaging (MRI), and arthrography show the whole joint.
Ozone Therapy in Arthritis:
Mechanism of action of Ozone
- Proteolytic enzymes and endogenous ROS are inhibited
- Bradykinin and inflammatory PG release is inhibited
- Release of immunosuppressive cytokines TGF-beta and IL-10 may inhibit inflammation
- Disappearance of edema leads to improved circulation, washing away of lactic acid and relief in pain
- Ozone injections act as an analgesic
- Algic stimulation of skin can reduce pain through mechanism of Diffuse Noxious Inhibitory Control
- H2O2 may cause irreversible damage and death of nociceptors; consequently activation threshold
- Simultaneous release of endorphins and blocked release of algic stimuli
Mode of administration
- Ozone therapy is given in the form of Injections under aseptic precautions around the knee (Peri articular Injections) and inside the knee joint (Intra articular)
- Peri articular injections are given for 10 to 15 sittings or intra articular injections are done for 3-5 sittings depending upon the age of the patient and severity of the disease