Avascular necrosis (AVN) is a disease in which the blood supply to the head of the joint bone reduces drastically, causing a complete disorganization and ultimate collapse of the head of the bone. Though the hip joint is most commonly affected, AVN can also involve other joints such as the shoulder. This condition may be caused due to long-term use of steroids, excessive intake of alcohol, and chronic diseases like blood disorders and auto immune disorders. Of late, there has been a gradual increase in the incidence of auto immune disorders with a resulting increase in the use of steroids; hence, AV N is being diagnosed much more frequently. Patients in their late 20s and early 30s usually present with this disease.
The conservative management of this condition in the modern system of medicine is to give biphosphonates in order to possibly reduce the rate of decrease of calcium and thereby preserve the joint structure to the maximum extent possible. This is supplemented with graded physiotherapy to preserve joint function and maintain muscular strength. A slightly advanced condition calls for core decompression surgery in order to reduce stress on the joint. Further management is only with the use of pain killers like paracetamol, and to adopt a ‘wait and watch’ policy. Patients who progress to the third or fourth stage of the disease involving gross destruction of the joint are usually advised total replacement of the joint. Joint replacement surgery can be prohibitively costly; in addition, it may not provide the full range of movement which the person previously had with a normal joint.
In this scenario, Ayurvedic herbal treatment can be very successfully utilized to bring about a complete and effective management of AVN. Ayurvedic treatment can differ from patient to patient, depending upon the presentation of the disease as well as severity of symptoms, which usually include pain, stiffness, rigidity, and limitation of movement. Patients with a very mild condition can be given medicines to reduce inflammation, treat muscular spasm, increase blood supply to the joint, as well as provide medication to help reorganize the joint structure. This is usually supplemented with local therapy in the form of application of medicated oils and local fomentation. Mild exercises also help along with oral medication and local therapy. This treatment is usually sufficient for patients suffering from the second stage of AVN.
Unfortunately, most patients present for Ayurvedic treatment when AVN has progressed to stage 3 or 4, that is, the last stages of the condition. In this scenario, highly aggressive treatment needs to be instituted to bring about an early resolution of symptoms and healing to the maximum extent possible. Ayurvedic medication needs to be given in high doses for a period of at least six to eight months. In addition, highly fortified medicated enemas are given once every week for a period of two or three months.
Even in an advanced stage of AVN, Ayurvedic herbal therapy is highly effective and successful in treating and resolving all the symptoms of pain, stiffness and limitation of movement. Patients who take treatment and physiotherapy regularly become free of symptoms in just a span of three to five months and carry on their day-to-day activities in a normal way. Medications can then be tapered gradually depending upon the response of the patient and severity of symptoms. Low dose supplementation therapy can be continued in order to maintain the process of joint healing and reorganization, as well as to prevent a relapse of the condition.
Ayurvedic herbal therapy is safe even for long-term use. Ayurvedic herbal treatment can thus be judiciously utilized in the successful and effective management of AVN at all its different stages of presentation.