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 joint 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 sudden or repeated, low-grade trauma, 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, AVN is being diagnosed much
more frequently. Patients in their late 20s and early 30s usually present with
this disease. The condition may happen within a span of a few days to a few
weeks, but the ensuing physical disability may remain life-long. A similar
condition in children, known as Perthe’s disease, may reverse spontaneously
within a year or two.
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. If the causative
factors persist, other joints may become involved.
Most patients taking
biphosphonates, or having undergone core decompression surgery, either do not
benefit at all, or find the beneficial effects to be transitory. Such patients
can be treated with Ayurvedic herbal medicines for a period of about four to
six months and usually get complete and lasting benefit from pain, stiffness,
and limitation of movement.
Patients having the
third or fourth stage of the condition usually require higher doses of
Ayurvedic oral medicines, supplemented with one or several courses of medicated
enemas. Most patients with severe involvement of AVN do recover significantly
with the regular use of Ayurvedic treatment for a period of about eight to
twelve months.
To sum up, modern
treatment is not very effective in controlling the severe pain and other
symptoms associated with AVN. The much touted joint replacement surgery is
available to only a select few, and has its own limitations. Ayurvedic herbal
treatment is a comprehensive, safe and economical treatment for all the stages
of AVN.
The writer, Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com To start Ayurvedic treatment for AVN, click here
