Arthritis "A Necessary Evil" for Pharmaceutical Industry
Submitted by akshat0026 on Mon, 03/10/2008 - 07:14.
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This is My First Blog To Pharmainfo.NET
Pharmaceutical Industries emphasize more on the Advertisement and in the Marketing of the products which are consumed frequently and are on never ending demands.
These products generally come either in the category of Cosmetics or Drugs for general diseases like cough & cold, fever, painkillers etc. Leaving the first two, "Pain is big business in this country," the companies like Unichem Laboratories Ltd., Glenmark Pharmaceuticals Limited are investing more in Pain Management Category and are gaining around a profit of 15% in their yearly sales.
These facts are enough to be praised by a Pharmacist - As a Marketing Representative but Pharmacist - As a Health Counselor; has to check these on growing consumption of Pain relief drugs.
Enacting the role of Social Health Counselor I would like to haul every ones eye on the reason why painkillers are hiking in sales. The disease I found to be responsible for this is Arthritis. I would rather go for the title of “The Necessary Evil,” for the Pharmaceutical Industry, before discussing further first we should have an elemental idea about the Joints, their functions and about the diseases itself.
The Joints and The Arthritis
The skeleton is a framework of joints that support the body and enables it to perform a fantastic range of movements. A joint is a point where bones meet and move against each other. These are in turn controlled by muscles, tendons & ligaments attached to the bones.
The human body comprises more than 200 joints and the principal ones are the elbows, hands, hips, knees, feet & spine.
The word Arthritis literally means “Inflamed Joints”. ARTH means “joint” but not the muscles, tendons, ligaments or bones. ITIS means “inflammation”. However, the term does not exclusively refer to the inflammation of joints.
Arthritis may also indicate a joint that is injured, strained, infected, damaged or worn.
Arthritis may develop in any one or more of joints. This common condition is defined as pain, stiffness or swelling in or around the joint that persists for more than two weeks.
When any joint in our body is affected by arthritis, we experience considerable discomfort and pain.
Let us try to understand the anatomy of a joint.
Anatomy of Joint
The joint is fixed with a layer of cartilage on each side of bone. The surfaces of the two bones are opposite to each other at the joint and helps in the movement of bones in different ways. Let’s take a brief watch on types of joints:
Ø Immovable or Fibrous Joints: The bones are tightly held with the help of white fibrous connective tissue e.g. Sutures between the skull bones.
Ø Slightly or Cartilaginous Joints: In such joints, the opposing surfaces are connected by fibro cartilage that allows very little movement e.g. joints between adjacent vertebrae.
Ø Movably or Synovial Joint: The joint membrane called the synovial membrane surrounds the joint space, provides lubricating fluid for the cartilage surface e.g. Ball & socket(hip & shoulder),Hinge joints(Ankle, knee& elbow)
Fibrous tissue (the joint capsule) connects the bones and gives stability to the joint. Muscles taper down into tendons and attach to the bone usually just above or below the joint. The joint is remarkably well-engineered .The cartilage is spongy and acts like a sponge absorber. The joint is self-lubricating and has a capacity of self-healing from the injury. This is about the joint anatomy in a nutshell.
The Mechanism of Joints
Cartilage is a type of connective tissue, which is present on both sides of the joint at the bone. It is a gristle material, which is tough, somewhat elastic and durable. It does not have the blood supply therefore; it takes its oxygen and nutrients from surrounding joint fluid. When we use a joint, the fluid and waste products gets out of the cartilage due to the pressure and when it is relieved, the fluid gets back together with the oxygen and nutrients. Thus, the health of the cartilage depends on the use of the joint.
Over a period of time, the cartilage may become frayed and as a result, the bone surface on one side of the joint rubs against the bone on the other side of the joint resulting in a less elastic joint surface.
Now, it is easy to understand the causes and symptoms of different arthritis categories.
Major Categories of Arthritis
Mainly people think that arthritis is the name of a single disease but it is not so. There are 127 kinds of arthritis currently known. They are divided into different categories. Each category has a different basic problems and a different treatment according to its nature and severity. They range from rare to common and from trivial to serious. Therefore sometimes it may cause difficulties even for the most skilled doctors to diagnosis the specific arthritis category, which may in turn required laboratory tests and x-rays.
Since our doctors more experienced than us, so we should not deal our arthritis lonely. But we can help our doctors by understanding our symptoms and types of arthritis. So we must be familiar with the different categories of arthritis. Therefore these are defined below for our convenience.
Arthritis Categories
Catilage Degeneration: Thinning of Joint Cartilage.
This is the kind of arthritis, which almost everyone gets with the increasing age and it does not have any response to medical treatment. The disease related to this kind is the Osteoarthritis which is the most common disease people generally have but fortunately it is in mild condition. It causes problem occasionally with very mild stiffness & pain. The tissue involved in Osteoarthritis is the Cartilage.
Ø It is a gristle material that is though, elastic & very durable.
Ø It does not have blood supply hence gets its oxygen & nutrition from its surrounding joint fluid.
Ø Over many years the cartilage become frayed & may wear away entirely.
When we use a joint the pressure expressed by fluid & the waste products get out of the Cartilage and when the pressure is relived, the fluid seeps back together with oxygen and nutrients. Hence the health of the cartilage depends upon the use of the joint.
Synovities: Inflammation of the joint Membrane.
Synovities it is the first and truest kind of arthritis, and Rheumatoid arthritis is a perfect example of this problem. In rheumatoid arthritis the synovial membrane lining the joint becomes inflamed. It is considered that the cells in the synoviel membrane divided and grow, and inflammatory cells come into the joint from other parts of the body. Let’s see what happens in this type of diseases:
Ø Due to the mass of inflammatory cells the joint appears swollen.
Ø The cells release enzymes into the joint space and the enzymes cause further irritation and pain.
Ø The increased blood flow makes the joint warm.
If this process continues for long time these enzymes that, may gradually digest the cartilage and bone of the joints, which in turn damages the joint.
For most people arthritis means rheumatoid arthritis this shows that, how common it is, in the society.
Crystal Arthritis: Inflammation within the
Joint Space
The best example of a crystal arthritis is Gout. It is the most painful disease. Many people think that it is not arthritis. In crystal arthritis, a small mineral crystal formed during the body’s reaction, comes into the joint space causes a painful illness. Now what are the gout crystals?
Ø Gout crystals are made up of uric acid.
Ø The inflammatory reactions caused are extremely intense.
Ø The crystal formed is due to the condition called Hyperuricemia.
Hyperuricemia means increased level of uric acid in blood. This condition is not at all a disease but a variation from normal. In other words we can say that it is the problems related with particular enzymes.
So the easiest way to control uric level in our body is the large intake of fluid and more basic food like sodium bicarbonate (baking soda, NaHCO3). This will result in the faster elimination of uric acid through urine.
Attachment Arthritis: Inflammation of the Joint Attachment
The common disease of this type is known as Ankylosing Spondylitis (A.S.). Now it is also called only Spondylitis. The most common feature of this disease is “Poker spine” & the patients have a very stiff back and are unable to bend. How it is different from Rheumatoid arthritis (R.A.):
Ø R.A. affects the joints of hands & feet while A.S. affects the central parts of the body.
Ø R.A. is a type of Synovitis while A.S. is a type of Attachment Arthritis.
The inflammation in this case is not in the lining membrane of the joint but it is where the ligaments & tendons attach to bones, right next to the joint. That is why it causes more stiffness than pain. The most interesting thing about this disease is that it is a Genetic disease. The gene region-B27 is present on the sixth chromosome.
Common Arthritis
Cartilage degeneration is a universal problem that increases with age. It can also be defined as the change occurring in the skeleton with age. This category contains the most common disease called osteoarthritis. It is the most common form of arthritis and affects mainly people of middle age and older.
Pain Management
This was all about the diseases and its types which clearly shows that the term Arthritis is the complied form of many pain bearing diseases providing a comfortable pedestal for pain killers in market to reach the pinnacle of sales.
For example, In the Pain Management category, Glenmark was the first to launch Valdecoxib in India, a second generation COX2 inhibitor, under the brand names of Valus and Vorth. Glenmark’s Valdecoxib was ranked amongst the most successful products in India. It alone contributed around 10% to Domestic sales.
At this stage a Pharmacist has to act as a Social Health Counselor without creating a controversy in Production Market, but to emphasize on the other alternative for the betterment of public health form this evil.
Earlier we found that the cartilage has self-healing capacity from injury. Also disorders related to this disease mainly affect cartilage of the respective joints. Hence we required the treatment which could boost the natural healing power of the cartilage of the affected joints.
The Nature - based therapies are usually gentle without the adverse reaction. They actually boost the body’s own natural defense by treating the complete person including physical and mental status. They can enhance the general health and well being as well as treat the arthritis. Hence it is the most convenient treatment for such a complicated, severe and sometimes incurable disease. It is because it not only cures the disease but also keep us fit and enables us to do the regular work.
Main Indian Natural based treatments for Arthritis are detailed below:
1.YOGA
The drug treatment can relieve the pain temporarily, but it does not mobilize the joints. One of the main benefits of yogic exercise in arthritis is that sufferers learn to work their joint again. The beneficial effect of yoga therapy is not confined to the joints alone. Yoga enables blood circulation to improve and though it can not reverse arthritis once the condition has set in, it can help to prevent further accumulation of waste matter in the joints.
Yoga also keeps the muscles utilized and helps drainage of toxins from the lymphatic system. The yogic exercise mainly is:
Ø Asanas
Ø Sukshma Vyayam
Ø Pranayam
Ø Relaxation
Ø Cleansing Process
2. NATUROPATHY
Naturopathy comprises a common sense attitude to health based on the body’s own healing capabilities. The body has the power to heal itself provided it is properly treated and maintained. The principal elements of naturopathy are natural resources including fresh air (Vayu), Sun light (Agni), Pure water (Jal), Environment (Aakash) and Earth (Prithvi). In addition to these, good nutrition, hygiene, rest and exercise also help in keeping the body in harmony. Naturopathy believes that the underlying cause of all disease is the unwanted accumulation of waste products and the body’s inability to dispose of these naturally and safely.
The main naturopathic procedures are:
Ø Mud Pack
Ø Local Massage
Ø Various types of Packs.
Ø Wax treatment
Ø Enema
Ø Fasting and diet control.
3. AYURVADIC TREATMENT
It is an ancient Indian medicine system based on natural herbs and minerals. Herbs work quite differently from pharmaceutical drugs. The ingredients of the herbs restore balance and harmony to the whole body rather than simply treating the symptoms. Because the whole plant rather than its isolated chemicals are used, there is less risk of overdose or adverse side effect.
Ayurveda treatment also includes Panchakarma techniques, which eliminates the accumulated waste products from the body and increase the efficiency. This includes:
Ø Massage with oils and herbs. (Snehan)
Ø Herbal Steam Bath (Swedan)
Ø Purification of body with Medicated Enema (Vasti)
Ø Induced Purgation (Virechan).
Today we all are aware from the fact that the average life of the people is now increased, but we cannot neglect that the increased life is accompanied with much more complications. These complications can range from common to rare & trivial to serious.
Arthritis is also one of the most common diseases. One of the 6 persons is now suffering from these diseases. In United States a person has to spend 1$ from his 7$ earned on painkillers.
This is the reason why I have given stress on "The Necessary Evil” because the demand of high production of Analgesics indicating more consumption which in turn setting up the image of Pharmacist as the “Money Makers” on the Cost of Broken Backbones of the Public Health of the Peoples.
This image is totally against the profession of a pharmacist so; I wish that we the pharmacist should put some efforts to scrub out the tag of “Arthritis – A Necessary Evil”.
