INTRODUCTION:

 Osteoarthritis (OA) is the commonest musculoskeletal disorder in older individuals, and it is the leading cause of pain, and physical disability ^.According to the American College of Rheumatology Diagnostic and Therapeutic Criteria Committee, Osteoarthritis is defined as a heterogeneous group of conditions leading to joint symptoms and signs which are associated with defective integrity of articular cartilage along with changes in the underlying bone at the joint margins. Pain is the most prominent and disabling symptom of OA resulting in reduced participation in activities and negative effects on mood, sleep, and overall quality of life^. Knee OA is the most common type of OA compared to other joints results in greater physical disability. Development of osteoarthritis include systemic, joint environment and joint overloading factors. Increasing age, female sex, heredity and race are the systemic risk factors. In females, the estrogen deficiency during the menopausal age affects not only the bone and articular cartilage directly but also increases the chance of being obese that in turn will lead to an increase in joint overloading. 

The epidemiological studies show that osteoarthritis affects people above the age of 50 years and more prevalent among female gender. It is suggest that the hormonal changes of menopausal women especially decreasing  estrogen level, lead to increasing OA. OA is the 2nd most common rheumatological problem and most frequent joint disease. The prevalence of osteoarthritis in India ranges from 22%- 39%.  In a WHO study, it has been revealed that by the year 2050, 130 million will suffer from osteoarthritis worldwide, of whom 40 million will be disabled by the disease. Globally, knee osteoarthritis is the fourth significant cause of incapability in women and eighth in men.

Modern system of medicine:

NSAIDs are the most popular drugs to treat osteoarthritic pain. They can be administered either topically or orally. In clinical trials, oral NSAIDs produce ~30% greater improvement in pain than high-dose acetaminophen. Occasional patients treated with NSAIDs experience dramatic pain relief, whereas others experience little improvement. Initially, NSAIDs should be administered topically or taken orally on an “as needed”.

Homeopathy is a natural, safe and effective treatment option for those suffering from osteoarthritis of knee joint of a climacteric age group patient. This alternative medical system was developed by German physician and chemist Dr. Samuel Hahnemann. In Homoeopathy the innermost core of philosophy allows treating the patient on the idea of individualization. Homoeopathy acts both as a preventive moreover as a curative mode of treatment because it relies on the totality of presenting symptoms regardless of the name of disease. The totality includes subjective and objective understanding about the disease state where the underlying cause and also the individual’s susceptibility are being addresses There is a need for medicines that have good efficacy without having side effects, which have low toxicity to the patients with OA. The homeopathic system of medicine has remedies that are already proven on human beings having no side effects to the patients, yet are effective.                                                                                                                             

JUSTIFICATION OF THE STUDY: Although many studies have been done on osteoarthritis of knee joints in all age groups but study on climacteric group is still remain scarce in Homoeopathy. Modern system of medicines use NSAIDS for treatment of such cases which are having short term relief in pain as well as adverse effects in many organs such as kidney, heart etc. with no signifacant improvement in quality of life. Homoeopathic treatment is based on the simple principal of symptoms similarity. With the availability of a great array of remedies in the modern scenario, homoeopathy has a great scope in relieving the long standing symptoms of climacteric woman suffering from osteoarthritis of knee joint and improving overall health related quality of life by administering Individualized Homoeopathic Medicine after through case taking and repertorization using Kent’s repertory.

RESEARCH QUESTION: Is Individualized Homoeopathic Medicine effective in managing the pain and quality of life in patients with OA knee of climacteric age group?

HYPOTHESIS:

Null Hypothesis (H_O): There is no significant role of individualized homoeopathic medicines in managing the pain and quality of life in patients of OA Knee of climacteric age group.

Alternative Hypothesis (H_A): Individualized homoeopathic medicines has significant role in managing the pain and quality of life in patients of OA Knee of climacteric age group.