Avascular necrosis (AVN), also known as osteonecrosis or ischemic bone necrosis, is a condition that occurs when the blood supply to a bone is disrupted, leading to the death of bone tissue. The term “avascular” refers to the lack of blood supply, and “necrosis” means tissue death.
In a healthy bone, blood vessels supply oxygen and nutrients to the bone tissue, allowing it to function properly and maintain its structural integrity. However, various factors can interrupt this blood flow, leading to AVN. The lack of blood supply deprives the bone of essential nutrients and oxygen, causing the bone tissue to die.
AVN can affect various bones in the body, but it commonly occurs in the hip joint. Other commonly affected areas include the knee, shoulder, ankle, and wrist. AVN can occur in one or both sides of the body, and it can affect multiple joints simultaneously.
There are several known causes and risk factors for AVN, including:
Trauma: Injury or trauma to a bone can disrupt the blood supply and lead to AVN. Fractures, dislocations, and joint injuries are examples of trauma that can cause AVN.
Steroid use: Prolonged or high-dose use of corticosteroid medications can increase the risk of AVN. Steroids can affect the body’s ability to maintain healthy bone tissue and impair blood flow to the bones.
Alcohol abuse: Excessive alcohol consumption can weaken bones and impair blood circulation, increasing the risk of AVN.
Medical conditions: Certain medical conditions, such as sickle cell disease, lupus, HIV infection, and autoimmune disorders, can predispose individuals to AVN.
Radiation therapy: High-dose or prolonged radiation therapy for cancer treatment can damage blood vessels and increase the risk of AVN in the nearby bones.
The symptoms of AVN vary depending on the affected bone and the stage of the condition. In the early stages, there may be no symptoms or only mild discomfort. As the condition progresses, symptoms may include joint pain, limited range of motion, stiffness, and difficulty bearing weight on the affected joint.
The diagnosis of AVN typically involves a combination of medical history, physical examination, and imaging studies such as X-rays, magnetic resonance imaging (MRI), or bone scans. These tests can help evaluate the extent of bone damage and determine the most appropriate treatment approach.
The treatment of AVN aims to relieve pain, preserve joint function, and prevent further deterioration of the bone. The specific treatment options depend on factors such as the stage of AVN, the affected bone, and the underlying cause. Treatment may include:
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain medications can help manage pain and inflammation associated with AVN.
Physical therapy: Exercises and physical therapy can improve joint function, strengthen muscles around the affected joint, and reduce pain.
Assistive devices: The use of crutches, canes, or walkers may be recommended to relieve pressure on the affected joint and assist with mobility.
Surgical interventions: In advanced cases of AVN, surgical procedures such as core decompression, bone grafting, joint replacement, or joint-preserving surgeries may be necessary.
The prognosis of AVN depends on various factors, including the stage of the condition, the affected bone, and the underlying cause. Early detection and appropriate treatment can help manage symptoms, preserve joint function, and slow down the progression of AVN. However, in severe cases, where significant bone damage has occurred, joint replacement surgery may be required to restore function and alleviate pain.
Acupuncture points for Avascular Necrosis (AVN)
Acupuncture is a traditional Chinese medicine practice that involves the insertion of thin needles into specific points on the body. While acupuncture can provide pain relief and promote overall well-being and can be used as a complementary therapy to manage the problem Here are acupuncture points that are commonly used in the treatment of AVN:
GB34 (Yanglingquan): Located on the outside of the lower leg, below the knee. This point is used to strengthen the tendons and bones and promote circulation in the affected area.
SP9 (Yinlingquan): Found on the inside of the lower leg, below the knee. It is used to tonify the spleen and benefit the bones.
ST36 (Zusanli): Situated on the front of the lower leg, below the knee and outside the shinbone. This point is known for its ability to tonify qi (vital energy) and promote overall health.
SP6 (Sanyinjiao): Located on the inside of the lower leg, above the ankle. This point is commonly used for promoting blood circulation and relieving pain.
KD3 (Taixi): Found on the inside of the ankle, between the ankle bone and Achilles tendon. It is believed to strengthen the kidneys and benefit bone health.
BL40 (Weizhong): Situated in the middle of the back of the knee crease. This point is used to relieve knee pain and promote circulation in the lower limbs.
GB39 (Xuanzhong): Located on the outside of the lower leg, just below the knee joint. It is used to strengthen the tendons and relieve pain in the lower limbs.
LI4 (Hegu): Found in the webbing between the thumb and index finger. This point is known for its analgesic properties and can be used to relieve pain.
LI11 (Quchi): Situated on the outer side of the elbow crease. It is used to clear heat and reduce inflammation in the body.
LV3 (Taichong): Located on the top of the foot, between the big toe and the second toe. This point is believed to promote the free flow of qi and benefit the liver.
GV20 (Baihui): Found on the top of the head, midway between the ears. It is used to tonify qi and promote overall well-being.
GV14 (Dazhui): Situated on the back of the neck, below the seventh cervical vertebra. This point is known for its ability to strengthen the bones and relieve pain.
LV8 (Ququan): Located on the inside of the lower leg, below the knee. It is believed to benefit the liver and promote blood circulation.
SP10 (Xuehai): Found on the inside of the thigh, about three finger-widths above the kneecap. This point is used to clear heat and promote blood circulation.
KD7 (Fuliu): Situated on the inside of the ankle, just above the prominence of the ankle bone. It is used to tonify the kidneys and promote circulation in the lower limbs.
HT7 (Shenmen): Located on the inside of the wrist, in the depression between the two tendons. This point is known for its calming and pain-relieving effects.
BL17 (Geshu): Found on the back, at the level of the lower border of the shoulder blades. This point is believed to nourish the blood and promote circulation.
BL23
BL60 (Kunlun): Located on the outside of the ankle, between the Achilles tendon and the prominence of the ankle bone. This point is used to relieve pain and promote circulation in the lower limbs.
GB30 (Huantiao): Found on the outside of the hip, in the depression behind the greater trochanter. It is used to alleviate hip pain and promote blood flow in the affected area.
It’s important to note that acupuncture treatments should be performed by a trained and licensed acupuncturist. They will consider your specific symptoms, medical history, and overall condition to develop an individualized treatment plan. Acupuncture may be combined with other therapies to provide comprehensive care for AVN, but it’s always best to consult with a healthcare professional for a proper diagnosis and guidance on appropriate treatment options.
Tips to manage Avascular Necrosis (AVN) naturally
While avascular necrosis (AVN) often requires medical intervention, there are several natural approaches that can be incorporated into your overall management plan. It’s important to note that these tips are not intended as a substitute for medical advice, and you should consult with your healthcare professional before making any significant changes. Here are 15 natural tips to help manage AVN:
Pain management: Use hot or cold compresses, gentle massage, or over-the-counter pain relievers to manage pain and inflammation.
Weight management: Maintain a healthy weight to reduce stress on the affected joints and bones.
Physical therapy: Engage in specific exercises and stretches recommended by a physical therapist to improve joint mobility, strengthen supporting muscles, and enhance overall function.
Low-impact exercises: Opt for exercises that are easy on the joints, such as swimming, cycling, or tai chi, to improve cardiovascular health and promote joint mobility.
Rest and modify activities: Take breaks when needed and avoid activities that put excessive strain on the affected joints.
Assistive devices: Consider using assistive devices like crutches or canes to reduce weight-bearing stress on the affected joints.
Herbal remedies: Certain herbs, such as turmeric, ginger, and boswellia, have anti-inflammatory properties and may help manage pain and inflammation. Consult with a qualified herbalist or healthcare provider before using any herbal supplements.
Omega-3 fatty acids: Incorporate foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel), flaxseeds, and chia seeds, into your diet. Omega-3s have anti-inflammatory effects and may help reduce joint inflammation.
Vitamin and mineral supplementation: Ensure you have an adequate intake of vitamins and minerals essential for bone health, such as vitamin D, calcium, and magnesium. Consult with a healthcare provider to determine if supplementation is necessary.
Stress reduction techniques: Chronic stress can exacerbate pain and inflammation. Practice stress reduction techniques such as deep breathing, meditation, yoga, or engaging in hobbies and activities you enjoy.
Dietary modifications: Follow a balanced diet rich in fruits, vegetables, whole grains, and lean proteins to support overall health and provide essential nutrients for bone healing and maintenance.
Avoid excessive alcohol consumption: Alcohol can weaken bones and impair blood circulation, increasing the risk of AVN. Limit alcohol intake or avoid it altogether.
Smoking cessation: Smoking damages blood vessels and impairs circulation, which can worsen AVN symptoms. Quitting smoking can help improve overall blood flow and support healing.
Proper footwear: Use comfortable and supportive footwear to minimize stress on the affected joints and provide adequate cushioning.
Emotional support: Living with AVN can be emotionally challenging. Seek support from friends, family, or support groups to help cope with the emotional aspects of managing a chronic condition.
Remember, these tips should be used in conjunction with medical guidance and treatment. It’s important to work closely with your healthcare provider to develop an individualized management plan that addresses your specific needs and the underlying cause of AVN.
Homeopathy medicines used for Avascular Necrosis (AVN)
Some commonly used homeopathic remedies for avascular necrosis (AVN). Remember to consult with a licensed homeopath for proper guidance and personalized treatment. Here are 15 homeopathic medicines that may be considered for AVN:
Symphytum officinale: Known as “knit bone,” Symphytum is often used for bone injuries, fractures, and conditions related to bone healing.
Calcarea phosphorica: This remedy is useful for bone and joint pain, including AVN, especially in individuals with a weak constitution and slow healing.
Ruta graveolens: Indicated for bone and joint injuries, Ruta can be considered for AVN accompanied by pain and stiffness in the affected areas.
Phosphorus: Helpful for bone and joint conditions, Phosphorus can be considered when there is rapid degeneration and brittle bones.
Silicea: Indicated for slow healing, Silicea may be useful in AVN cases where there is a delay in bone repair and symptoms of weakness.
Arnica montana: Known for its healing properties, Arnica can be considered for AVN with associated pain and bruising.
Calcarea fluorica: Useful for bone and joint conditions, Calcarea fluorica may be considered when there are bony overgrowths and calcifications.
Bryonia alba: Indicated for sharp, stitching pains that worsen with movement, Bryonia may be used for AVN accompanied by severe pain.
Staphysagria: Considered for bone and joint pain, Staphysagria may be helpful when there is a history of injury or trauma leading to AVN.
Aurum metallicum: Indicated for bone and joint degeneration, Aurum may be considered for AVN associated with depression and a sense of hopelessness.
Hypericum perforatum: Known for its nerve-healing properties, Hypericum can be considered for AVN with shooting or radiating pain along the affected nerves.
Causticum: Indicated for stiffness and contraction of tendons and ligaments, Causticum may be considered for AVN with stiffness and restricted movement.
Lachesis muta: Considered for circulatory disorders and congestion, Lachesis may be useful for AVN accompanied by hot, swollen, and purple joints.
Phosphoric acid: Indicated for bone pain and debility, Phosphoric acid may be considered for AVN associated with weakness and exhaustion.
Kali carbonicum: Useful for joint pain and stiffness, Kali carb may be considered when AVN affects the hip joint and there is a sense of heaviness.
It’s important to note that homeopathic remedies should be prescribed by a qualified homeopath after a thorough evaluation of your symptoms, medical history, and individual characteristics. Homeopathy is a highly individualized form of treatment, and the selection of remedies can vary based on the unique presentation of each case.
Ayurvedic medicines for Avascular Necrosis (AVN)
Ayurveda, the traditional medicine system of India, offers a holistic approach to health and well-being. It focuses on balancing the body, mind, and spirit to promote overall wellness. Ayurvedic treatments for avascular necrosis (AVN) aim to address the underlying imbalances and promote healing. It’s important to consult with a qualified Ayurvedic practitioner for proper diagnosis and personalized treatment. Here are 15 Ayurvedic medicines that may be considered for AVN:
Ashwagandha (Withania somnifera): Known for its rejuvenating properties, Ashwagandha may help strengthen bones, reduce inflammation, and improve overall well-being.
Guggul (Commiphora mukul): Guggul is believed to have anti-inflammatory properties and may help reduce pain and inflammation associated with AVN.
Shallaki (Boswellia serrata): Shallaki is commonly used in Ayurveda for joint disorders. It may help reduce pain, inflammation, and improve joint mobility.
Maharasnadi Kwath: This herbal formulation is used in Ayurveda for various musculoskeletal conditions, including AVN. It may help reduce pain and inflammation.
Triphala: Triphala is a combination of three fruits (amalaki, bibhitaki, and haritaki) and is known for its detoxifying properties. It may support overall health and help with AVN management.
Punarnava (Boerhavia diffusa): Punarnava is used in Ayurveda as a diuretic and may help reduce swelling and inflammation in the joints.
Mahanarayana Taila: This herbal oil is commonly used for joint pain and stiffness. It can be massaged onto the affected area to provide relief and improve circulation.
Rasna (Pluchea lanceolata): Rasna is used in Ayurveda for joint pain and inflammation. It may help reduce pain and improve mobility in AVN.
Yogaraja Guggulu: This Ayurvedic formulation combines various herbs and minerals. It is commonly used for joint disorders and may help reduce pain and inflammation.
Eranda Taila (Castor oil): Castor oil is used in Ayurveda for its anti-inflammatory and pain-relieving properties. It can be used externally as a massage oil to alleviate pain and improve joint function.
Dashmoolarishta: This Ayurvedic herbal formulation contains a blend of ten roots and is used for various musculoskeletal conditions. It may help reduce pain and inflammation in AVN.
Bala (Sida cordifolia): Bala is known for its strengthening and nourishing properties. It may help improve bone health and support the healing process in AVN.
Trayodashanga Guggulu: This Ayurvedic formulation is used for various joint disorders and may help reduce pain, inflammation, and promote healing.
Maha Yogaraja Guggulu: Similar to Yogaraja Guggulu, this formulation is used for joint disorders and may help reduce pain and inflammation in AVN.
Panchakarma therapies: Panchakarma is a set of cleansing and rejuvenating therapies in Ayurveda. Depending on the individual’s specific condition, treatments such as Abhyanga (therapeutic oil massage), Swedana (herbal steam therapy), and Basti (enema therapy) may be recommended to support the healing process.
It’s essential to consult with an experienced Ayurvedic practitioner who can evaluate your condition, recommend the appropriate medicines and therapies, and guide you through the treatment process. Individualized treatment plans are crucial in Ayurveda, as they consider your unique constitution and imbalances.
20 Yogasan for Avascular Necrosis (AVN)
Yogasanas, or yoga postures, can be beneficial in managing avascular necrosis (AVN) by improving flexibility, circulation, and strength. It’s important to consult with a yoga instructor or therapist who can guide you through the practice and tailor it to your specific needs. Here are 20 yogasanas that may be considered for AVN:
Tadasana (Mountain Pose): Helps improve posture and strengthens the legs and core.
Bhujangasana (Cobra Pose): Stretches the spine, chest, and shoulders, promoting flexibility.
Setu Bandhasana (Bridge Pose): Strengthens the lower back, buttocks, and thighs.
Salabhasana (Locust Pose): Tones and strengthens the lower back, buttocks, and legs.
Viparita Karani (Legs-up-the-Wall Pose): Promotes circulation and relaxation.
Marjariasana (Cat-Cow Pose): Increases flexibility and mobility in the spine.
Adho Mukha Svanasana (Downward-Facing Dog Pose): Stretches the spine, hamstrings, and calves.
Virabhadrasana II (Warrior II Pose): Strengthens the legs and stretches the hips.
Trikonasana (Triangle Pose): Stretches the hamstrings, hips, and sides of the body.
Ardha Chandrasana (Half Moon Pose): Improves balance and strengthens the legs.
Utthita Parsvakonasana (Extended Side Angle Pose): Stretches the side body and strengthens the legs.
Malasana (Garland Pose): Opens the hips and stretches the lower back and groin.
Gomukhasana (Cow Face Pose): Stretches the hips, shoulders, and arms.
Baddha Konasana (Butterfly Pose): Opens the hips and stretches the groin and inner thighs.
Janu Sirsasana (Head-to-Knee Forward Bend): Stretches the hamstrings and calves.
Paschimottanasana (Seated Forward Bend): Stretches the entire back of the body, including the hamstrings and spine.
Matsyasana (Fish Pose): Stretches the chest, neck, and shoulders and improves posture.
Balasana (Child’s Pose): Promotes relaxation and gently stretches the back and hips.
Savasana (Corpse Pose): Allows for deep relaxation and rejuvenation of the body and mind.
Pranayama (Breathing exercises): Practices like deep belly breathing and alternate nostril breathing can help calm the mind, reduce stress, and promote overall well-being.
Remember to practice yoga under the guidance of a qualified yoga instructor, especially if you have specific health concerns or limitations. It’s essential to listen to your body, modify the poses as needed, and avoid any movements or positions that cause pain or discomfort. Yoga should be practiced mindfully and with respect for your body’s limitations.
Physical Therapy for Avascular Necrosis (AVN)
Physical therapy plays a crucial role in the management of avascular necrosis (AVN) by improving joint mobility, strength, and function. A physical therapist will assess your condition and develop a personalized treatment plan based on your specific needs. Here are some common components of physical therapy for AVN:
Pain Management: Physical therapists may use various modalities such as heat, ice, ultrasound, or electrical stimulation to help alleviate pain and reduce inflammation in the affected area.
Range of Motion Exercises: Gentle and controlled movements are performed to improve joint mobility and prevent stiffness. These exercises help maintain the flexibility of the affected joint.
Strengthening Exercises: Specific exercises are prescribed to target the muscles surrounding the affected joint. Strengthening these muscles helps provide stability and support to the joint, reducing the stress on the affected area.
Weight-Bearing and Balance Training: Depending on the affected joint, weight-bearing exercises may be prescribed to gradually strengthen the joint and improve balance. These exercises are carefully tailored to the individual’s ability and tolerance.
Gait Training: If AVN affects the hip or knee joint, gait training may be incorporated to improve walking patterns and optimize biomechanics. This may include working on posture, stride length, and proper weight distribution.
Functional Training: Physical therapists focus on specific activities and movements that are essential for daily living. They help individuals regain functional abilities and adapt to any limitations caused by AVN.
Assistive Devices: Physical therapists may recommend and provide guidance on the use of assistive devices such as crutches, canes, or braces to support the affected joint and promote proper alignment and weight distribution.
Manual Therapy: Techniques such as joint mobilization, soft tissue mobilization, or myofascial release may be used by the physical therapist to improve joint mobility, reduce muscle tension, and alleviate pain.
Education and Self-Management: Physical therapists provide education on AVN, including precautions, activity modifications, and self-care strategies to manage symptoms and prevent further damage.
Home Exercise Program: A physical therapist will design a home exercise program tailored to your needs, ensuring that you continue to perform prescribed exercises and maintain progress between therapy sessions.
It’s important to work closely with your physical therapist to follow the recommended treatment plan and communicate any changes or concerns regarding your symptoms. Physical therapy for AVN is typically an ongoing process that may require several sessions over an extended period to achieve optimal outcomes.
Dr Neeraj Kaushik founder Kaushik Acupuncture & complementary medicine, best acupuncturist in Delhi NCR