Developmental Dysplasia of Hip (DDH) – Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Introduction

Developmental Dysplasia of Hip (DDH) is a congenital anomaly in which the hip joint develops defective. The baby may present with abnormal twisting or movements of the hip joint. The parents might notice a slight difference in the length of baby’s both legs that become evident once the child starts walking. Though it is an anomaly by birth, very early diagnosis and proper management can help correct the condition almost completely. Most cases of DDH are identifies in infancy or early childhood with difficulty in walking or an abnormal gait.

Signs and symptoms of DDH

• Hip joint that is stiff
• Lower limbs with different length
• While in standing position, the patient leans to the side affected
• The affected side foot tends to tilt towards the outside
• Thick and uneven folds of skin in groin or upper part of thigh

 

Causes of DDH

Exact cause of DDH is not known yet but some risk factors are found with increased risk, as follows:

• First born child as they are more tightly packed inside the uterus
• Breech presentation in the last phase of pregnancy
• Family history with similar condition
• Female children are affected more than male ones

 

Pathophysiology of DDH

DDH starts with genetic alterations and is mostly established from birth or early infancy. DDH is a wide spectrum of disorders associated with an abnormality of development of acetabulum and proximal femur, resulting in mechanical instability of the hip joint. It can develop with or without the dislocation of the hip joint.

Diagnosis of DDH

• Physical examination-the Ortolani test and Barlow manoeuvre
• Proper history taking with special reference to the family history
• Ultrasound scan

Treatments for DDH

A very early diagnosis of DDH can be managed by a fabric splint named as Pavlik harness, that keeps the hip of the baby with stability, enabling normal development to an extent.

Other treatment options include braces, hip spica (plaster cast), rehabilitation procedures and surgery. Surgical corrections to the ligaments in and around the hip help in DDH. In children below two years, a non-surgical procedure known as closed reduction is found beneficial. Though non-surgical, this procedure is done under anaesthesia.

 

Prognosis of DDH

The result of the treatment depends upon the time of diagnosis and intervention. If diagnosed and treated in the early infancy, most children get cured almost completely. But if not properly managed, DDH can lead to many complications including osteoarthritis.

Complications of DDH

• Difference in length of the limbs
• Painless limp
• Osteoarthritis
• Hip labral tear

 

 

DDH and Ayurveda

Sandhigatavaata

Sahaja Vaataroga

 

Nidana-Ayurvedic causes

Dhaatukshaya(degeneration)

Aavarana(obstruction to channels in the body)

 

Poorvarupa- Ayurvedic premonitory signs and symptoms

Non mentionné

 

Samprapti-Ayurvedic pathogenesis

In SandhigataVaata, the Vaata dosha gets vitiated due to the causative factors and gets lodged in the joints causing pain and swelling. It can happen at the hip joint also especially when it becomes sahaja or a birth defect.

 

Lakshana – Ayurvedic signs and symptoms

Vaatapoornadrutisparsam          – Feel of an air-filled bag on touch

Sopham                                           – Swelling

Prasaaranaakunchanayo: savedanaam pravrthim- Painful movements of joints like flexion and extension

 

Sadhyasadhyata-Ayurvedic prognosis

Yaapya(manageable with medicines, therapies and Pathya)

It is saadhya/krichrasadhya if it is new and involves only singe joint.

 

 

Chikitsa-Ayurvedic treatment

Samana

Lepana or herbal paste with soolaharadravyas (herbal medicines that reduce pain)

Parisheka or herbal wash with soolaha-sothahara dravyas (herbal medicines that reduce pain and swelling)

Upanaha or bandage with herbal paste inside it on the joint with Vaataharadravyas(herbal medicines that pacify Vaata dosha)

Sodhana

Sneha (Abhyanga)-medicated oil massage

Sweda (Potalisweda)-bolus therapy with herbs

Vasti-herbal enema

Virechana-herbal therapeutically induced purgation

Raktamokshana-blood letting

 

Commonly used Ayurvedic medicines

Maharasnadi kashayam

Amruthotharam kashayam

Rasnerandadi kashayam

Amruthaguggulu

Kaisoraguggulu

Guggulutiktakaghrutam

 

Remèdes maison

Pain medications to manage the pain.

The RICE mnemonic is helpful, especially when the pain if injury happens:

Rest: Rest the joint, take a break from activities involving the affected joint.

Ice: Applying ice pack locally

Compress: A compression bandage can help prevent swelling and help alignment. It should not be too tight and should be removed at night.

Elevate: Elevation while helping can help with blood flow and remove any swelling

Diet and behaviour suitable for DDH

• À éviter

Heavy meals and difficult to digest foods that cause indigestion.

Junk foods that cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks making the stomach more acidic and disturbed digestion

Refrigerated and frozen foods that cause weak and sluggish digestion by weakening Agni (digestive fire)

Curd causing vidaaha and thereby many other diseases.

 

• A ajouter

Light meals, warm and easily digestible foods

Green gram, veg soups, sesame oil.

Ragi products

If having good digestive power, have milk and milk products except curd

Freshly cooked and warm food processed with spices like cumin seeds, ginger, black pepper, ajwain etc

 

Comportement :

Protect yourself from very hot & cold climates.

Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.

Évitez de soulever des poids lourds et de pratiquer d'autres activités physiques intenses.

Avoid excess physical exercise, continued sitting and a sedentary lifestyle

Maintenir une alimentation et un sommeil réguliers.

Évitez de retenir ou de forcer les envies comme l'urine, les selles, la toux, les éternuements, etc.

Avoid climbing of stairs.

 

Yoga and Pranayama

Vigorous exercises are not allowed in very painful conditions.

Only stretching, moderate walking, and mild cardio exercises are advised

Children with DDH can be allowed to do Sookshma Vyayama involving all the joints especially hip

Adults with DDH can perform Vrikshasan, Taadasana, Pascimotthanasana etc to improve the mobility of the hip joint.

 

Documents de recherche

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192282/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850778/

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