Authors: Dr M. Shahid M.O. (UK) and Dr Ranjeet Singh

Overview:

The word “Arthitis” means ‘inflammation of joints’. It comes from two words, arthron meaning joints and itis meaning inflammation. It is chronic disease process. In the early stages, the whole body is usually involved and one or two joints may become completely deformed, leaving the patient handicapped and somewhat weakened. Arthritis assumed various forms, the most frequent being Osteoarthritis and Rheumatoid arthritis. Inflammation, the main features of arthritis which is a reaction of the joint tissues to some form of damage or injury.

What is Osteoarthritis ?

Osteoarthritis is a degenerative joint disease which usually occurs in the older age. According to Ayurveda, Osteoarthritis is a degenerative joint disease that occurs due to aggravation of vata dosha, is known as sandhi-gata-vata. This is the form of arthritis that usually comes with age and most often affects the fingers, knees, and hips.

Case definition

Painful condition of joint involving single or multiple joints restricting the movements with or without swelling and crepitus.

Types of Arthritis according to Ayurveda?

Ayurveda distinguishes three categories of arthritis, corresponding to Vata, Pitta and kapha to treat this condition properly, it is vital to carefully diagnose which patient have.

Vata-type Arthritis

If arthritis is due to Vata your joints crack and pop. They become dry and are not swollen as they may be if excess Vata is not the cause. The joints may also feel cold to the touch. They are painful mostly upon moment, and there is usually one particular tender spot. Jogging, jumping, trampolinig, or any strenuous exercise tends to aggravate the pain.

Pitta-type Arthritis

Pitta type Arthritis is characterized by inflammation, the joints become swollen and painful even without movement. It often looks red and feels hot to the touch.

Kapha -type Arthritis

In kaphaja of type Arthritis the joint also becomes stiff and swollen, but it feels cold and clammy rather than hot. A little movement, rather than aggravating the pain, tends to relieve it. The pain is greater in the morning, and as the person start moving around, the pain diminishes.

Differential diagnosis of Osteoarthritis ( Sandhigata -vata)?

  • Amavata
  • Vatarakta
  • Katigraha
  • Gridhasi
  • Anshashoola
  • Krostukshirsha
  • Ankylosis spondylosis

What are the symptoms of Osteoarthritis?

  1. Pain and stiffness in the joints- pain usually increases after exercise.
  2. Swelling of joints.
  3. Sounds with walking.

What are the possible causes of the osteoarthritis?

The possible causes include malnutrition, continuous physical stress, obesity, glandular insufficiency, calcium deficiency and shortage of HCL, and wearing unwholesome footwear.

Ayurvedic pathology

Depending on the person’s lifestyle, diet and emotional pattern, either vata ,pitta or kapha goes out of balance. then that particular dosha slows down Agni (digestive fire), resulting in the toxic, sticky byproduct of inadequate digestion known as ama.

Vata, the main active dosha, brings the ama into the colon, and from there it travels through the system and lodges in the asthi-dhatu (bone tissue) and in the joints, giving rise to the stiffness and pain, characteristic of arthritis.

So our aim in treating Arthritis is to remove the ama from the joint and bring it back to the colon and then to eliminate it.

Essentials of diagnosis

  • Joint pain exacerbates by activity and relieved with rest.
  • Stiffness that is self-limited upon awakening in the morning or when rising from a seated position after an extended period of inactivity.
  • Examination notable for increased bony prominence at the joint margins, crepitus or grating secretion upon joint manipulation, and tenderness over the joint line of the symptomatic joint.
  • Diagnosis supported by radiographic features of joint space narrowing and spur (osteophyte) formation.

Treatment of osteoarthritis

Treatment for each type of Arthritis is unique. But for all cases it is important to know that Arthritis begins in the colon.

This is why, to relieve Arthritis, it is important to keep the colon clean. To accomplish this, if you do not know positively whether it is Vata, Pitta, or Kapha type of Arthritis, taking Triphala at night with some warm water will be effective for all types. Alternatively, if you know positively which type is it, you can use Haritaki for Vata- type arthritis Amlaki for Pitta type and Bibhitaki for kapha type arthritis.

Specific principle of treatment according to vedic system

1.Fomentation ( Swedana)

Patra pinda sweda and Shashtika Shali pinda sweda

2. Bandage ( Bandhana)

Bandana is bandaging tightly with leaves of Vata pacifying drugs on affected joint. This bandaging does not leave any scope for vata to inflate the joint. In Osteoarthritis, swelling appears like a bag inflated with air. Bandage causes abatement in this swelling.

3. Application of Medicinal paste ( Pradeha)

Application of paste of vata pacifying leaves such as rasna, agnimantha, datura, shigru, eranda, nilagiri mixed with sandhava, oil and amla dravya (kanji)

4. Poultice ( Upnaha)

Poultice is one of the four types of fomentation explained by Charaka. The application of heat causes relaxation of the muscle and tendon improve the blood supply. It is effective in pain and stiffness.

5. Cautary (Agnikarma)

Agnikarma on mamsa, diseases located in shira, snayu and asthi are get elleviated. It is stated that diseases cured with agnikarma will never relapse and that cure with Ksharkarma or surgery may recure. Agnikarma suitable in mamsa and medo pradhan purusha. Also if pain relief is not satisfactory by other measures.

5. Blood letting ( Raktamokshana)

Blood letting with leech is advisable in synovial affusion, bursitis etc. acute inflammatory condition.

Simple home remedies

  1. Use warm seasame oil to massage and painful joints in the morning. Massage improves the blood circulation and reduces inflammation and stiffness.
  2. Put one tablespoon of fenugreek in a cup of water and set aside overnight. The next morning, mix well and drink.

Useful herbs

  1. Shunthi
  2. Shigru
  3. Garlic
  4. Erand
  5. Rasna
  6. Gugglu
  7. Dashmool

Some important Ayurvedic preparations

  1. Dashmool kwath, Devadar kwath, Erand kwath
  2. Mahanarayana oil, Bala oil, Panchaguna oil for local application
  3. Yograj gugglu, Mahayograj gugglu, Triphala gugglu
  4. Dashmoolarishtha
  5. Vatavidhawasan Rasa
  6. Vaishvanara powder

Preventive measures

  • Avoiding or minimising the use of the pungent, astringent, bitterrasa and sheeta virya aahar specially.
  • Intake of rejuvenation medicines before 45 years.
  • Regular practice of massage.
  • Rice pudding massage or oil pouring once in a year after 40 years of age.
  • Avoiding jerky movements.
  • Avoiding continuous and excessive use of one joint.
  • Avoid long standing, walking long distance.
  • maintaining a healthy weight may be the single most important thing you can do to prevent osteoarthritis.
  • protect your joints from serious injury or repeated minor injury to decrease your risk of damaging cartilage.
  • excise can help reduce joint pain and stiffness light to moderate intensity physical activity may prevent a decline in, and may even restore, health and function.

Certain Asnas ( postures) could help relieve your problem

Triangle posture

Lotus posture

Spinal twist

Bow posture

Inverted posture

Not to do

  • Any exercise related to joints
  • Staying at the low temperature
  • Eating chilled (cold) food
  • Tension
  • Day sleep
  • Wathing with cold water
  • Too much use of stairs
  • Living in A.C., cooker

Do’s

  • Oil massaging
  • Sun bath
  • Morning walk
  • Walking straight
  • Avoid heels
  • Avoid flat shoes, use knee cap when walk
  • Avoid slippers and flip-flop

Not to eat

Citrus fruits, pickles, chilled water, cabbage, cauliflower, bringjal, mushroom, lentil and black grams.

Beneficial diet

Onion, cucumber, green pea, radish, pineapple, roasted potao, cashew nuts, garlic and milk.

References:

>Ayurvedic pharmacology by Anil k.Mehta, Raghunandan Sharma, Pub- Chaukhamba Sanskrit Pratishthan, Edi-2005, Some important preparations for Osteoarthritis, pg no- 371.
>Ayurved modern medical practioners by Kumar S. Nagral, pub- Chaukhamba Sanskrit Pratishthan , Edi-1st 2008, Osteoarthritis, pg no-326.
>Nature Cure by B.M. Bhakhru, pub- JAICO pub. house, edi-5th 2010, causes of arthritis, pg no- 243.
>Ay. Home Remedies by Pratap Chauhan, pub- jiva institute, Edi-2010, home remedies for arthritis, pg no- 107.
> Practical prescriber for Ayurveda physicians by Abrar Multani, Edi- 3rd 2018, Sandhigata vata, Recommendations.
>A Guide to Ay. clinical practice by Vaidya Vasant Patil, pub- chaukhamba pub., Edi-2017, Sandhigata Vata- essentials of diagnosis, preventive meassures, pg no- 236-237-238.
>Ancient Healing of India By Vasant Lad, pub-piatkus, Edi-2006, treatment of OA, pg no-131.
>Ayurvedic Standered Treatment Guidelines- Ministry of AYUSH, Edi- 1st 2017, Sandhigata Vata- case definition, differential diagnosis,pg no-215.

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