OSTEOARTHRITIS & AYURVEDA

Dr Anurag Dikshit                                                       Dr Supriya Shukla Dikshit

BSc; BAMS; MD (Ayu); CCYP; PGDHA; QMHC       M.D. (Ayu)

Sahara Hospital, Lucknow                                              Ayurvedicremedies Clinic

Mob: 9415335166;      info@ayurvedicremedies.org                                                             www.ayurvedicremedies.org 

Osteoarthritis (OA) is the most common joint disorder, which is due to aging and wear and tear on a joint. Arthritis is an inflammation of one or more joints, joint is the area where two or more bones meet. In Ayurveda it is called Sandhivata and is classified as Vatavyadhi and it is also believed that any type of pain cannot be without the presence of Vata.

Although Sandhivata cripples a large number of persons, it rarely kills any persons. Thus, there is not other disease which causes so much suffering for so long. Because of the tendency to cripple without killing Sandhivata is one of the chronic diseases from the stand point of social and economic importance.

Causes, incidence, and risk factors

Osteoarthritis is a normal result of aging. It is also caused by 'wear and tear' on a joint.

·         Cartilage is the firm, rubbery tissue that cushions your bones at the joints, and allows bones to glide over one another.

·         If the cartilage breaks down and wears away, the bones rub together. This causes pain, swelling, and stiffness.

·         Bony spurs or extra bone may form around the joint. The ligaments and muscles around the joint become weaker and stiff.

Often, the cause of OA is unknown. It is mainly related to aging.

The symptoms of OA usually appear in middle age. Almost everyone has some symptoms by age 70. However, these symptoms may be minor.

Other factors can also lead to OA.

·         OA tends to run in families.

·         Being overweight increases the risk of OA in the hip, knee, ankle, and foot joints because extra weight causes more wear and tear.

·         Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints.

·         Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting of weight, climbing stairs, or walking also put you at risk.

·         Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.

Symptoms

Pain and stiffness in the joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint.

If you have osteoarthritis, your joints probably become stiff and hard to move over time. You may notice a rubbing, grating, or crackling sound when you move the joint. Joint swelling (bones around the joints may feel larger than normal)

Acharya Charaka has defined the disease that when provoked Vata locates in the Sandhi, it causes Shotha which on palpation appears like bag inflated with air and the movements of extension and flexion are accompanied with pain.

The phrase "morning stiffness" refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that "warms up" the joint.

During the day, the pain may get worse when you're active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night. Some people might not have symptoms, even though x-rays show the changes of OA.

Signs and tests

An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.

Treatments

LIFESTYLE CHANGES

Staying active and getting exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.

Other lifestyle recommendations include:

·         Yoga daily to increase joint regeneration.

·         Hot fomentation

·         Eating a healthy, balanced diet

·         Getting rest

·         Losing weight if you are overweight

MEDICATIONS

Various medicines of Ayurveda are used for this condition, they are-

Guggulu: Yogaraja Guggulu, Triyodashanga Guggulu, Kaishore Guggulu

Kashayam: Rasnasaptak Kwath, Dashmoola Kwath, etc

Local Oil application: Dhanwantaram Oil, Mahamasha Oil, Bala guduchyadi Oil etc

Rasa Yoga: Vata Gajankusha Ras, Vatari Ras, Vrahat Vata Chintamani Ras etc

Rasayana: Ashwagandhadi choorna, Chyavanprash etc

Hot Fomentation: Dashmoola, Rasnasaptak Kwatha etc

PANCHAKARMA THERAPY

It is a very unique therapeutic procedure, because of its preventive, promotive, prophylactic and rejuvinative properties as well as providing a radical cure. Among these Panchakarma, Basti Karma is such a Chikitsa that is applicable in all the Vatavyahdi. According to Sushruta it, also can be used in Kaphaja and Pittaja disorders by using different ingredients. Sandhivata is a Vatika disorders and Vata also controls and regulates other two Dosha, Dhatu and Mala and also all the body activities. Therefore, once Vata is controlled by Basti, all these factors are automatically regulated and total body equilibrium is achieved. Other Important panchakarma procedures are Abhyanga, Sarvaga Sweda, Pizhichil, Navarakhizhi, Patrapotali Pinda Sweda, Dhara, Upanaha etc they are used as per the condition of the patient.

ABHYANGA (Massage)

In this treatment, Specific Body massage for 45-60 minutes with herbal oil or herbal cream to tone up the body and to improve the blood circulation etc. is performed. It is useful for elimination of several aliments as well as it is indicated as PURVAKARMA - pretreatment procedure - for all the therapeutic Panchakarma procedure.

VASHPASWEDANAM: (Medicated Steam Bath)

This is a unique treatment and under this treatment leaves of medicinal plants are boiled and resulting steam is passed to the whole body. This treatment is helpful in to eliminate impurities from the body, reducing fat and also helpful in fighting with some skin diseases. This is also indicated as PURVAKARMA for Panchakarma procedures.

MARMA MASSAGE

This massage includes whole body massage with herbal oil or powder by hand and  foot, for 90 minutes. This is good for rejuvenating the body, to reduce mental tension, sexual weakness, to improve vitality etc. relieves back pain, stiffness and sports injuries but also stimulates various bodily organs and systems.

PATRAPOTALI PINDA SWEDA

Herbal leaves and herbs or herbal powders are applied to the whole body in boluses with hot medicated oils for 45 minutes per day for a period of 7 to 14 days. This treatment is for osteoarthritis, arthritis, swelling. Spondylitis, sports injuries etc.

JANU VASTI

In this process specially prepared warm medicated oil is kept over the Joint involved with herbal paste boundary. This treatment lasts for 45 minutes to 1 hour and it is good for any type of joint pain.

PIZHICHIL

In this treatment, lukewarm herbal oils are applied all over the body by two to four trained masseurs in a special rhythmic way for about 60 to 90 minutes per day fora period of 7 to 21 days. This treatment is very useful for rheumatic diseases like arthritis, paralysis, hemiplegia, and nervous disorders etc.

NAVARAKHIZHI

It is a process by which the whole body or any specific part thereof is made to perspire by the application of certain medicated puddings externally in the form of boluses tied up in a muslin bag. This is applied by two to four masseurs for about 60 to 90 minutes per day for a period of 14 days. This treatment is for rheumatism, pain in the joints, emaciation of limbs, blood pressure, cholesterol and certain kinds of skin diseases.

UPANAHA

Upanaha is bandaging here a paste of the roots of the Vayu subduing drugs is prepared and is then applied on the affected joints.