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.

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CHIKUNGUNYA : AN AYURVEDIC APPROACH

*Dr. Anurag Dikshit                                                                                                ** Dr Supriya

Chikungunya, a debilitating but non fatal chikungunya viral illness, spreads by the bites of Aedes Egypti mosquito. Though the prime features of the illness is fever and severe arthralgia (Joint Pain) and are accompanied by chills and constitutional symptoms such as headache, photophobia, conjunctival infection, anorexia, nausea, and abdominal pain, Rash may appear at the outset or several days into the illness.

 

Though the fever subsides early, arthritis is one of the persistent symptoms of the disease. Migratory polyarthritis mainly affecting the small joints of the hands, wrists, ankles, and feet, with lesser involvement of the larger joints are encountered.

Epidemic of chikungunya was seen in 2007-08 in the state of Kerala and Karnataka, affecting nearly 20 lakh people. Ayurveda was then proved to be an effective therapy for the successful management of Chikungunya.

In acute phase (2-3 days), sudden onset of fever to 39-40°C Chills headache, nausea, vomiting, joint pain with or without swelling, low back ache, rash, remittance of fever in 1-2 days are seen.

In this stage, effective management by use of Ayurvedic medicine like: Sudarshan Choorna, Amrutarishta, punanavasava, Amruthothatharam Kashayam, Godanti Bhasma, Visamjwarantak Lauha are given for fever and pain.

For Nausea and Vomiting, Bilwadi Gulika, Bilwadi leham Dhanwantaram gulika, Guduchi kanda kwath, trishun tab, bhoonimba swaras, tender coconut water etc are given.

In late Phase, Post fever arthralgia, symptoms are polyarticular, migratory arthritis affecting small joints of hand and wrist etc, pain on movement which worsen in early morning but improve by mild exercise and exacerbate by strenuous exercise, generalized muscular pain, swelling of feet etc are seen.

In this stage, Dashmoola Kashayam, Yogaraja Guggulu, Indukantam Kashayam, Karpooradi Tailam (Local Application), decoction of Guduchi, sunthi, tulasi, haridra are to be given for polyarthralgia with no or minimal inflammation, panchakarma therapies like, upanaha Sweda, Dhanyamla Dhara, nadiswedanam are used to cure the disease.

 

In case of Rashes, restlessness etc, Punarnavadi Kashayam, Chandraprabha vati, Lepa application by Upanaha or Ellumnishadi Choorna is to be applied.

In case of swelling of legs, feet, wrist joint, gulguluthiktakam Kashayam, Varnadi Kashayam, rasana saptakam Kashayam, Gokshuradi Guggula, Simhanada Guggulu etc are to be given along with panchakarma treatment of Dhanyamala Dhara, Naadi Swedanam, Valooka Swedanam.

Diet:

1. Light food like, kanji, yoosha of mudga, kulatha.
2. Vegetables should be prepared in less oil, non spicy, like carrot, lauki, beans, small fished, bread, karela, torai.
3. Drinking water made from the phanta of Sunthi, pepper, dhanya, tulasi.

Don’s:

1. Leafy vegetables, kala chana, curd, banana, sour substances, meat, heavy foods, oily foods.

Prevention

Ayurveda described such diseases under Janpadodhwansa.

1. Increase of Immunity can control such disease, the medication are: Sudarshana Choorna, Guduchi, Tulsi, Chyavanaprash, Bilwadi Gulika etc

2.      Mosquito Eradication:-  Application of Neem oil; bath with neem and soap; Spray of Garlic Juice; Smoking with Mustard, neem leaves and saindha namaka or Guggul, neem leaves, ghee. Chikungunya is one more reason (in addition to dengue and yellow fever) that A. aegypti must be controlled.

3.      Body should be covered by cloths as mosquito in species responsible for the disease bites in day time.

Investigation

1. Complete Blood Count
2. Viral Assay
3. ASLO, RA, TSH, LFT

Word of Caution

Medication indicated above should be taken only under the guidance of Medical Practitioner.

Ayurvedicremedies Lucknow; U.P.; India, Mob: +919415335166

Web: www.ayurvedicremedies.org ; email: drji@ayurvedicremedies.org

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Why take cancer causing drugs when harmless ayurveda medicines available

Dear All

Few days back, in TOI i read the Article, "Paracetamol Tied to Blood Cancer". It was horrific to hear or read the activity of such a common OTC drug. even pregnant ladies and new born child all are given this medication as first line of medication. We all know that for fever paracetamol is given so is Nimesulide, we all know that Nimesulide now is a banned drug for child in fever or as pain killer.

My question is, why we are experimenting with the people of India? first we try this drug in population and then say after tens years of practice we say.... no this drug is carcinogenic and if taken can cause cancer so we stop this....

When we have Indigenous Drugs like Guduchi Ghana Vati, Sudarshana Choorna, Amrutarishta and Sanjeevani Vati as drugs with similar efficacy and time tested (more than 3000 years), if you still want a study do it on these drugs with similar design like that of study of paracetamol in 65000 men and women.

We all shout when Dengue or Chikungunia takes a toll that Guduchi (or Amruta) plant is very effective in cure, why not take these medicines with Guduchi as one of the ingredient for all types of fever and do a study yourself of the efficacy.

This is the Apathy of Govt that, the NRHM program in Many States are functioning with AYUSH doctors but without any AYUSH medicines. My Dear policy makers, without medicine is it possible for a doctor to show results? You are forcing them to work with Allopathic Medicines in CHC and PHC's.

In China it is mandatory to practice indigenous medicine for all the doctors, herbal drug is the most lucrative business world wide... but we are still not coming out of our slumber of western are our ruler attitude.

Now its time for public to think again for second alternative of treatment, let your Doctor asses you for medication.    

Dr Anurag Dikshit
www.ayurvedicremedies.org

Court Order for AYUSH NRHM Medical Officer 2011-20-04

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for detail please see: http://elegalix.allahabadhighcourt.in/elegalix/WebShowJudgment.do