Arthritis-RA-Ayurvedic View/Treatment

Rheumatoid arthritis is a chronic, disabling autoimmune disease which may affect multiple tissues and organs but principally affects movable synovial joints. Women are affected 3x’s more often than men. The autoimmune disease process invokes inflammation usually beginning in the synovial membrane and extending to the articular cartilage and bone.
Ayurvedic texts describe a number of diseases characterized by pain and swelling of joints According to Ayurveda arthritis are of three types. These three are (1) Amavāta, (2) Sandhivāta (3) Vātarakta. Note that all these designations share the common term “Vāta”. Amavāta corre­lates quite closely with rheumatoid arthritis as known in Western medicine while Sandhivāta is a pure vata disease most closely corresponding to osteoarthritis. Vātarakta most closely correlates to gouty arthritis.
 Among these amavāta is a chronic, often progressive, and sometimes disfiguring disease. Amavāta is classified as a difficult to cure (Krichhrasadhya) disease in Ayurveda. It is character­ized by pain and swelling of multiple joints. As the name denotes this disease is caused due to lowering of agni and accumulation of systemic ama which because of its physical similarity with kapha has an affinity for the seats of kapha (kaphasthana) principally the joints (sandhi) and conjoining with vitiated Vāta precipitates a condition of painful swelling of all joints. Because of its antigenic nature, ama acts like an autoantigen and creates autoimmune disease of the joints.
The concept of ama is fundamental in understanding the Ayurvedic perspective on the pathology of rheumatoid arthritis. Ama is a toxic substance which accumulates in the body and cannot be properly digested, metabolized, or utilized. There are three types of ama:
1. Rasama – formed from the gastrointestinal tract from incompletely digested foods
2. Malama – formed in any of the seven dhatus from accumulated metabolic wastes
3. Doshama – formed due to a sudden disturbance of the doshas from an external cause
Whatever the type, ama always has certain common properties. It is apakva (not cooked) and asiddhi (not achieved its final form). In general, ama means an unripe, uncooked, immature, and indigestible substance.
Amavāta which manifests peripherally in joints essentially has its origin in the gut in the form of mandagni and ama formation. Simultaneously, there is a malfunctioning of Samana Vāta subdosha, also located in the gut. Accordingly the principal line of treatment, particularly during early stages of the disease, is to treat the agni by langhana, dipana, pacana, and appropriate herbs and spices in order to promote the agni and exhaust ama. Thus Ayurveda makes a unique approach to the management of rheumatoid arthritis, the main target being the gut not the joints.. Fasting (langhana) and vegetarian light hot diet are useful in the early stages. In the context of chronic amavāta when ama is no longer actively forming and accumulating but the disease is persisting in the form of morbid continuum and residual permanent joint destruction, the line of management is different. In such cases, in addition to ama pacana one has to prescribe specific antiarthritic, anti-inflammatory and analgesic remedies along with physiotherapeutic and rehabilitative therapies.
Common Clinical Symptoms
· Angamarda (pain in specific areas of the body)
· Aruchi (loss of appetite)
· Trishna (increased thirst)
· Alasya (loss of zest or enthusiasm for life)
· Jwara (increased body temperature)
· Apaka (low agni)
· Sandhi Stabdata, Sandhi Shoota, Sandhi Shopha (stiffness, inflammation and swelling of the joints)
In addition to these symptoms, amavāta can have many others in specific individuals including frequent urination, reduction of perspiration, hyper salivation, nausea and vomiting, constipation, flatulence. Although Vāta is the pre eminent dosha involved in this condition, on the basis of doshanubandha lakshanas (signs connected to specific dosha), amavāta can be classified into three types:

· Vāta – will manifest with sharp, cutting pain and more digestive symptoms
· Pitta – will manifest with daha (burning sensation) throughout the body and in the joints with more intense redness
· Kapha–will manifest with more heaviness, rigidity and perhaps itching
 
 
Treatment of Amavāta (Rheumatoid Arthritis)
 
The treatment of amavāta consists of ten principle approaches:
1. Langhana                               
2. Swedana                                
3. Tikta-Katu Ahara                   
4. Deepana                                 
5. Pachana 
6. Snehana-Virechan 
7. Niruha Vasti
8. Upanaha swedana (local)
9. Aushadis (Medicines)
10.Additional treatments according to predominant dosha of the disease

Some common preparations are combinations of guggulu gum resin (Commiphora mukul) with other herbs. They are generally taken in tablet form in dosages of 2-3 grams 3x’s/day:
Yogaraj Guggulu, Kaishore Guggulu, Simhanad Guggulu, Rasna Guggulu
 
Other preparations are taken as kwaths (decoctions) made by boiling 3-4 grams of powdered herb in 240 ml. of water:
Panchakola kwath, Maharasnadi kwath, Dashmoola kwath, Guduchyadi kwath, Panchtikta kwath

Powdered herbs are another dosage form for select plant medicines:
Rasna, Bhallataka, Gaurakha (Dalbergia lanceolaria), Ashwagandha, Yastimadhu, Copacini (Smilax china), Pippali, Eranda brista Haritaki (Haritaki powder cooked in eranda tailam), Vatsanabhi (Aconitum ferox), Maricha (Piper nigrum; black pepper), Haritaki (Terminalia chebula), Trivrit, Shallaki (Boswellia serrata)
 
External Lepas (Poultices)
Datura lepa, Eranda lepa, Arka lepa, Mustard Seed lepa
The notion that food can modify the course of rheumatoid arthritis has long been rejected by Western medicine as foolish and even quackery. However, Ayurvedic physicians have known for generations that foods definitely affect inflammation—the critical process in amavāta.
Although it is not possible to develop a standard “amavāta diet” for all individuals due to constitutional differences and idiosyncratic features of the disease in each person, the foods which help or provoke symptoms in the greatest percentage of people can be identified.

Pathya
Bitter gourd, Coconut water, Loki (a type of vegetable), Coconut milk, Barley, Carrot juice, Amaranth, Beetroot juice, Old rice, Squash (all species), Buttermilk, Zucchini, Ginger, Pumpkin, Cinnamon, Leafy green salad, Cardamom, Kichadi, Turmeric, Garlic

Apathya
Yogurt, Cauliflower, Black gram, Okra, Cold Beverages, Beef, Broccoli, White potato, Cola drinks, Tea, Poultry, Cabbage, Ice cream, Caffeine, Dried Fruits, White sugar, Spinach, Chocolate, Alcohol
The fundamental perception of amavāta/rheumatoid arthritis is very different in Ayurveda. From the Ayurvedic perspective, until ama can be removed, agni restored and Vāta dosha normalized, no treatment method—conventional or holistic—will be effective.
The modern, conventional treatment for rheumatoid arthritis includes some combination of steroids (usually prednisone), antimetabolites (usually methotrexate), Tissue Necrosis Factor agents (e.g. Humera, Embrel) and sometimes a non-steroidal anti-inflammatory drug (to relieve pain) and an accompanying antacid (to treat the gastric side effects of all four of these). Although this treatment can often relieve joint pain and inflammation and slow or halt the disease process, they all have significant side effects.

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19 thoughts on “Arthritis-RA-Ayurvedic View/Treatment

  1. Hello Doctor, I am suffering from knee joint pain since last 6-7 months. I had to handle all household work after my second delivery which resulted in osteoarthritis as mentioned by one of the ayurvedic doctor whom i consulted. It was cured with his treatment, basically with mahanarayan tail massage and other medication. But again it has started. I took 7 days oil massage treatment from same doctor. It was better for few days but didnt improve after that. Now everyday i first put hot water on my knees and then massage my knees with mahanarayan tail before going to sleep. The pain is reduced but doesnt go away completely. Wanted to know if there is any permanent solution for my problem

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  2. Hello Dr. Rajesh Shrotriya

    My mother is is having Frozen Shoulder since Nov 2013 (she has arthritis and a small 0.7% of RA) and she tried various treatments including Panchakarma, Allopathy treatments including steroid injection, Physiotherapy and various Oils; she also does Physiotherapy exercises at home but the pain is constant. Could you please suggest a line of treatment which can help her reduce the pain. I was also told that applying Go-mutra will help and now I read with interest on your website too about the efficacy of Go-mutra for RA, request your advice please.

    Sincerely….Ashok Bhat

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    1. Application of gao mutra is not going to help. Now regarding treatment as you have said that many treatment have already been given. even steroid injection. I feel proper diagnosis is still missing so as not to get expected results. I would advise you to forward me the complete history of you mother illness so as to respond you with some genuine effective suggestion.

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  3. doctor if in artheritis one cannot stand for long and have continuous joint pain while walking what is the herbal treatment

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  6. My mother is having severe pain in the knee joint and it is swollen due to RA. She is taking ayurvedic medicine. Recently someone advised me to take cow urine, I started myself alongwith my parents. I had digestion problem, within taking 2-3 days cow urine mine problem disappear. I am not facing digestion problem. What is the exact quantity cow urine should be given my mother, so that see can have less inflammatory pain.

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    1. 3 spoon cow urine with 3 spoon lukewarm water early morning empty stomach… but only cow urine wont work.. she need to take herbal treatment alongwith it.. and also post her concerns to physiotherapy4alll.blogspot.in

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  7. Dear Doctor,

    My sister aged 45 has swelling at elbow joint since last 3 months.
    Doctors says it’s rheumatic problem.

    My sister is worried because my aunty had got hands deformed due to rheumatism.

    Pls suggest her medicine.

    Yours sincerely
    Harish Tamhankar

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