Osteoarthritis Ayurvedic Treatment
Arthritis is normally referred to joint disease or joint pains. It is most common in women but frequently seen in older people. The symptoms can be mild, moderate or severe. Swelling pain, stiffness,decreased range of motion are the common symptoms of arthritis. These may stay about the same for years and progress or get worse over time.
Ayurveda offers effective and safe treatment for prevention and cure of Arthritis
Osteoarthritis (OA) is a condition that usually develops gradually, over several years, due to wear and tear of joints and affects a number of different joints. Therefore, they cannot act normally. Due to gradual erosion, ligaments face stretching that initiates the pain. Females are more prone to this than males especially after menopause. its high prevalence among elderly people made it as a major cause of disability among them.
Osteoarthritis is a chronic degenerative disorder of multifactorial etiology, characterized by loss of articular cartilage and periarticular bone remodeling. It involves the entire joint including the nearby muscles, underlying bone, ligaments, synovium and capsule.
CLASSIFICATION OF OSTEOARTHRITIS
- Idiopathic (Primary) O.A. – is the most common form of the disease, no predisposing factor is
- Secondary O.A. – is pathologically indistinguishable from idiopathic O.A. but is attributable to an underlying causes like trauma, calcium deposition, other diseases etc
Risk factors for Osteoarthritis
- Age – old age is risky
- Sex – females having more chance to be affected.
- Trauma – Direct or indirect injuries to the articular cartilage lead to its degeneration. Fractures of different bones, especially of weight bearing.
- Abnormal posture, abnormal walking styles, and unequal length of leg will exert stress and strain over the
- Diseases like Hyperparathyroidism, Diabetes mellitus, etc. also may lead to osteoarthritis
People with an elevated body mass index (BMI) as a measure of relative weight for obesity, has a positive tendancy to develop arthritis.
Joint Pain- Most important symptom. Typically, the pain of osteoarthritis is aggravated by joint use and relieved by rest, but as the disease progresses, it may become
Stiffness- Progressive stiffness of the involved joint upon arising in the morning or after a period of inactivity may be prominent but usually lasts less than 20 min. It is due to spasm of muscles.
Swelling– Physical examination of the osteoarthritis joint reveals localized soft tissue swelling of mild degree. It is due to the changes in articular ends.
Crepitus– rubbing sound or feeling on joint movement is called as crepitus. It is one of the characteristic sign of osteoarthritis
Local rise of temperature- On palpation of the joint local rise in temperature is an indicative of
Muscle Atrophy– weakness of local muscles involved is atrophy which may be due to disuse or due to reflex inhibition of muscle contraction
PATHOLOGY OF OSTEOARTHRITIS
The changes mainly occur in cartilages, adjacent bones and synovium. The changes are most marked in the weight-bearing regions of articular cartilages. Initially there will be thinning of cartilages which lead to structural change in them. Further progression o causes loosening, flaking and fissuring of the cartilage resulting in breaking off of pieces of cartilage. Strength of associated bones will be reduced along with spur formation on margins of bones called as osteophytes.
Main reasons for the development of osteoarthritis are
- The properties of the articular cartilage and bones are normal, but excessive load on the joint causes the tissue fail.
- The applied load is reasonable, but the quality of the cartilage or bone are
In the early stages the cartilage is thicker than normal. With the progression of osteoarthritis, joint surface thins then the cartilage softens.
Laboratory and Radiological Findings
Radiological techniques like x ray,MRI scan,CT scan etc are used for diagnosis. They reveal tissue damage, structural changes etc.
The management of osteoarthritis involves conservative, medical to surgical methods
Patients should be educated about their condition and its progression, including advice on joint protection and emphasizing the importance of strengthening and exercise. Patients with overweight should be advised for weight loss.
Some non-pharmacological interventions that can be offered include local heat or ice packs, joint supports, and physiotherapy which are the most effective conservative approach.
Simple analgesics and topical NSAIDs are the base of most medical management for OA, along with the conservative measures..
If conservative and medical interventions fail, then surgical intervention may be considered, especially if their joint symptoms have a substantial impact on their quality of life.
Osteoarthritis in Ayurveda or Sandhigatha vata
Osteoarthritis can be correlated to sandhigata vata according to Ayurveda. Deranged vata among the three doshas, is the main culprit behind sandhigata vata. Vatadosha is mainly situated in bones &joints hence due to vitiation of Vatadosha there are changes or deformity occurs in these in bones &joints.
Nidana and samprapthi
Nidana of sandhigata vata can be classified to two
Include injuries, trauma especially to marma (vital points), etc are coming under this category
This again divided into two
- Unhealthy food habits
Ahara or food is the most common contributing factor for the producing of a disease. Habituation to foods which are excessively dry ,cold,and light also to spicy food articles will trigger vitiation of vata. Another main cause is alcohol abuse which is also a cause for vata vitiation.
Another unhealthy food habits are untimely food, skipping foods, food articles which are contradict to season and place.
Faulty lifestyle or behaviors
- Excessive fasting
- Excessive or improper exercise
- Excessive physical straining which are intolerable to body.
- Carrying excessive load causes excessive pressure and stretching effect over the structures of the joint.
- Apart this physical causes excessive mental stress,sadness etc also vitiate vata.
Aggravation of Vata in the bones & bone-marrow dries joints and gives rise to cracking of bones & joints, piercing pain in the joints diminution of muscle tissue & strength, causing weakness and pain.
Ayurveda offers effective and safe treatment for prevention and cure of osteoarthritis. Ayurvedic treatment has the potential of regenerating the cartilage in mild to moderate OA. In case of severe OA, it arrests the progress of degeneration. General lines of treatment would be Snehana (oleation), Svedana (fomentation), Mridu Samshodhana (mild bio-purification), Basti (enema) and Vatahara Aushadha (Vata pacifying medicines). Regulation of Ahara and Vihara may also be applicable in Sandhigata Vata.
Sahacharadi kashayam: Commonly used medicine for managing painful conditions. It is a good antioxidant combination which help to prevent degeneration1
Maharasnadi kashayam: This formulation is prepared from parts of 26 different plants that are used in traditional medicine for a variety of purposes such as reduction of pain, reduction of inflammation, and antipyretic activity 2
Ashtavargam kashayam: Used to treat joint pain,and other vata vydahis
Yogaraja guggulu: It reduces inflammation and prevent degeneration.
Gandha taila: helps to reduce the friction between bones and prevent degeneration.
Treatment of Sandhigatavata usually begins with a basic process like virechana. It cleanses the body and help to open different channelsthus help in better absorption of medicaments. In addition, this also helps in maintaining or restoring the optimum equilibrium in Tridosha. Drugs like erandataila etc are used for this purpose.
Vata vitiation causes dryness of joints which initiate degeneration of tissues. Oil application prevent the same. massage stimulates blood circulation and assists the lymphatic system, improving the elimination of waste throughout the body. Absorption through the skin can be enhanced by suspending the drug in an oily vehicle and rubbing it on the skin. Thus, the medicaments used as massage are absorbed through the skin.Oils like Dhanwantharam tailam, murivenna,narayana taila, sahacharadi taila,panchasnham kuzhambu etc are some of the oils used for abhyanga in OA.
Different methods like bashpa sweda, patrapottali sweda, jambira panda sweda etc are used for sudation based on the condition of the patient.This will help to open the pores in body and helps for elimination of waste materials and absorption. This therapy also help to reduce stiffness and increase range of movements.
Upanaha: This is application of medicinal pastes over affected area and covers the area with some particular leaves which reduce inflammation and stiffness.
This is considered as the best treatment for vata diseases. rectal and colon regions are rich in capillary blood vessels hich enhances quick absorption of medicine.
Leech application will improve local circulation thus accelerate tissue repair.
Unwholesome food habits are one of the main reason of osteoarthritis. Correcting the diet habits will reduce vatarakopa . Ayurveda advices that food should be in optimum quantity which should maintain the equilibrium of three doshas.
In vata vyadhi like osteoarthritis you should avoid excess spicy foods and should follow proper timings. Advised are food prepared out of wheat, shashtika shali ( a type of rice),green gram, black gram, ghee, Milk, garlic, chicken. Fruits like grapes, mango etc are good to reduce vata, better to avoid citrus fruits. Consumption of alcohol should be avoided completely. You should consume adequate water daily which help you to rehydrate.
- Correction of poor posture
- Excessive loading of the involved joint should be avoided
- Patients with OA of the knee or hip should avoid prolonged standing, kneeling, and squatting
- Obese patients should reduce body weight.
- An exercise program should be designed to maintain range of motion, strengthen periarticular muscles, and improve physical fitness
YOGA and Physiotherapy
Physiotherapy is the most effective treatment modality for osteoarthritis in modern aspects. It will help to reduce stiffness and improve circulation.
Practicing yoga is very much helpful to overcome difficulties associated with OA. This will make your mind calm , stretch your body properly and relax your muscles. Practicing ,techniques like pranayama will increase your energy level.
Beneficial poses/asanas for osteoarthritis
- Veerbhadrasana or Warrior pose
- Setubandhasana or Bridge pose
- Vrikshasana or Tree pose
- Trikonasana or Triangle pose
- Soorya namaskaram
- Bhujangasanam or snakes posture
Researches proving yoga will reduce pain, inflammation morning stiffness and anxity in patients with osteoarthritis7.
Some Single drugs effective for osteoarthritis
Aswagandha (Withania somnifera (L) :It is an important medicinal plant with antiarthritis and several other pharmacological properties. The root extract showed anti-inflammatory activity which was comparable to that of 5 mg/kg hydrocortisone sodium succinate (Ai-Hindawi et al., 1992).
Shallaki (Boswellia serrata Roxb.): Shallaki is proved to act as an effective agent to reduce the pain and inflammation associated with the disease.
Guggulu(Commiphora mukul) : The oleoresin fraction of guggul possesses significant anti-arthritic and anti-inflammatory activities; the minimum effective dose being 125 mg/kg g body weight (Shanthakumari et al., 1964).
BALA(Sida cordifolia): bala is a proved anti arthritic drug in ayurvda which can reduce inflammation and pain5.
Rasna(Alpinia galanga) : flavonoids, glycosides, phenolic compounds, saponins and tannins in alpinia galangal showed significant antiinflamatory action on researches6.
Some home remedies for osteoarthritis
- pouring moderate hot water boiled with tamarind leaves and salt will help to reduce pain
- Applying hot water bag is also helpful.
- Application of steam will be helpful to reduce pain
- Warm oil application is helpful in non inflammatory conditions.
- Application of paste prepared out of tamarind leaves, moringa leaves and salt is helpful to reduce inflammation
Ayurveda offers “safe and effective treatment alternatives” for OA. Health is achieved by balancing not only the body, but mind and spirit as well. Treatments procedures like yoga, meditation, and the appropriate use of herbal therapies will help to achieve it.. These modalities offer their benefits without the significant risks associated with conventional medical treatments. Yoga and panchakarma is a golden combination which provide complete care for prevention and cure of osteoarthritis.
As one of the major ayurvedic multispeciality hospital in India, Sreerudra Ayurveda is one of the most recognized ayurvedic treatment center for arthritis in Kerala. The hospital is located in Alappuzha district, Kerala