Bones Don’t Lie: Ayurvedic Wisdom to Outsmart Osteoarthritis

OsteoArthritis,a condition caused due to the degeneration of bone or joint , which leads to severe inflammation of joint associated with pain,swelling , restricted movements.In ayurveda,it’s the Sandhivata,in which the different joints present in the shareera or body got inflammed and result in swelling and pain.Usually it affects the older generation but ,in some cases can affect the children too.It affect the larger weight bearing joints.Now a days it can be categorised under lifestyle diseases.

Causes

Osteoarthritis,is common in women after their 40s,it’s a degenerative disease,reduced space between the joints which leads to friction,thus pain occurs.
Idiopathic – primary cause.
Secondary,it can be from either from local or systemic factors such as :

Traumatic – Any injury to any joint,or fracture
Hormonal imbalance
Metabolic – Wilson’s disease, Obesity
Inflammation – OA,Gout.

Signs and symptoms

वातपूर्णदृतिस्पर्शः शोथः सन्धिगतेऽनिले|
प्रसारणाकुञ्चनयोः प्रवृत्तिश्च सवेदना||३७||
-च.चि.२८
According to Acharya Charaka, explains that ,
वातपूर्णदृतिस्पर्शः- tenderness present , and sound arises.
शोथः- swelling
प्रसारणाकुञ्चनयोःप्रवृत्तिश्च सवेदना- Severe pain present on Flexion and extension.

● Swelling of joints
● Pain
● Restricted movement
● Difficulty in walking
● Morning stiffness less than 30 min
● Mainly on weight bearing joints ,knees,hip,ankle ..etc
● Stiffness

Classification and Clinical Features

OA can be classified into mainly 3 based on their affected sites.
● OA Of Knee – In this type there will be severe pain in the joints, swelling,Range of movement will be restricted . Crepitations present.
Gait – Antalgic gait.
Chronic Knee OA results in Varus deformity -Genuvarun,Genu Valgum .

Radiographic Findings – Space reduction between the joints,osteophytes present.

● OA of Hip – This is mainly affecting the ball and socket joint ,where degeneration happens to the head of femur, and this causes pain, restricted movement mainly for internal rotation.
Waisting of Hip Muscles.
● OA of Phalangeal joints.- This type which affects the smaller joints ,distal is more affected ,associated with pain,swelling , stiffness, common in women.
Heberden’s Nodes present.

Investigations

● X RAY
● Blood test – CRP,ESR,RA factor,
● Synovial Fluid Analysis
● Physical examination

Treatment

Sandhigata vata is a disease that is caused due to the aggravation of vata and depletion of Kapha to increase the mobility, vata pacifying drugs and treatment can be adopted,either externally and internally.

External:
● Abhyangam – Applying oil over the area affected,as the oil is one among the sneha which helps to reduce vata and thus increase unctuousness to the joint.
common oils used are –
Murivenna
Tila Tailam
Ksheerabala tailam
Mahanarayana Tailam
Dhanwantara Tailam
Kottumchukkadi Tailam
● Swedana – Fomentation,which relieves stiffness, strengths and improves the circulation of the joint. Usually done after abhyanga.It can be done in the form of Kizhi- Podikizhi- ie; the vata pacifying drugs are made into fine powder and prepared to a bolus Bag .
Elakizhi- where the Medicated leaves and other herbs are heated and prepared and tied to a bolus form .
Njavarakizhi – where the Njavara rice is cooked in milk and bala( sida cordifolia) decoction and tied to a bolus.This helps to reduce the waisting of muscle and strengthen it.
● Lepanam – The powdered herbs are made into apaste applied over the affected area.
Jatamayadi choorna lepam
Rasanadi chorna lepam.

● Local vasti – It’s a line of treatment where the warm medicated oils are poured and pooled for a stipulated time in a compartment prepared with wheat flour and black gram.It can be administered over the knee joint- Janu vasti,Low back – Kati vasti, Neck – Greeva vasti.
● Pichu – A large piece of cotton swab is dipped in medicated oils and placed over the affected sites and bandaged for about 20 – 30 min.
● Pizhichil – Medicated oil is being poured all over the body from a certain height for a stipulated time to pacify the vata dosha.

Shodhana -Purificatory treatment

In chronic Osteoarthritis ,Virechana is one among the panchakarma Treatment advised.

Vasti – Asthapana Basti, Anuvasana basti,which can be given in divided dose such as matra vasti – where minimal amount of medicine is administered,yoga vasti – which is administered within 8 days .

Snehapana – can be administered with GuggulutiktakaGhritam, Indukanthaghritam, Tiktaka Ghritam.

Internal Medicine
Rasnasaptaka kashyam
Indukantha kashayam
Kaishora guggulu
Rasnaerandadi kashayam

Lifestyle and Diet Modification

● Physical activity – It includes all those activities that are done as part of daily life ,walking , gym, excercise,which help to increase mobility of joints.
● Yoga and meditation – can influence the individual’s mind,and streching can improve a person’s mind and thus reduce the pain.
● Limit the intake of saturated fats
● Reduce the intake of sugar
● Include more fibre, calcium, magnesium rich food .More vegetable
● Bananas can be included which have high amounts of Potassium and magnesium which increase bone density.