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Ayurveda to prevent, cure and alleviate Rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory, systemic connective tissue and joint disorder which affects principally the synovial joints and hence the term rheumatoid arthritis. It is considered to be both an extravascular immune complex disease and cell mediated immune disorder in which the sequence of events leads to inflammatory, granuloma formation and joint destruction.

In its typical and complete form, RA is a chronic inflammatory, destructive and deforming polyarthritis associated with systemic disturbance, a variety of extra articulatory lesions and the presence of circulating antiglobulin antibodies (rheumatoid factor), while the pattern of joint involvement is characteristically symmetrical, peripheral and its course typically prolonged, with exacerbations and remissions, atypical, asymmetrical and incomplete forms are not uncommon and have led to difficulties in diagnosis.

Causes and pathogenesis of Rheumatoid arthritis

• Age: any age but mostly 20-45 years and peak at 35-40 years
• Sex: more in females with 3:1 ratio with females
• Climate: more in temperate climates but low incidence in tropic
• Family history: with family history of the disease, shows increased frequency of HLA antigen DR4. in addition, those having DR3 antigen may have more severe disease
• Psychological factors: proceeding physical and emotional shock common
• Exposure to cold and wet environment
• Trauma: the traumatic joints may resume the pathology but subsequently other joints get involved

The causes of RA are unknown. However, in genetically predisposed individuals, some environmental antigenic trigger probably a virus, stimulate the production of anti-autobodies (IgM Rheumatoid factor) against the body’s own IgM immunoglobulins. This process can become self-perpetuating. Tissue damage results from immune complex deposition in the synovium and blood vessel walls, activation of complement and release of inflammatory enzymes.

Symptoms of rheumatoid arthritis

Common symptoms of rheumatoid arthritis are

• Symmetrical peripheral polyarthritis
• Severe early morning stiffness
• Arthritis of atypical distribution
• Tenosynovitis and or carpal tunnel syndrome
• Fatigue, weight loss, fever, acute onset of pericarditis and or pleurisy with fever
• Articular lesions
• Extra articular manifestations

Amavata- Ayurvedic perspective of Rheumatoid arthritis

In ayurveda amavata can be correlated to rheumatoid arthritis. The word amavata is derived from the word ama and vata. The aggravated doshas entering together into sacral joints, shoulder joints and induce stiffness of the whole body due to pain.

Causes rheumatoid arthritis according to ayurveda

Common symptoms of rheumatoid arthritis are
• Symmetrical peripheral polyarthritis
• Severe early morning stiffness
• Arthritis of atypical distribution
• Tenosynovitis and or carpal tunnel syndrome
• Fatigue, weight loss, fever, acute onset of pericarditis and or pleurisy with fever
• Articular lesions
• Extra articular manifestations

Pathogenesis of amavata

Doshas vitiated in amavata are vata, pitta and kapha. The vitiated dhatus are all the seven dhatus. On account of causative factors, the ama deposited i the places of kapha gets mobilised by aggravated vata. This ama mixes with local kapha and pitta and further gets vitiated and then driven to srotases by aggravated vata.

The vitiated annarasa, which moistens and forms a coating to the channels producing sliminess exhibiting various colours. The individual develops weakness and heaviness in heart etc. Thus the ama generates several disorders which may be severe. Later on, this morbidity enters to sacral and shoulder joints causes stiffness, sluggishness of activity (due to pain) and hence the disease amavata.

Symptoms of amavata

The general features of amavata are:
• Angamarda- bodyache
• Alasya- laziness
• Apaka- indigestion
• Aruchi- anorexia
• Gaurava- heaviness
• Sunathanga- swelling of the parts/ joints
• Thrushna- thirst
• Jvara- fever
• Vikunjana or contraction of cervical/ thoracic/ lumbar/ sacral/ knee/ shoulder and iliosacral joints
The weakness of digestive function gives rise to avipaka and subsequently produces ama which is responsible for vitiation of tridoshas.

Features of advanced rheumatism in ayurveda

• Agnidourbalya- loss of appetite
• Praseka- hypersalivation
• Aruchi- anorexia
• Daha- burning sensation
• Kukshi kadinya- hardness in abdomen
• Sula- colic pain
• Thrit- thirst
• Chardi- vomitting
• Vit vibadhata- constipation
• Jadya- inactivity
• Anaha- distention of abdomen with gas
• Antrakujana- gurgling sound in intestine
• Bahumutratha- polyuria
• Hrit graham- dysfunction of heart
• Brama- giddiness
• Murcha- unconsciousness
• Uthsahahani- depression
• Nidra viparyaya- loss of sleep
• Virasya- hatredness for food

Ayurvedic herbal treatment of rheumatoid arthritis

The ayurvedic practitioner has to assess the stage of the disease and decide whether the condition is ama or pakva or jeerna avastha and the formulate the line of treatment.

• In amavastha: agni deepana and ama pachana measures are principal and later on dosha sodhana and samana measures should be adopted
• In pakva avastha: agni palana (maintaining agni throughout) and sodhana ans samana have to be employed according to the predominance of doshas
• In jeerna avastha (chronic stage): the agni palana, pathya (proper nutrition containing easily digestible food) to overcome anemia and the sodhana if necessary and samana may be advocated.

The treatment methods are
• Langana to check further production of ama
• Ruksha sweda- like valuka sweda (fomentation with sand) without oil
• Herbs to increase the digestive fire
• Pungent and bitter herbs are beneficial
• Panchakarma therapy like virechana with castor oil
• Sodhana type of vasti

Herbs of choice in rheumatoid arthritis

Rasna, eranda, sunti, nirgundi, shallaki, guggulu

Preferable diet in rheumatoid arthritis

Red rice, horse gram, bitter gourd, garlic, ginger, warm water, herbs of bitter and pungent taste

Apathya (don’t take) in amavata

• Yoghurt, fish, milk
• Incompatible foods
• Foods which are heavy for digestion
• Sleeping in day time
• Waking up in night
• Cold breeze

Ayurherbs offers effective treatments in all the acute and chronic conditions like

• Calcaneal spur
• Carpal tunnel syndrome
• Frozen shoulder
• Low back ache
• Sciatica
• Muscle pain
• Osteoarthritis
• Osteoporosis
• Plantar fasciitis
• Tennis elbow,
• Ankylosis spondylitis
• Gouty arthritis