Rheumatiod arthritis is a chronic multi system inflammatory disease primarily affecting the synovium and adjacent tissue.
It can be a disabling and painful condition.
This can lead to substantial loss of functioning and mobility if not adequately treated.
While RA symptoms can affect several organs in the body, the joint symptoms of RA include:
RHEUMATOID ARTHRITIS is correlated in Ayurveda as AMAVATA.
Ayurvedic treatments for RA depend on which diagnostic samhita the practitioner uses/refers to give treatment.For example, those who practice from the guidelines “Madhava Nidana” believe that imbalances in the gut and inflammatory compounds cause RA.On the other hand, practitioners from the “Ashtanga Hridaya” school of thought believe that RA is the result of poor dietary and lifestyle habits that cause inflammation in the body.Both approaches use herbs, supplements, dietary changes, and exercise to help relieve RA symptoms.
According to Ayurveda AMA is the basic cause for all the diseases. The ama in the amashaya reaches the joints and other parts of the body to cause pain, swelling, tenderness can be seen here.
This reference is from Madhava nidhana who has divided this into two categories i.e aharaja nidana (causes that is produced due to food) and viharaja nidana (causes that is produced by our physical activities)
- Aharaja nidana
Virrudha ahara sevana (foods that are mutually contradictory) followed with physical activities that will get the agin (digestive fire) diminished.
- Viharaja nidana
If a person is having sedentary lifestyle and always consumes oily food, soon followed by physical exertion, then such person is having a tendency to suffer from amavata.
Viruddha sevana (consumption of food that is incompatible to the body) —– mandaagni (decrease in the digestive fire of the individual) —– ama utpatti (because of indigestion of food the ama is produced) —– viruddha cheshta, vyayama (and even because of incompatible physical activities) —– vata prakopa (vata dosha in the body gets aggravated) —– vata takes ama from sleshma sthana (as vata is the only movable dosha is the body, vata takes kapha from its place to other parts of the body) —– the ama with the advent of vata reaches dhamanies (the ama with the help of vata reaches the arteries) —-– the ama sticks to all the srotas due to its pichilata (sliminess) —– due to this the circulation slows down —– this leads to burden on the hrudaya( heart) —– when ama resides in the sandi (joints) then the symptoms starts to manifest.
Principles of management
Amavastha: Langhana, Rukshana procedures, medicines.
Niramavastha: Shamana drugs and Panchakarma procedures.
The foremost treatment mentioned in samhithas for Vatarakta is Raktamokshana. Raktamokshana is a parasurgical procedure to expel out the vitiated blood from the selected areas of the body. Since the time of Veda, Ayurveda has much productive materials about Raktavirechana Karma as a part of treatment. Blood should be let out with leech, needle, or venesection according to morbidity and strength. Since the main doshas involved in the pathology of Vatarakta are Vitiated Vata and Rakta. Because of the vitiation of Rakta, shodhana of Rakta is essential. Raktamokshana is considered to be the supreme therapy as it drains out the impure blood and cures the disease. Acharyas have also quoted that it not only purifies the channels, but also lets the other parts become free from disease and the action is faster than other remedies. Clearing the channels off Vitiated blood helps in the Samprapti vighatana (releasing the pathogenesis of the disease), thus curing the disease.
Langhana is line of treatment; it can be gain by fasting or giving light food like green gram soup or gruel.
With this rukshana can be achieved by some procedures like application of sudation by sand pottali (Valuka sweda), salt pottali or powder pottalis.
If pitta is involved in the disease, this rukshana can be done with dhanyamla dhara or dashmoola kashaya dhara to get better effect.
Externally lepas (paste) can be apply to reduce pain and inflammation like
- Kottamchukkadi: kapha dominance,
- Jadamayadi: pitta Rakta dominance,
- Shunthi+Gomutra lepa: swelling and pain, vata, kapha predominance.
- Upanaha prepared with gomutra, buttermilk and dhanyamla can be apply to painful and swollen part.
- Decoctions like Amrutottaram, Rasna-panchak, Gulguluthikthakam can be used.
- Gulika like Ama pachana vati, Kaishore Guggulu, Sanjivani vati.
- Powders like shunthi (Ginger), Vaishwanar, guduchi etc will be more beneficial.
- Basti like vaitarana, kshar basti is more effective in this condition.
- Decoctions like Rasnasaptakam, Manjishthadi, Kokilakshadi can be used.
- Gulika like Yogaraja, Kaishore Guggulu, Simhanad guggulu.
- Powders like Rasayana, guduchi etc will be more beneficial.
Virechana: In this condition Acharyas have also mentioned that at first the patient should undergo Virechana after unction with unctuous or rough mild purgatives. Virechana is explained in the management of Vatarakta as a prime treatment modality. It cleans the Dhatu by doing purification of body. Virechana drug due to its Ushna, Tikshna, Sukshma Guna reaches to heart by the virtue of their potency and thereby circulates all over the body. They liquefy the morbid Dosha and bring them up to the Amashaya from here the morbid factors through anal canal route are expelled out leading to Virechana. It has direct effect on Agnisthana and thus also helpful in increasing Agni. In disease RA, Srotorodha is present which is clear due to the property of Srotovishyandana of Virechana drugs. Virechana also help in normalizing the Pratiloma Gati of Vata thus release the general symptoms. Thus, Virechana help in breaking the Samprapti of disease
Basti: Regarding Basti, Acharyas have opined that there is no treatment of Vatarakta equal to Basti. Because of its vast field of therapeutic action, it has also been recognized as a complete therapy. Basti is not merely the enema, rather it is a highly complex, sophisticated and systemic therapy having wider range of therapeutic actions and indications. It is considered as a prime treatment modality for Vata Dosha. Since Vitiated Vata is involved in the pathology of Vatarakta, Basti karma has been explained as the main treatment modality in the management of Vatarakta.
Different types of basti can be used in RA and it is found to be very effective like Ksheera Basti, Yapana Basti, Yoga Basti etc.
Besides, Classical texts also reveal the treatment according to the type of Vatarakta i.e the external type (Uttana Vatarakta ) should be treated with Lepa, Abhyanga, Parisheka, Upnaha, while the deep one (Gambhira vatarakta) should be treated with Virechana, Asthapana, Shamana Snehapana.
Lepa: A type of therapy wherein paste of drug is applied to the affected part. Drug enters through Romakupa and further gets absorbed through channels leading to desired effects.
Abhyanga (Oil massage): Abhyanga can increase the fresh oxygenated blood supply to the muscles and organs, and aid the drainage of venous blood, promoting the removal of waste products from the body. By increasing the flow of lymphatic material, waste removal is also aided and white blood cell production is increased, boosting one’s natural immunity. It also influences the equilibrium in the nervous system. It helps in alleviating rheumatic disorders. It improves flexibility, softness and firmness of the skin and for long life. It is the most ancient method used to remove muscular fatigue and pain.
According to Ayurveda, certain foods may worsen RA symptoms like –
- Drinking alcohol
- Eating spicy foods
- Taking in excess salt
- Consuming too many sour, sweet, or sugary foods
- Eating uncooked foods
- Eating foods that cause acid reflux
As a result, an Ayurveda will recommend avoiding these foods.Ayurveda also recommend soups that contain barley and rice, as these are thought to add a sense of lightness to the body.It may also recommend a castor oil food. This is when a person consumes castor oil, a natural laxative, to encourage intestinal purification.Over several days, a person will reintroduce foods and ultimately progress to a healthful routine diet.
Exercise and lifestyle
Ayurvedic practitioners believe that positive lifestyle habits can support RA treatment. They believe that a sedentary lifestyle leads to the formation of “ama,” which causes inflammation and disease. Practicing yoga, an essential part of Ayurvedic medicine, can help a person with RA to be more active and also reduce stiffness and pain.
Ayurveda may recommend the following tips for people with RA:
- Using hot water, not cold, to bathe in and drink
- Avoiding exposure to cold breezes
- Avoiding late-night or late-afternoon naps
- Practicing yoga to relieve mental stress
- Using massage therapy with herbal oils to reduce pain and stiffness