By Dr Sajimon George BAMS, AAA, ATMS
Osteoarthritis is the most common cause of chronic joint pain. It is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of one or more of your joints.
Osteoarthritis affects 15-20% of the population. Osteoarthritis occurs most often in knees, hips and hands. Other joints, particularly the shoulders, can also be affected.
Osteoarthritis rarely affects other joints, except as a result of injury or unusual physical stress. It is the leading cause of pain and disability among the elderly. Osteoarthritis is the third leading cause of life-years lost due to disability. Obesity and joint injury are important potentially modifiable risk factors for the development of osteoarthritis.
Arthritis is an inflammatory condition of one or more joints, manifesting typically with pain , tenderness , swelling , and morning stiffness of the affected joint or joints.
Osteoarthritis is essentially a vatha disorder, with the involvment of pitha and kapha doshas.
Osteoarthritis is a common condition affecting both women and men, especially in the latter decades in other words during the Vatha predominant life stage. Vatha has dry and light qualities and its vitiation leads to imbalance of Kapha dosha. This depletion leads to osteo arthritis in which the cartilage in the joints wears away causing friction, pain and limited joint mobility and affects the large weight-bearing joints, like the hips and knees, also hands, feet, and spine.
Occurrence of arthritis indicates the manifested stage of the disease. This stage may have been preceded by joint discomfort or cracking and popping during the starting stage of the disease. Left untreated, most arthritic conditions progress to the advanced stage of disease with deformity, destruction of the articular surface and loss of function.
According to Ayurveda this is a Vatha predominant condition. Causative factors responsible for the vitiation of Vatha are:
These are a few other factors responsible for the vitiation of Vatha Dosha.
Principle of knee pain treatment in Ayurveda
Ayurvedic treatment for arthritis and its therapies for arthritic conditions should always be individualized.
Classical descriptions of arthritic diseases cannot be accurately matched with the disease entities currently described in Western medicine.
Inspection (Darshanam), Palpation (sparshanam ) and Clinical interview (prashna) will lead to an individualized diagnosis. But in the modern medicine , syndromes described in modern rheumatology are more standardized by definition based upon laboratory results.
Ayurveda offer a unique perspective on arthritis through the concepts of agni and ama. Due to vitiation of agni, ama or partially digested or undigested nutrients is produced and achieves toxic nature. This accumulates in the gut and is then spread through subtle channels of the body and reaches the joints with the help of Vatha. Modern medicine has validated the link between arthritis and the gut as the cause of various forms of seronegative arthritis and post-infective and reactive arthritis.
The Ayurvedic treatment for arthritis thus includes procedures such as Panchakarma for returning the toxins to the gut for excretion, rehabilitation of agni , lifestyle and dietary changes to address the initial cause of vitiation of agni and build-up of ama.
The Ayurvedic treatment for arthritis is in one way a partnership between practitioner and patient. Both palliative and deeper therapies should form part of the plan. Osteoarthritis is manageable rather than curable.
Depending upon the individual’s stage of progression of the disease the prognosis can be made. Aim of knee pain treatment in ayurveda can be disappearance of symptoms, reduction of symptoms, non-progression of the disease or, in the worst case, slower rate of disease progression. It is important for the patient to understand the goals and to appreciate the potential outcome of their efforts.
External application of Paste of Medicated powder: It is useful in the acute stage for reducing oedema, burning sensation and pain.
Dhara or Pouring of medicinal liquids: Based on symptoms, dhara or pouring of warm herbal decoction, medicated milk(Ksheera kashaya) over affected joints for 45-50 minutes is useful. This procedure can reduce pain and oedema within hours.
Internal administration of ghee or oils: This includes oral administration of ghee or oils processed with bitter and astringent herbs. This is the first step of Panchakarma treatment procedure. Choice of preparation is made by physician after assessing patient’s condition.
Steaming and other heating procedures: This provide flexibility to stiffened joint structures. It is useful in removal of blockage of subtle channels or srothas.
Virechana or Medicated purgation: It is a cleansing method, performed by giving some herbal purgatives which helps to regain power of fire principle.
Vasthi or Enema like procedure: Designed to clean the lower alimentary canal and most effective in Ayurvedic treatment bringing cleansing of subtle channels or srothas spread all over the body. This is very effective in removing abnormally increased Vatha principle. Special ingeredients may be added to it making it a brimhana vasthi which can cause regeneration of affected joints.
Rasayana therapy: This therapy follow pancha karma. Formulations and procedures meant for rejuvenation of asthi or bone dhathu are used here. These medicines will be continued for long period.
Herbs with the following properties are used for knee pain treatment in ayurveda.
Snehana (Oiliness), brimhana (nutritive) , normalizing function of asthi or bone dhathu. This can regulate fire principle in cellular level (dhatwagni) and correct transformation of dhathus.
Boswelia serrata (Sallaki), Commiphora mukul (Guggul), Strychnos nuxvomica (vishamushti), Tinospora cordifolia (Guloochi), etc some herbs useful in this condition.
Yoga should be approached cautiously with the assistance of qualified Ayurvedic doctor. It is crucial that clients with arthritis take ample time to warm up their joints before asana practice or indeed any form of exercise.
Yoga can be quite hand-intensive and many with arthritis have affected hands. However, practiced with due caution, yoga, swimming and walking are important for maintaining strength and flexibility in the affected joints.
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