Rheumatoid arthritis Treatment in Ayurveda

By Sajimon George BAMS, AAA, ATMS

Rheumatoid Arthritis (RA) is an autoimmune disease affecting any ethnic group. Its prevalence is 1%. Though it affect all age groups, it is more common in 30-50 years. Women are affected three times in comparison to male. It affect joints and its covering called synovial membrane and in the later stages leading to degenerative changes. During progress of the disease it may affect many other organs such as covering of lungs ie, pleura and covering of heart or pericardium. The disease starts with morning stiffness, loss of appetite, general weakness and sometimes may be associated with mild fever and generalized muscle pain. When joints are affected, it become swollen, stiff, and warm and pain starts. The common joints affected are knee, wrist fingers, neck and ankle. As joint inflammation progress, excess synovial fluid is produced and the joint become swollen. It is considered that the degenerative changes happening to the joint are not directly proportional to the swelling, pain or stiffness of the joints. In advanced stages chronic inflammation affect cartilage, bones, ligaments and deformity of joints happen. In RA patients there may be periods of remission and bouts of flare ups or increased disease activity.Fortunately, there is RA treatment in Ayurveda. Ayurveda consider rheumatoid arthritis as a systemic disease caused by vitiated rakta or blood tissue and Vatha.

Signs and Symptoms of RA:

• Pain & morning stiffness in the smaller joints of the hands & feet.
• Warm, Swollen and tender joints are affected in a symmetrical pattern or both side of body is affected.
• Generalized fatigue and feeling of unwell.
• Sleep disturbance.
• Fever and headache.
• Restricted movement in the affected joints.
• Deformed joints in advanced stages.
• Nodules or firm lumps under the skin of pressure points such as fingers, knuckles, hands and elbows.

Rheumatoid arthritis Treatment Ayurveda (Ayurvedic approach)

Clinical presentation of RA is comparable to Vatha Raktha explained in Ayurvedic classics. Excess physical and mental activities, indulging in bitter and astringent foods, lack of activities cause aggravation of Vatha. To be specific Vyana Vatha, the sub division of Vatha is aggravated which is the cause of blood circulation. Irregular and unwholesome food habits, sedentary life style, habit of sleeping in day time, eating meat of animals of water logged areas, black gram, curd and excessive sour salty food, trauma are cause of aggravation of Raktha dhatu or blood tissue. This vitiated Raktha dhatu or blood tissue starts vitiating Vyana Vatha and Vyana Vatha in turn aggravate Raktha. These vitiated factors spread all over the body and starts pathogenesis in the joints. Vatha Raktha disease thus manifest in different joints.

Based on the progress of the disease it has two stages. Initial stage Uthana Vatha Raktha and advanced stage called Gambheera Vatha Raktha. In Uthana, Twak(Skin) and Mamsa(Muscle tissue) are affected while in Gambheera Vatha Raktha , deeper tissues Medas (Fat tissue), Asthi(Bone tissue) , Majja(Marrow) are affected.

Prodromal symptoms

• Excessive sweating
• Blackish discoloration of skin
• Tenderness
• Laziness
• Fatigue
• Numbness
• Burning sensation

Uthana Vatha Raktha

Symptoms

• Itching
• Burning sensation
• Dilatation of blood vessels
• Reddish or Blackish discoloration of skin
• Numbness of extremities

Gambheera Vatha Raktha

Symptoms

• Firm and fixed nodules
• Excruciating pain
• Cyanosis
• Pricking pain
• Suppurative changes
• Stiff and immovable joints
• Gait changes
• Contracture of vessels around joints
• Wasting of muscles

Treatment principles

General approach

Any 

RA treatment in Ayurveda or formulation will be pacifying Vatha and Raktha

Snehana

Generally snehana or oleation is done with medicated ghee processed with milk and bitter medicines.

Vamana-Medicated vomiting

In conditions with Kapha predominant symptoms such as itching etc.

Virechana-Medicated purgation

Purgatives with drying nature for patients will snigdha or oily body.

Purgatives with oily nature indicated for patients with dryness.

Vasthi

Medicated enema with medicated oils/ghee and Ksheeravasthi(containing medicated milk) are useful.

Lepa

Paste made of suitable medicines are applied over areas where pain, discoloration, edema or burning is felt. When paste gets dried itself, it will be removed.

Abhyanga

Mild massage with suitable oils may be done in appropriate conditions.

Pariseka

Pouring of herbal decoctions, medicated milk is very useful especially when patient is suffering from burning sensation or throbbing pain.

Avagaha

Sitting in a vessel filled with suitable herbal decoction for stipulated period.

Yoga and meditation

Yoga, Pranaayama and meditation are very useful in patients with RA. In patients who suffer from generalized fatigue and depression with chronic pain pranaayama and meditation are useful. When stiffness, pain and wasting of muscles manifest, suitable yogasanas under strict supervision of a qualified medical practitioner is useful to improve mobility.

Padhya or Desirable foods

Wheat, Pulses like green gram, bitter guard, grapes and snake guard are useful.

Apadhya or undesirable foods/things

• Day sleep,
• Regular exposure to heat
• Excess use of pungent, hot and heavy to digest food is contra indicated.

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