Pain is an agonizing symptom experienced by human beings which many a time induces distress. Rheumatoid arthritis (Amavata) is the most crippling of the joint diseases. It occurs throughout the world in the all climates & all ethnic groups. Ayurvedic treatment of rheumatoid arthritis requires knowledge of interpretation of the diseases from ayurvedic perspective. Ama which is associated with aggregated vata plays a dominant role. The clinical presentation of Amavata closely mimics with the special variety of Rheumatological disorders called Rheumatoid Arthritis, in accordance with their similarities on clinical features, like multiple joint pain, swelling, stiffness, fever, general debility. Women are affected approximately 3 times more often than men. Pregnancy is often associated with remission of the disease in the last trimester with subsequent relapses after delivery. A genetic susceptibility to altered immune responses probably is important in Rheumatoid Arthritis. Management of Rheumatoid Arthritis includes use of analgesics, Steroids for the pain management which are having several adverse reactions and drug dependency. Amavata is a disease of Chronic Joint pain & body pain compared to Rheumatoid Arthritis explained in Modern Medicine. Here we will find out more about management and Ayurvedic treatment of rheumatoid arthritis.
Ayurvedic treatment of Rheumatoid Arthritis: An Introduction
Due to the irregular dietary habits and irregular activities like doing exercise soon after consuming food etc., results in indigestion and formation of ama. Further the vitiated vata stimulates this Ama and takes this to various kapha sthans like Urah. Kantha, Shiras etc through Raktavahini Dhamanies. During the course this Ama also mixes with three doshas and finally becomes picchiIa & Kled.
Signs and Symptoms :- According to modern medicine pain, swelling, tenderness, morning stiffness, muscle weakness, restriction of joint movement, loss of appetite, subcutaneous nodules, low grade fever, sleeplessness, deformities in joints and bones; fatigue etc signs & symptoms of the disease have been mentioned.
Criteria for the diagnosis according to Modern Medicine:-American College of Rheumotology has given 7 points as criteria. Among them patient should have at least 4 points to diagnose him as R.A. patient. Those 7 points are: 1)Morning stiffness. 2)Arthritis of three (or) more joints. 3)Arthritis of hand joints. 4) Symmetric arthritis. 5) Rheumatoid nodules. 6) Serum R.A. factor’s positivity. 7) Radiographic Changes.
Ayurvedic Treatment of rheumatoid arthritis: Symptoms
Symptoms have been mentioned in a scientific manner. According to Ayurved the main Lakshanas (Symptoms) of the disease are:-1) Angamardha-Pain in different parts of the body. 2) Aruchi -Anorexia.3) Tirishna –Thirst 4) Alasyam-Fatigue 5) Gauravam-Heaviness 6)Jvara-Fever 7) Apakah-Indigestion 8) Sandhishula-Joint pain 9)Sandhishotha-Joint swelling 9) Sandhi-sthabdhata-Joint stiffness 10)Sandhi-sparshaasahyatva-Joint tenderness 11)Agni-dourblya-Impaired digestive capacity.
In later stages of Amavata (R.A.) the patient will have painful swelling in Hasta (hand joints), Pada (Pedal joints) Shirah (head), Gulpha (ankle joint), Trika (Sacral joint), janu (knee joint), uru. (Thigh) etc. Most scientifically it is said that wherever the Amadosha reaches there the patient suffers from more pain and swelling and even sometimes feel “Vrischika damsa vedan” (Scorpian sting like pain).
Allopathic Vs Ayurvedic Treatment of Rheumatoid Arthritis According to modern point of view main goals of therapy of R.A. are
- Relief of pain
- Reduction of inflammation.
- Preservation of Functional capacity
The drugs of modern medicine are mainly properties. divided into 3 groups :-
- Non-steroidal anti-inflammatory drugs.
- DMARDS- Disease modifying anti rheumatic
- Glucocorticoid drugs.
- As first line of treatment. normally asprin like nonsteriod anti-inflammatory drugs along with low dose glucocorticoids are used.
- As second line of treatment DMARDS like gold compounds, D-pencillamine, Antimalarials, sulfa salazine etc. are used.
- Some times immuno suppressive drugs like Azathioprine, Cyclophosphamide etc are used. Though all the above drugs are in practice no drug is having satisfactory results. Almost all are having severe adverse effects. Even NSAIDS prolong use causes gastric irritaion, platlet dysfunction, azotemia etc.
Ayurvedic treatment of rheumatoid arthritis (AMAVATA):
- Among the snehas used for Snehapana Eranda taila is said to be the best because it is has both Amapachan and virechen. Other snehas indicated as pana are Sunti Ghritam, Kanjika Shatphala ghritam, Prasarinitailam, Saindavaditailam etc
- Among Swedakarmas mainly ruksha sweda like valuka sweda, potalisweda etc are indicated
- Virechan yogas mentioned for Amavata (RA) like Trivritadi churnam, Hareetaki prayog, Aragvada palavaprayog, Eranda Kwatha pryog, Eranda taila prayog Etc. are used.
- Vasti:- treatment of R.A. can be overcome by Anuvasana vastis with vatanasaka tailas like Nirgundi, Saindavadi tailas etc. Niruhavasti formulations. with Dashmula Kwath, Maharasnadi Kwath, Rasna Erandamula kwath etc. are indicated.
- Some of the important Amavata (R.A.) Nasak guggulu, vati, kwatha are as follows Simhanada guggulu drugs, Rasona panda, Vatari guggulu, Yogaraja guggulu, Rasnadi kwath, Vyadhi sardoola guggulu, Rasna saptaka kwatha, Siva guggulu etc.
- External lepas, tailas for symptomatic relief; Himsradilepa, Satapushpadilepa, Vija yabhairava tailam, Sainda vadi tailam.
- Rasa Aushadies used in Amavata (R.A.):- Amavatariras, Amavatarivatika, Amavateswararas. Vatagajendraras, Amapramathini Vatika, Amavatadrivajraras, Amrita manjariras etc. For Amapachan and maintenance of Agni in Amavata (RA)-patient even pathya & apathyas are mentioned in Ayurvedic classics.
PATHYA: Pathya is referred to the Ahara and Vihara, which causes pacification of the disease. Apathya is referred to the Ahara and Vihara, which causes complications and aggravate the disease. Ahara is the base and cause for the Strength, Complexion and Vitality of the living beings. It has the ability to promote health as well as to control the disease Pathology. The benefits of food like health, strength, longevity and energy are achieved only when the food is consumed by the person according to its Swabhava, Samyoga, Samskara, Matra, Desha, Kala, Upayokta and Upayoga Samstha. Otherwise it will end up in manifestation of diseases.
LIST OF PATHYA AHARA FOUND IN THE DISEASE AMAVATA:
Purana Shali (Old variety of Rice), Laghu Rakta shali (Red variety of Rice), Shasthika shali (Rice harvested in 60 days), Yava (Barley), Chanaka (Chickpea), Kulatha (Horsegram), Shruta Sheeta Jala (Luke Warm Water), Panchkolashruta Jala (Water with Panchakola), Shunti siddha jala (Ginger Water),Purana Sidhu (Old Wine), Gomutra (Cow’s Urine), Lasuna (Garlic), Ardraka (Wet Ginger), Sunthi (Dry Ginger), Takra (Buttermilk), Patola (Bottlegourd), Karavellaka (Bitter gourd), Varthaka (Brinjal), Nimba patra(Neem leaves), Shigru (Drum Stick), Jangala Mamsa(Forest meat).
LIST OF APATHYA AHARA FOUND IN THE DISEASE AMAVATA:
- Navanna (New variety of Rice), Masha (Black gram), Taila (Oil), Dushita Jala(Polluted water), Sheeta Jala (Cold water), Nutana Madya(New Wine), Aluka (Potato), Dadhi (Curd), Ksheera(Milk), Guda (Jaggery), Matsya (Fish), Anupa Mamsa (Marshyland Animal meat).
- Dravyas possessing Guru(heavy), Snigdha(oily), Ati Drava(watery), Picchila(slippery) and Abhishyandi(sticky) Guna are considered as Apathya for Amavata. For better understanding, the Pathya and Apathya for the patients so as to reduce the severity of the disease.
- It is good to consume little less quantity of food which facilitates the action of Pachaka Pitta(digestive fire) which will help to control the formation of Ama.
- Since the diet which aggravates the Kapha, also contributes the formation of Ama. Thus, dairy products, oily food items, salty and sour food articles should be avoided.
- Consumption of incompatible food items i.e. Viruddha Ahara should be strictly avoided since, it is considered to be a chief etiological factor of the disease.
- Most of the vegetables are good to reduce the formation of Kapha as well Ama. However, they should be consumed warm and along with some spices to counteract their cold nature.
- Cold beverages, Cold water, Ice cream should be avoided as they can precipitate the disease.
- It is better to avoid excessive water intake after consuming food as it interferes with the concentration of the digestive enzymes and slows down the digestive process.
NOTE: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. The drugs described in this article are for general information/educational purpose only. Anyone should not use these without consulting a qualified Ayurveda doctor/physician.