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Article: Amavata (Rheumatoid Arthritis) | Arthritis Supplements | Joints Pain Treatment

Amavata (Rheumatoid Arthritis): Cure and Care by Ayurveda 

Author:
Dr. Imlikumba

B.A.M.S, M.D (Panchakarma), KRTC (Jamnagar)  
MO (Ayur) Bokajan PHC  

Introduction

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 all climates & all ethnic groups. Ayurvedic treatment of rheumatoid arthritis requires knowledge of the interpretation of the disease from an Ayurvedic perspective. Ama, which is associated with aggravated Vata, plays a dominant role. The clinical presentation of Amavata closely mimics the special variety of rheumatological disorders called rheumatoid arthritis, in accordance with their similarities in clinical features, such as multiple joint pain, swelling, stiffness, fever, and 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 is probably important in rheumatoid arthritis. Management of rheumatoid arthritis includes the use of analgesics and steroids for pain management, which have several adverse reactions and can lead to drug dependency. Amavata is a disease of chronic joint and body pain compared to rheumatoid arthritis as explained in modern medicine. Here we will explore the management and Ayurvedic treatment of rheumatoid arthritis.

Ayurvedic Treatment of Rheumatoid Arthritis: An Introduction

Due to irregular dietary habits and irregular activities like doing exercise soon after consuming food, results in indigestion and formation of Ama. Further, the vitiated Vata stimulates this Ama and takes it to various Kapha Sthans (sites) like Urah (chest), Kantha (throat), Shiras (head), etc., through Raktavahini Dhamanies (blood vessels). During the course, this Ama also mixes with the three doshas and finally becomes Picchila (sticky) and Kled (moist).

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

Criteria for Diagnosis According to Modern Medicine:

The American College of Rheumatology has given 7 points as criteria. Among them, a patient should have at least 4 points to be diagnosed as an RA patient:

  1. Morning stiffness
  2. Arthritis of three (or more) joints
  3. Arthritis of hand joints
  4. Symmetric arthritis
  5. Rheumatoid nodules
  6. Serum RA factor positivity
  7. Radiographic changes

Ayurvedic Symptoms:

According to Ayurveda, the main 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)
  10. Sandhi-sthabdhata (joint stiffness)
  11. Sandhi-sparshaasahyatva (joint tenderness)
  12. Agni-dourblya (impaired digestive capacity)

In later stages of Amavata (RA), the patient will have painful swelling in Hasta (hand joints), Pada (foot joints), Shirah (head), Gulpha (ankle joint), Trika (sacral joint), Janu (knee joint), Uru (thigh), etc. It is said that wherever the Amadosha reaches, the patient suffers from more pain and swelling, sometimes feeling "Vrischika Damsa Vedana" (scorpion sting-like pain).

Allopathic Vs Ayurvedic Treatment of Rheumatoid Arthritis

Modern Medicine Approach:

The main goals of therapy for RA are:

  1. Relief of pain
  2. Reduction of inflammation
  3. Preservation of functional capacity

Modern drugs are divided into three groups:

  1. Non-steroidal anti-inflammatory drugs (NSAIDs)
  2. DMARDs (Disease-modifying anti-rheumatic drugs)
  3. Glucocorticoid drugs

Initially, aspirin-like NSAIDs along with low-dose glucocorticoids are used. As a second line of treatment, DMARDs like gold compounds, D-penicillamine, antimalarials, and sulfasalazine are used. Sometimes, immunosuppressive drugs like azathioprine and cyclophosphamide are used. However, these drugs often have severe adverse effects. Prolonged use of NSAIDs can cause gastric irritation, platelet dysfunction, and azotemia.

Ayurvedic Treatment of Rheumatoid Arthritis (Amavata):

  1. Sneha (Oleation) Therapy:

   - Eranda Taila (castor oil) is the best because it has both Amapachana (digestion of Ama) and Virechana (purgative) properties.

   - Other Snehas (oleations) include Sunti Ghritam, Kanjika Shatphala Ghritam, Prasarini Tailam, and Saindavadi Tailam.

  1. Swedakarma (Sudation Therapy):

   - Mainly Ruksha Sweda (dry fomentation) like Valuka Sweda (sand fomentation) and Potali Sweda (bolus fomentation).

  1. Virechana (Purgation):

   - Formulations like Trivritadi Churnam, Hareetaki Prayog, Aragvada Palavaprayog, Eranda Kwatha Prayog, and Eranda Taila Prayog.

  1. Vasti (Enema Therapy):

   - Anuvasana Vasti with Vatanasaka Tailas like Nirgundi and Saindavadi Tailas.

   - Niruha Vasti formulations with Dashmula Kwath, Maharasnadi Kwath, and Rasna Erandamula Kwath.

  1. Guggulu Formulations:

   - Simhanada Guggulu, Vatari Guggulu, Yogaraja Guggulu, Rasnadi Kwath, Vyadhi Sardoola Guggulu, Rasna Saptaka Kwatha, Siva Guggulu, etc.

  1. External Lepas (Pastes) and Tailas (Oils):

   - Himsradi Lepa, Satapushpadi Lepa, Vijayabhairava Tailam, Saindavadi Tailam.

  1. Rasa Aushadies (Mercurial Preparations):

   - Amavatari Rasa, Amavatari Vatika, Amavateshwara Rasa, Vatagajendra Rasa, Amapramathini Vatika, Amavatadrivajra Rasa, Amrita Manjari Rasa, etc.

Pathya (Useful Diet and Lifestyle):

Ahara (Diet):

  - Old variety of rice (Purana Shali), red variety of rice (Laghu Rakta Shali), barley (Yava), chickpea (Chanaka), horse gram (Kulatha), lukewarm water (Shruta Sheeta Jala), water with Panchakola (Panchkolashruta Jala), ginger water (Shunti Siddha Jala), old wine (Purana Sidhu), cow's urine (Gomutra), garlic (Lasuna), wet ginger (Ardraka), dry ginger (Sunthi), buttermilk (Takra), bottle gourd (Patola), bitter gourd (Karavellaka), brinjal (Varthaka), neem leaves (Nimba Patra), drumstick (Shigru), forest meat (Jangala Mamsa).

Vihara (Lifestyle):

  • It is good to consume a little less quantity of food to facilitate the action of Pachaka Pitta (digestive fire), which will help control the formation of Ama.
  • Avoid food items that aggravate Kapha, such as dairy products, oily food, and salty and sour food.
  • Avoid incompatible food items (Viruddha Ahara) as they are considered a chief etiological factor of the disease.
  • Most vegetables should be consumed warm and with some spices to counteract their cold nature.
  • Avoid cold beverages, cold water, and ice cream as they can precipitate the disease.
  • Avoid excessive water intake after consuming food as it interferes with digestive enzyme concentration and slows the digestive process.

Conclusion

Ayurvedic treatments for rheumatoid arthritis (Amavata) include a comprehensive approach involving oleation, sudation, purgation, enema therapy, specific formulations, and lifestyle modifications. Proper diagnosis and treatment by a qualified Ayurvedic practitioner are essential for effective management.

Note: Ayurvedic medicines and treatments should be taken under the supervision of a qualified Ayurvedic doctor/physician. The information provided in this article is for educational purposes and should not replace professional medical advice.