Even for the slightest possible movement for the body, which has to be performed intentionally, in the muscular skeletal system, a person has to have joints. Even for a simple procedure like writing to complex procedures like walking, athletics, acrobatics multiple joints are involved. We might know the importance of joints until we are unable to move them due to external trauma or internal diseases like osteo arthritis rheumatoid arthritis and so on. . As far as modern drug therapy is concerned, it is palliative and symptomatic. No Allopathic treatment of OA and RA is aimed at reducing joint pain, maintaining mobility and no pharmacological agent has been shown to prevent, delay the progression of, or reverse the pathological changes in humans.
Apart from NSAIDs, glucocorticoid therapy and immuno-suppressive therapy may be of use, but long term use of these therapies is again controversial.
There are many other conditions and syndromes which involves arthritis as one of the diagnosing criteria. In almost all, no available therapy proves to be of much help.
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AYURVEDA
The most ancient pathy and life science known to man kind has a history which goes beyond 5000 years.Ayurveda looks at the human body in its peculiar on way. Every functional process of the body is carried out by three Humours (Doshas) : Vata, Pitta and Kapha
Body as a structure is composed of seven tissue elements (Dhatus) (the coordination roughly can be made as Rasa ((Plasma, Lymph, Interstitial fluid), Rakta (Blood), Maumsa (Muscles), Medha (Fat / Adipose Tissue), Asthi (Bones/Skeletal System), Majja(Bone Marrow) and Shukra (Reproductive Tissue) .
And three gross waste products (Malas) Purish (Faecal Matter ), Mutra (Urine), and Sweda(Sweat)
JOINTS AND HUMOURS: (SANDHEE AND DOSHAS)
Movements of Joints are the function of ‘vata’. Softness of joints and its nutrition is the function of ‘pitta’. Stability of joints, function of synovial fluid are contributed to functions of ‘kapha’
JOINTS AND TISSUE ELEMENTS (SANDHEE AND DHATU)
Mainly asthi (Bony Frame work) and Maumsa (Musculature) are involved in stretching of the joints.
According to Ayurveda, Asthidharakala or the skeletal system is analogous to the rectum of large intestines.
BODY PROTOTYPES
Like endomorph, mesomorph and ectomorph body types, ayurveda has described vata, pitta, and kapha and mixed body types 5000 years back. Of that, Vata and Kapha prototypes are proven to diseases of the joints.
SYMPTOMS: Stiffness, pain and tremor are roughly attributed to vata. Burning sensation, redness, heat to pitta and oedema, swelling, coldness to kapha
AETIOPATHOLOGY:
Ayurveda believes in ‘cause and effect’ philosophy. Causes of joint disabilities are variable. Ranging from trauma to consumption of food which vitiates humours leading to the disease of joints. These diseases may be divided into two major categories, one in which Vata is involved. Second group compromises the diseases involving other humours (Kapha and Pitta) and the undigested unwanted elements.
As the aetiopathology progresses involvement of deeper tissue elements like majja(Bone marrow) and shukra(Reproductive tissue), positive family history, analogous body prototype and many such factors make the prognosis worse.
Differential Diagnosis include mainly Sandheegata vata, (Osteo Arthritis), Aama Vata (Rheumatoid Arthritis) and Vata Rakta (Gout).
COMMEN CAUSES:
Old age, recurrent trauma, vata prototype and many vata vitiating eatables like pulses junk food, etc initiates an aggravates pathogenesis of sandheegata vata (O A)
Continuous use of fast food, exercise after meals, regular day sleep and many such factors which tend to accumulate the undigested unwanted elements in the body (Aama) initiate and aggravate aamavata (RA). It is a chronic disease with acute pain attacks pitta and rakta vitiating process like regular consumption of curd, mustard etc effects in vata rakta(GOUT).
Although all are joint related diseases, aetiopathology and stages differ, giving rise to difference in symptoms. Careful history taking clinical examinations according to ayurveda reveal the apt diagnosis.
TREATMENT ASPECTS:
Depending upon the course and the stage of the diseases, treatment principle varies. On the broader sense treatment modalities are of two types. Shodhan or Panchakarma (Eliminative/Detoxifying Therapies) and Shamana (Pacifying Therapies). Former one eliminates the responsible humours (Doshas) and elements and shamana pacifies, digest them. Procedures and drug choice depend on the modality decided. If the humours are in aggregative stages, and patients psycho-mental strength is good, one can go for the shodhana (Eliminative )type of treatment or otherwise.
(NOTE: All the below mentioned procedures may sound violent and aggressive, but these are basic detoxifying procedures carried out smoothly for thousands of years which give miraculous results. If wanted, these can be ommited and the disease can be managed on herbal drug therapy and pre-procedures mentioned below without any compromise in the results.)
Shodhana(Detoxifing) Therapy includes Five major categories namely:
Vamana, (Medicated Emesis), Vitiated humours are thrown away by aural route. Mainly performed in kapha dominant conditions.
Virechana (Medicated Purgation) Pitta dominant humours are eliminated by purgative therapy.
Vasti (Medicated Enema) As vata is the pre-dominant factor in causing joint diseases Vasti(Medicated Enema) carries utmost importance as it tackles vata dominant humours As stated earlier due to analogy or rectum and large intestine with the skeletal system (Asthidharakala) , vasti proves to be of great use.
Raktamokshna (Blood letting) Vitiated humours and blood are eliminated by blood letting
Nasya: (Administrating drugs by nasal route)
These Five Procedures (Panchakarma) are sub divided further and are performed according to condition of the disease, patient etc.
.Poorva Karma (Pre procedures) like (Snehan) Oleation and Fomentation (Swedan) are must before the actual shodhana procedures. In joint diseases external application (Massage) of medicated oils and fomentation relieves most of the symptoms. Selection of oil to be used varies according to the condition and humours involved. Four major and thirteen subtypes of fomentation are described in ancient literature of Ayurveda. Each of these possess its own properties and can be utilised accordingly. For digestion of unwanted material in the surrounding tissues internal medicines are also prescribed. Choice of the herbal drug (herbs, oil, ghee, decoction, powder, paste) or combination depends upon many factors such as body prototype age, sex, humours, stage of the aetiopathogenisis, digestive capacity (Agni) etc.
In short, Ayurveda looks into the disease in a holistic approach. Factors responsible for causation of the disease is found out and treated, rather than treating a symptom. In this manner, it provides the “complete treatment”. Reoccurrences of the disease is avoided by proper rejuvenative(Rasayana) drugs and by following the prescribed daily regimen (Dina charya).Arthritis, as a disease or as a symptom is being managed by ayurvedic way in,out patient and in patient department since thousands of years together without any side effects.
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