The term ‘Arthritis’ is a loose term.  Any joint pain with swelling, redness of overlying skin, restriction of movement comes under arthritis. The term has become so common that there is nobody who does not mention it.

Arthritis is actually many symptoms which   causes more than 80 diseases. These include, Rheumatoid arthritis, Osteo arthritis, gout etc.

Rheumatoid Arthritis (RA)

It is the second most common rheumatic disease. An incredibly painful disease which affects mainly the joints.  It can shorten the life span  from around 6-10 years and can have a major impact on a person’s life as well as on the rest of the family. 42% of RA patients registered disabled within 3 years and many people have to give up work within one year of diagnosis.

Coming to its definition – RA is a chronic systemic inflammatory disorder of unknown cause involving the joints.

Causes

• Remains unknown
• Family studies indicate a genetic cause
• Experimental observations in animals suggest an ‘autoimmune phenomena’, which means when the body  fails to differentiate between self and non self so react to one’s own tissues causing damage.
• Clinical features
• Fatigue and weakness
• Joint stiffness
• Pain and swelling of joint. Usually in symmetric function especially in joints of hands, wrist and feet.
• Cardinal features in hand – Swan- neck & button hole, deformity of fingers during later stage.
• Cardinal features in foot – Lateral deviation of toes
• Presence rheumatoid nodules.

Diagnosis

The diagnosis of RA is based in 7 criteria. Of this  a patient having RA will be having five of seven criteria.

The criteria are,

1. Morning stiffness :- It lasting for more than 1 hour for more than 6 weeks
2. Arthritis (inflammation of joints) of 3 or more joint areas
3. Arthritis of head joint
4. Symmetric arthritis – involvement of same joint on either side of the body
5. Rheumatoid nodules – A solid raised area over body part of hand or feet seen by physician
6. Presence of RA factors in blood, diagnosed by blood test.
7. X-ray changes – shows erosion or decalcification of bones & joints.

Treatment & Management

Ayurveda does not consider RA simply as one particular roga (disease). Instead based on the different manifestations  of the clinical signs it can be called as vatashonitha, Amavata or sandigata  vata, avarana vata etc.

According to modern medicine there is no such cure for RA but progression of disease can be slowed.

Treatment in Ayurveda mainly focuses on the following criteria.

I       Nidana thyaga (Avoid the causative factor)

1. food articles
   • Avoid curd, fried oily foods
   • Red meat
   • Black grain, peanuts
   • Avoiding food that causes digestive imbalance like indigestion, burning seansation
   • Virudhahara (Incompatible foods)

2. Liquid articles         –    Avoid tea, coffee, soft drink, alcohol
3. Avoid smoking
4. Activities                  –

• Avoid keeping awake at night
• Riding two wheelers for long hours
• Rough handling

5. Avoid sedentary life style & improper dietary habits

II     Aushadha (Medicines)

Use of,  1)  Kashaya     –    Kokilasksha kashayam

Guggulutikthaka kashayam

Maharasanadi kashayam

Sahacharadi kashayam

2)    Arishtas                    –    Aswagandharishtam, Dasamoolarishtam

3)    Gulika (Tablets)    –    Kaishora guggulu, Abha guggulu, Simhanada guggulu

4)    Lepas (Application of powders) – Nagaradi churna  Jatamayadi churna,  Grihadhoomadi churna

III    Panchakarma

1. Abhyangam (with sahacharadi tailam, pindathailam etc.)
2. Pizhichil (with sahacharadi tailam, pindathailam etc.)
3. Vasti (enema)  with Sahacharadi anuvasana tailam
4. An important one is Raktamoshana using  Jalauka (leeches), Siravyadha (vein cutting) etc.

IV    Rasayanas (Rejuvenation Therapy)

Using  Vardamana pipaly rasayanam,  Sukumara rasayanam,  narasimha rasayana,  chyavana prasham etc.

V     Physiotherapy and rest   – to improve joint movements  & strengthen muscles.

VI    Occupational therapy

Includes training, advice, counseling which help people do daily activities more with less pain.

VII  Meditation – Relaxation – Yoga

To relieve from stress and mental impact affecting the patient and his family. Yogasanas like Vajrasana, Shirshasana  etc. and other asanas according to condition.

VIII Rehabilitation

• Educating the patient and his family about the disease and its consequences
• Non-pharmacological measure to reduce reduce the impact of the disese.