Rheumatoid Arthritis is one of the commonest joint disorders with varied clinical sign and symptoms involving multiple joints at various sites .
In Version 2 estimates for the Global Burden of Diseases 2000 Study , published in the World Health Report 2002 , Rheumatoid Arthritis is the leading cause of YLDs (Years Lived with Disability) at global level , accounting for 0.8% of total global YLD .The disease has shown to put an enormous economic burden on society .
It is a psychosomatic disease which is also of autoimmune origin .The essential feature of an autoimmune disease is that tissue injury is caused by the immunologic reaction of the organism with its own tissues .
It is characterized by symmetrical polyarthritis , fever , raised ESR , morning stiffness . The affected joint shows synovitis , damage of articular cartilage , formation of pannus , end muscle wasting . If untreated this disease often leads to complications like spindle shaped joint deformity , ulnar deviation , Z- deformity , bony ankylosis of the affected joint .
It is said that rheumatism licks the joints and bites the heart . That is why even cardiac pathologies like endocarditis , pericardial effusion etc are also seen as complication of this disease .
Juvenile Idiopathic Arthritis
Juvenile arthritis encompasses a range of disorders in children and adolescents aged 15 and below, which can be classified into groupings including infectious arthritis, reactive arthritis , connective tissue diseases and congenital and developmental diseases . The most common of these diseases is now called juvenile idiopathic arthritis (JIA), an umbrella term which describes children with an inflammatory arthritis of unknown origin which has persisted for at last 6 weeks . In the past numerous other terms including juvenile chronic polyarthritis, juvenile chronic arthritis (JCA), juvenile rheumatoid arthritis (JRA) and Still’s disease have been used for this.
In Ayurveda , Amavata is a disease which has simulation with Rheumatoid Arthritis . In Amavata , ama ( undigested proteins or autoantibodies ) are spread to various joints by vata causing inflammation and pain in the joints .
Classification: According to severity , it is of two types :
a) Samanya Amavata b) Pravrddha Amavata
Symptoms of Samanya Amavata : Angamarda ( Bodyache ) , Aruchi ( Anorexia ) , Trishna ( Thirst ) , Alasya ( Lethargy ) , Gauravam ( Heaviness ) , Jwara ( Fever ) . These symptoms are produced due to prevalence of Ama in the body .
Symptoms of Pravrddha Amavata : Sarujam Shotha ( Pain and inflammation in the joints of hands , feet , knee , sacrum etc .) , Vrishchika dansha vata vedana ( pain like scorpion sting ) , Agnimandya (Sluggish digestion ) , Aruchi ( Anorexia ) , Gauravam ( Heaviness ) , Utsahahani ( Lassitude ) , Asya vairasya ( Tastelessness ) , Bahumutrata ( Excessive urination ) , Kukshishoola ( Pain in abdomen ) , Nidra viparyaya ( Disturbed sleep ) , Vida vibandha ( Constipation ) , Jadta ( Stiffness ) , Praseka ( Excessive salivation ) .
- Virrudha Ahaar ( Incompatible diet )
- Virrudha Cheshta ( Incompatible lifestyle ) eg sedentary habits , exertion immediately after consuming unctuous food , sleeping during daytime , awakening at night , upholding natural urges etc .
- Mandagni ( Sluggish digestion )
Ayurvedic Management Of Amavata
- Ahaar Chikitsa ( Dietary Regimen )
- Vihaar Chiktsa ( Lifestyle Modifications )
- Agatabadha Pratishedha ( Therapeutic Measures )
Do’s : Garlic , ginger , turmeric , cinnamon , pepper , barley , green gram , bitter gourd , ridge gourd , snake gourd , drumstick , coriander leaves , curry leaves , amaranth , radish , carrot , papaya , warm water .
Don’t’s : Dairy products , meat , fried food , refrigerated food , alcohol , spicy food , white sugar, potatoes , tomatoes , apple , banana , grapes , jackfruit , mango , watermelon , pineapple , cabbage , cauliflower , double beans , French beans , mustard leaves , black gram ,groundnut , water chestnut .
- Physical activities causing pain in the joints should be avoided .
- Staying in one position for too long should be avoided .
- Good posture of the joints should be maintained .
- Weight should be controlled as excess of weight adds stress to the joints .
- Exercise or walk is very important to maintain the mobility of joints .
- Yoga and Pranayam are very helpful .
- Avoid sudden temperature variations .
Agatabadha Pratishedha ( Therapeutic Measures ) :
This includes Langhan ( Fasting ) , Shodhan Chikitsa ( Purificatory measures ) and Shaman Chikitsa ( Drug Therapy ) .
Langhan : It is the first line of management in the treatment of Amavata . Langhan means either absolute fasting or light diet . It increases the digestion and metabolism . It also helps in digestion of already formed ama .
Shodhan Chikitsa : It is the purification of body by Panchkarma therapy . It helps in removal of accumulated ama from the gut and microchannels so that vata can circulate and perform its physiological functions in the whole body .
Snehapana ( Internal oleation ) and dry Svedana ( Fomentation ) is given as purvakarma . Shodhana treatment given are Virechana ( purgation ) and Basti ( enema ) .
Shaman Chikitsa : It helps check further formation of ama by correcting agnimandya ( sluggish digestion ) and also helps in pacifying vitiated Vata dosha . Drugs having katu , tikta rasa ; deepan properties are used in the treatment of Amavata .These increase agni ( metabolism ) , digest ama , remove excess kapha , clear srotorodha ( obstruction of channels ) .
Herbs And Medicines
Herbs : Commiphora mukul , Pluchea lanceolata , Allium sativum , Trachyspermum ammi , Ricinus communis , Withania somnifera , Vitex nigundo , Zingiber officinalis , Boswellia serrata , Tinospora cordifolia etc .
Medicines : Many medicines in the form of tablet , powder , decoction , oil are indicated which should be taken strictly under supervision .
Prognosis : Disease with early onset and single dosha involvement can be cured . With the involvement of two doshas it becomes yapya ( difficult to cure ) . As the disease becomes chronic , it involves multiple joints along with systemic complications , makes it incurable .
With Ayurvedic remedies the Rheumatoid Arthritis can be controlled and the quality of life can be improved significantly .
[sws_green_box box_size=”600″]Article by,