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Osteoarthritis and Ayurved

Sujal Torgal Patil

The three dosh i.e. vata, pitta, kapha are responsible for the wellbeing of the entire physical and mental infrastructure of our body. They are also responsible for any illnesses that occur. The three dosh get vitiated themselves and then vitiate the respective organ or system and eventually precipitate as diseases. ‘Pain’ forms the cardinal symptom of any vata disorder.
Arthritis is a painful inflammatory condition of the joints, with types like osteoarthritis, rheumatoid arthritis, gouty arthritis. Osteoarthritis is the most common form of arthritis. It occurs when the protective cartilage on the ends of your bones wears down over time.
Although osteoarthritis can damage any joint in the body, the disorder most commonly affects joints in the hands, knees, hips and spine. Osteoarthritis often gradually worsens, and conventionally no cure exists! At the best it could be managed. The incidence of osteoarthritis is increasing due to inappropriate dietary and lifestyle changes. Being a degenerative disease, it is common after the age of 50 or after menopause but there is rise in cases affecting younger patients. Although not a life threatening disease, it restricts normal movements of the body, forcing the patient to lead a restricted life.
IAyurved has its own sophisticated diagnostic system; as said earlier OA generally belongs to a cluster of diseases in which the Ayurvedic principle of kinetic energy, ‘VATA dosh’, prevails. According to Ayurved, the causes of OA are most often attributed to improper diet, unfavourable lifestyle, trauma, aging processes, and constitutional predispositions which cause aggravation of vata, which then pathologically gets dislodged in the respective joint and cartilage, which is already weakened due to aging, repeated trauma, lack of exercise or inappropriate and exhaustive movements. Eating of excessive dry, extreme heavy, less nutritive food, processed-canned-dried-fermented-acidic foods cause aggravation of vata.
Vata brings dryness (rukshata), lightness (laghutva), porosity (saushirya), and coarseness (kharatva) into the joints. Asthi dhatu (bony tissue) is formed from the meda dhatu(fatty tissue), when there is imbalance in the meda dhatu it shows in the asthi dhatu as well.
Corresponding to Ayurvedic models of pathogenesis, the disease is caused when the aggravated vata settles in the knee joint (or any other affected joint) and begins to destroy the structure and function of the joint. The features seen in OA and sandhi-gata-vata are similar. In the ayurvedic disease-entity, pain in the joint (sandhi-shula) is the main feature and can be accompanied by other features including swelling (shotha), stiffness (stabdhata), crepitus (atopa) and difficulties in performing proper functions of the joint. In early stages along with vata there could be involvement of pitta or kapha dosha also, which is the early inflammatory stage (navaavastha) which resembles rheumatoid arthritis but is not. So diagnosis of the condition is critical. But in jeerna(chronic) sandhi-gata-vata which resembles OA, the reduction and regulation of the vata dosha stands to the fore of a complex ayurvedic treatment.
Ayurved tries to manage this disorder with a multimodal approach.
Accurate diagnosis of the condition forms the foremost step. After differentiating the condition i.e. sandhigata vata (which resembles OA) from amavata (which resembles Rheumatoid arthritis), or vata rakta (which resembles gouty arthritis), the physician examines the patient while noting their prakriti, dietary and other history, seasonal and climatic assessment, nature of pain etc.
Aahar and Vihaar– further in the line of management, are the dietary corrections and lifestyle modifications. Foods aggravating vata should be barred from the diet. Diet which suits ones constitution, which isn’t too heavy or light for digestion, which on the contrary boosts the digestive fire, is freshly cooked and warm, which improves the bone and joint health should be given importance. Old grains like rice, wheat, barley, ragi, green gram, cow ghee, nuts, butter, dates, raisins, bitter vegetables, milk form the main ingredients of the diet.
In the lifestyle part, one should assume a certain position for a long time causing undue pressure on certain joints. Continuous sitting, standing, running, hopping, inappropriate posture or even sedentary lifestyle should be avoided. So also day nap, night vigil, suppression of natural urges like urination or excessive exertion is undesirable as ultimately result in vata imbalance.
Lose weight– higher BMI is usually associated with joint pain and inflammatory diseases. Therefore ideally one should reduce those extra kilos and bring the body to equilibrium.
Therapeutic management – externally and internally treatments are designed to target the reduction of abnormal vata which will reduce pain and improve movements simultaneously strengthening the joint structure. External treatments like snehan (oil massage), swedan (sudation therapy), janu basti, kati basti, parishek, pottali swedan, lepa etc reduce the inflammation and pain. If required purificatory procedures like panchakarma may be advised by the physician after thorough assessment.
Yoga and exercise– dependant on the area or the joint affected, certain poses help in strengthening the body whereas some may end up worsening the condition. Bhujangasan, shalabhasan, naukasan, suryanamaskar help in increasing the back flexibility. Poses like gomukhasana, ardhamatsyendrasana, baddhakonasan, vajrasan help in strengthening the knee, ankle and smaller joints of feet but shouldn’t be practised in extreme pain or swelling. Slow walking, jogging and swimming also helps in mobilising the joints. Pranayam if done regularly increases body’s endurance and helps in better pain tolerance. Meditative practices like guided meditation help in healing and focussing better on the ailment.
Oral medication – is dependent on the stage of the disease and the condition of the patient. There is no immediate pain relief as in case of popping painkillers but eventually there is as the disease starts reversing internally and the body regains its strength.
Kitchen herbs – turmeric, dried ginger, fennel, garlic, sesame oil, fenugreek, and castor can be incorporated in food or as home remedies internally and externally.
In the latter half of our lives our bodies become quite vulnerable to degenerative diseases which are quite natural. But the picture today shows many youth falling prey to these lifestyle disorders. The above guidelines can act both as preventive and curative measures in curbing osteoarthritis altogether.


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