Rheumatoid arthritis is a chronic disease which usually affects middle aged persons, and is seen more in women than in men. Children too, may get affected. In this disease, the synovial membrane, or the covering tissue of the joints gets swollen, resulting in stiffness, pain and limitation of movement. In severe conditions, the joints may ultimately become deformed. A disturbed immune function is believed to be responsible for this disease.
In Ayurveda, rheumatoid arthritis is known as "Sandhi Vata". This is not to be confused with "Aam Vata" which is the name given to Rheumatic Fever, or the fever which causes pain and swelling in joints and also affect the heart.
Management Of Rhematoid Arthritis
Rheumatoid arthritis of recent origin usually responds well to standard anti-inflammatory treatment. However, by nature this is a chronic disease, and while symptoms can be controlled, there is presently no cure. Standard modern medicine may not be very helpful once the condition becomes chronic, or treatment may have significant side effects. It is in such patients that Ayurvedic herbal treatment may be very useful and effective. One major advantage of Ayurvedic herbal medicines in such an affliction is that medicines may be taken for long periods without any serious side-effects.
Ayurvedic treatment of rheumatoid arthritis consists of the following procedures:
(i) "Snehan" ( use of local and oral medicated lubricants)
(ii) "Swedan" (local fomentation)
(iii) "Lep" (Local application of medications)
(iv) "Anuloman" ( mild laxative treatment for prolonged periods)
(v) "Raktamokshan" (blood letting)
(vi) "Dahan" (local heat branding ) and
(vii) "Shaman" ( symptomatic oral treatment).
Mahanarayan oil( containing mainly Asparagus racemosus), Bala (Sida cordifolia) oil, Vishgarbha oil are some of the medications used for snehan procedures. While local application is quite simple, oral use of medicated lubricants is best done under the direct supervision of a qualified and experienced Ayurvedic practitioner.While local fomentation can be done in several ways, "Naadi swedan" is the most effective. In this procedure, a jet of medicated steam is directed at the affected joints, usually after the snehan procedure. A decoction of Nirgundi (Vitex negundo) is usually used for this procedure.
Local medicated applications include Lepgoli, Dashang lep, and a mixture of Shrung, Daruharidra ( Berberis aristata), Alum, and Rakta Chandan (Santalum album). Several medicated herbal ointments are also available.
Local pain can be immediately reduced by blood-letting. This can be done by syringe or using leeches. About 50 ml. of blood is usually withdrawn from a vein near the affected joint. Local heat branding is used by some physicians to reduce acute tenderness of the joints. Various special metal instruments are used for this procedure.Castor oil and Haritaki (Terminalia chebula) treated with castor oil are used for mild, prolonged laxative treatment.
Oral Ayurveda Management
Oral medications include Maharasnadi decoction, Triphala Guggulu, Yograj Guggulu and Ashwagandharishta. Shallaki (Boswellia serrata) and Guggulu (Commiphora mukul) compounds are given for prolonged periods. Multiple herbal compounds containing Guggulu are available, which are used according to the presenting symptoms and the staging of the disease as done by the Ayurvedic practitioner.
It is advisable to avoid very sour, salty and cold (refrigerated) food products, as also fermented products. Using tolerable amounts of ginger and garlic in the daily diet is helpful. Some yogic asanas have been found to be useful in arthritis, and may be performed regularly under the supervision and advice of an expert in this field. Vata-If arthritis is due to vata, your joints will crack and pop. They become dry and are not swollen as they may be if excess vata is not the cause.
Pitta-The arthritis is characterized by inflammation. The joint becomes swollen and is painful even without movement. It often looks red and feels hot to the touch.
Kapha-In kapha-type arthritis, the joint also becomes stiff and swollen, but it feels cold and clammy rather than hot. A little movement, rather than aggravating the pain, tends to relieve it.
General Treatment of Arthritis
Depending on a person's lifestyle, diet, and emotional pattern, either vata, pitta, or kapha goes out of balance. Then that particular dosha slows down agni (digestive fire), resulting in the toxic, sticky by-product of inadequate digestion known as ama.
Vata, the main active dosha, brings the ama into the colon, and from there it travels through the system and lodges in the bone tissue and in the joints, giving rise to the stiffness and pain characteristic of arthritis.
Ayurveda attempts to remove the ama from the joint and bring it back to the colon, and then to eliminate it. To do this, we need to keep the colon clean. It is best to determine the type of arthritis and manage it for the remedies recommended for the specific type. If you do not know whether the arthritis is vata, pitta, or kapha arthritis, take 1 teaspoon triphala at night with 1/2 to 1 cup warm water.
If you know positively which type it is, you can use the following (1/2 to 1 teaspoon with warm water):
Haritaki for vata-type arthritis
Amalaki for pitta-type
Bibbitaki for kapha-type arthritis
Ayurveda recommends general techniques for increasing the intensity of the digestive fire (agni) in order to burn up the toxins that are harming the body.
Hot, spicy foods and herbs, including galangal and cayenne are frequently used.
A three- to five-day detoxification diet is often prescribed. Vegetables, juices, spices and herbs are taken during the fast, which lasts until the body shows signs that the digestive fire is burning strong. These signs include a return of the appetite, a feeling of lightness and a clear coating to the tongue.
Enemas and other means of cleaning the colon are often used to help detoxify the body.
Ruby, garnet or other "hot" gems set in gold are used for all three types of arthritis.
Various oils may be applied to the skin in order to help the body clear toxins, relieve pain and restore mobility.
Mahanarayan oil improves flexibility, stiffness, muscle fatigue, and removes pain. It is mixed with sesame oil (1:1) and applied to the painful areas. This oil also breaks up blockages and begins to heal locally. After oil application, warm heat, yoga, bath, or mild exercise further improves this situation.
Narayan oil is good for muscle and joint pain, lower body circulation, and reversing imbalances caused by aging.
The patient may be asked to sit in a sauna, or may have steam applied directly to the afflicted areas.
A variety of herbs, spices and bitters are used in ayurveda. These are often applied externally or ingested. These are believed to cleanse the body and to relieve pain and stiffness. Mint, ephedra, golden seal, gentian, nirgundi, eucalyptus leaves, prasarini, quassia, coptis, scute, phellodendrom, aloe, guggul, du huo, ligusticum, Siberian ginseng, myrrh, and yucca are some of the herbs used.
Treating Vata-type arthritis
Diet-In addition to the general treatment, Vata-type arthritis responds well to a three- to five-day detoxification diet and an anti- Vata diet. This diet includes warm, heavy and moist foods that give one strength.
Herbs, Essential Oils-Take yogaraj guggulu, 1 tablet 3 times per day. it cleanses bone tissue, strengthens bones, and improves flexibility.
Take 1/2 to 1 teaspoon Haritaki with warm water Apply mahanarayan oil on the affected joint, followed by application of local moist heat. For example, apply the mahanarayan oil into the affected joint, rub it into the skin, and then soak your foot in warm to bearably hot water. Add a "teabag' of brown mustard seeds to the water. (Wrap 2 tablespoons of mustard > seeds in a handkerchief or cheesecloth to make the tea bag.)
Helpful yoga postures:
Half Bridge pose
Treating Pitta-type arthritis
Pitta arthritis often has more pain and inflammation associated with it than other types.
In addition to the general treatment, Pitta-type arthritis responds well to a five- to seven-day detoxification diet and an anti-Pitta diet. Specific herbs for Pitta arthritis include guggul, sandalwood, aloe, saffron and chaparral. Apply ice packs on the inflammed part to quell the "fire."
Diet-The anti-Pitta diet consists of cool, slightly dry, and heavy foods.
Useful Ayurvedic Herbal Formulas
Take 1 tablet of kaishore guggulu (350 mg.) 3 times a day.
1/2 teaspoon sudarsban twice a day, washed down with warm water.
Brahmi and sandalwood oils (mixed together) are very beneficial.
Musta and nirgundi relieve pain.
Externally, apply cool castor oil or coconut oil to the painful area.
Apply a cooling substance, such as sandalwood powder paste to the affected part. Make the paste by taking 1 teaspoon of sandalwood powder and adding sufficient water to make a paste. Rub it gently onto the joint.
If the joint is hot and inflamed, put an ice-bag on it. This will help to ease the pain and inflammation.
Helpful yoga postures:
Treating Kapha-type arthritis
Arthritis is classified as kapha when the joint is painful, swollen, stiff, and feels cold and clammy to the touch.
Diet-In addition to the general treatment, Kapha-type arthritis responds well to a one- to two-week detoxification diet. The anti-Kapha diet is light, dry and warm. Avoid cold, oily, and heavy foods.
Pure guggul is best for this condition.
Punarnava guggulu tablets (250 mg.). Take 1 tablet 3 times a day.
Apply a paste of vacha (calamus root) powder externally to the joint. To make the paste, add sufficient warm water to 1 teaspoon of powder to make a paste.
If the joint fills with fluid, make an paste of equal amounts of punarnava powder and ginger powder. Mix 1 teaspoon of each with enough warm water to form a paste, and apply on the joint.
Hot herbs are also helpful, such as cinnamon, dry ginger, turmeric, trikatu.