Diseases of the joints are better known as rheumatic diseases. Osteoarthritis, rheumatoid arthritis and gout are common varieties of arthritis encountered in clinical practice.
Rheumatism is generally used for soft tissue inflammation or injury. Cervical spondylosis, sciatica and lumbago are also considered as rheumatic diseases.
To understand the disease process in various types of arthritis, it is necessary to understand the basic make up of a joint. Diagram of a typical joint is shown below:
Fig: Anatomy of the joint
Joints possess a synovial membrane (it covers the joint from inside) and cartilage (see diagram) which covers the articulating surface of the bone and merges at its free edges with the internal synovial membrane lining of the joint cavity.
The joint cavity contains a small amount of synovial fluid. The cartilage derives nutrition from the synovial fluid like a sponge. Synovial fluid acts as a shock absorber as it avoids friction between bones. It is also responsible for the nutrition of the joint.
With passage of age the synovial fluid decreases and friction between the bones increases. There is stiffness and loss of function of the joint function. This is encountered in osteoarthritis. In addition, there is pain and inflammation.
Rheumatoid arthritis is an autoimmune disorder in which rheumatoid factor is found to be positive. Gout is related to high levels of uric acid in the blood. Psoriasis, a skin disorder is also associated with arthritis known as psoriatic arthritis.
Pain, inflammation (swelling), fever, loss of function, and morning stiffness are cardinal features of arthritis. Based on the character of pain, involvement of the joint and laboratory tests, the final diagnosis is arrived at.
Some form of arthritis involves other organs like heart and muscles. It is common in rheumatic and rheumatoid arthritis respectively.
Rheumatoid arthritis accounts for 15 per cent of the total rheumatic disorders. The incidence is more common in women. The disease is more prevalent in cold and damp conditions.
Ama (substance produced by malfunctioning of the digestive system) is considered to be root cause of Amavata (Rheumatoid arthritis) in Ayurveda. It circulates in the blood and finally collects in the joint surface causing pain and loss of function. Rheumatoid arthritis accounts for 15 per cent of the total rheumatic disorders. The incidence is more common in women. The disease is more prevalent in cold and damp conditions
Signs and Symptoms
- Rheumatoid arthritis is a chronic form of arthritis characterized by pain and inflammation of more than two joints.
- It commonly strikes small joints of the hands. The arthritis has symmetrical pattern unlike gout and osteoarthritis.
- The finger joints are worst effected by rheumatoid arthritis.
- Deviation of hand and z- shaped deformity of the thumb are special features of rheumatoid arthritis.
- Rheumatoid factor is found to be positive in 80 per cent of the patients.
- Erythrocytic sedimentation rate (ESR) is on the higher side in acute cases.
- Total leukocyte count (TLC) and differential leukocyte count (DLC) are also high.
- In rare cases anaemia is found.
- Rheumatoid arthritis not only affects joints but it attacks organs like heart, muscle and eye also.
Allopathic Treatment & Side Effects
Painkillers and corticosteroids are used in the treatment of rheumatoid arthritis. Recently disease modifying antirheumatic drugs has been used with positive results. All the three classes of drugs provide instant relief but they have unpleasant side effects ion long term.
- Mahayograja guggul 2 tabs twice daily with hot water is a traditional remedy for rheumatoid arthritis.
- In severe cases, one tablet of Brihatavatachintamani rasa, is given twice a day, for one week. The medicine should be used under expert supervision.
- Maharasna quatha, six teaspoonfuls, with water should be consumed twice a day, for better effects.
- Trikatu powder is recommended for improving digestion. This drug is a boon for rheumatoid arthritis patients. One teaspoonful, with warm water not only corrects digestion but stimulates appetite also.
- Vishagarbha taila is used for local application twice a day.
- Hot fomentation following massage is helpful in reducing stiffness of the joints
Precautions and diet
- The patient should consume fresh vegetables, garlic and black pepper.
- Exposure to cold and damp conditions should be avoided.
- Use of curd is prohibited at night.
- White grams, pea, soybean, potato, and cold water bath should be avoided.
- Wheat, ghee, sathi variety of rice, ginger, garlic, punarnava, pomegranate, mango, and grape are useful in rheumatoid arthritis.
Ayurveda Clinical Studies
Ajmodadi churna: Present clinical trial was carried out on 20 patients by using castor oil, (dry fomentation and a polyherbal compound Ajmodadi churna. After three month of therapy quite improvement in symptoms of rheumatoid arthritis was observed.
In a study involving 15 patients, Ajmodadi churna proved to be effective in lowering the titre of rheumatoid factor, C-reactive protein, erythrocyte sediment rate, anti-cyclic citrullinated phosphate antibody and symptoms of rheumatoid arthritis.
Alambushadi Ghan Vati: Statistically significant improvement was observed in clinical, functional and hematological parameters in group A (Alambushadi Ghan Vati Group) and no improvement was in these parameters in group B (Placebo group) after the course of treatment.
Godanti bhasma: Several papers regarding efficacy of Godanti bhasma in the management of Rheumatoid arthritis have been published
Maharasnadi Quatha: Twenty two patients suffering from rheumatoid arthritis were given Vatari Guggulu and Maharasnadi Quatha internally for 3 to 6 weeks. The results were assessed in terms of clinical recovery and functional improvement. Relief from pain, oedema and fever was statistically significant (P<0.01) and fall in ESR levels was highly significant (P<0.001).
Babu G, Bhuyan GC, Prasad GP, Swamy GK. The clinical effect of Shunthi Guggulu and Godanti in the management of Amavata. J Res Ayur Siddh 2009; 30:39-50.
Kumar A, Kumar N. Effects of a herbo-mineral combination (sunthi guggulu godanti) in amavata (rheumatoid arthritis). J Res Ayur Siddh 2003; 24:14-30.
Mishra PK, Rai NP. Effect of Castor Oil along with Ajmodadi Churna & Ruksha Sweda in the Management of Rheumatoid Arthritis vis-a-vis Amavata. Int J Pharm Res Scholars 2014; 3: 566-72.
Mishra PK, Rai NP. Prognostic effect of Ajmodadi churna in the management of rheumatoid arthritis vis-a vis amavata. Univ J Pharm 2014; 3: 47-9.
Singh JP, Tiwari SK. Clinical evaluation of Alambushadi Ghan Vati in Amavata (Rheumatoid arthritis). J Res Ayur Siddh 2010; 31:85-94.
Swamy GK, Bhattathiri PPN. Vatari Guggulu and Maharasnadi Quatha in the management of Amavata-A clinical study. J Res Ayur and Siddh 1998; 19:41-8.
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