Rheumatology in Ayurveda

Ayurveda has a detailed description of structure and functions of360 bones and 210 joints. Formation of fluid inside the joints is also described. Various rheumatological syndromes described in Ayurveda include: Sandhigata Vata (degenerative-noninflammatory joint disease), Aam Vata (inflammatory joint disease, swollen joints), Vata Rakta, Asthikshaya (osteoporosis, osteomalacia), Kroshtuksheersha, Grudhrasi, Avabahuk, Vishvachi, etc. Management principles remain same as above though details of some of these diseases are unavailable. Fasting and diet modifications are important constituents of therapy. Basti (rectal administration of drugs) is also important in management of rheumatological diseases.
Many plants and formulations have shown promising results in reducing swelling and pain in arthritis. More clinical studies with larger sample size are necessary to establish evidence on efficacy of these drugs.

Ayurveda plants for Arthritis:

Guggulu (Commiphora wightii) Nirgundi (Vitex negundo)
Bhallatak (Semecarpus anacardium) Pippali (Piper longum)
Ginger (Zingiber officinalis) Rasna (Inula helenium)
Ashwagandha (Withania somnifera) Guduchi (Tinospora cordifolia)
Turmeric (Curcuma longa) Eranda (Ricinus communis)
Amalaki (Emblica officinalis) Triphala

Ayurveda formulations for Arthritis:

Aam Vata Sandhigata Vata
Yogaraj Guggulu Gokshuradi Guggulu
Arogyavardhini Nirgundi tail
Eranda shunthi Dashamoola kwath
Sinhananda Guggulu Ashwagandha choorna
Vishatinduka vati Chandraprabha vati
Rasnasaptak kwatha Dashanga lepa
Ajmodadi churna Trayodashanga Gugguluc
Khandashunthyavaleha Bhallatakasav
Bhallatak ksheerpak Abha Guggulu
Vatavidhwans Mahavatavidhvansa
  Mahayograj Guggulu

 (Drugs must be used on prescription from a qualified Ayurveda professional)

Adverse events and other issues

  • Heavy metal contamination : Lead, mercury and arsenic are toxic metals used in Ayurveda drugs. Innumerable Ayu rveda drugs contain mercury. Lead is a constituent of Mahayograj guggulu and Vatavidhwans - drugs used in arthritis. Various purification processes are described in Ayurveda literature before medicinal use of raw metals. The reported incidence of adverse events appears to be small as compared to estimated consumption of these drugs. Similar to vegetables, lead is found in pure herbal formulations due to environmental contamination (pesticides, fuel, rubber, paints, plastic, etc.).
  • Drug interactions : Ginger and garlic are associated with increased risk of bleeding. They must be consumed with caution alongwith painkillers and steroids.
  • Adulteration : Many reports indicate addition of steroids in dispensed herbal products. Charak calls such physicians as Chadmachar (dishonest, deceptive, fraudulent, feigned) doctors. A therapist who assures complete cure, asks to stop prescription medications, insists on secrecy of prescription, prescribes very severe diet restrictions, does not possess practice license, asks for advance payment and requests sexual relationship is considered to be a dangerous (Arthritis Foundation).
  • Cost of Therapy : Higher price does not necessarily mean effective treatment. Many of the therapies appear costly and lead to diversion and wastage of valuable resources.
  • Delay in diagnosis : Practitioners of complementary medicine are not trained in modern rheumatology diagnosis. There is enough evidence to suggest that conditions such as early rheumatoid arthritis and joint pains due to SLE, vasculitis and other inflammatory connective tissue diseases require early diagnosis and aggressive modern therapy. Delay in seeking rheumatology advice can be detrimental and even be life-threatening in these situations.

 

Instructions for patients using herbomineral formulations

  • Do not take on empty stomach. Take drugs after food.
  • Use for limited period not exceeding 3-4 months.
  • Do not use in children, pregnant women, elderly.
  • Do not use in anaemia and kidney failure (Check blood before starting the drug).
  • Do not take unlabelled drugs with unknown contents.



 

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