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Sandhigatavata (arthritis): Cure & care by ayurveda

Dr. Imlikumba, Health Naturally Clinic, Mercy Building: Kevijau colony, Dimapur: Nagaland, +91
Published on 5 Sep. 2017 8:15 PM IST
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According to Ayurveda Sandhivata disease comes under vatavyadhi. Sandhigatavata (Osteoarthritis) is common amongst the elderly and obese persons. Sandhigatvata is chronic disease and not only it affects the body & health but also affects daily activities of a person. So the patient is hampered physically as well as mentally. Since knee is the weight bearing joint it is more susceptible to wear and tear. Sandhigatavata occurring at the knee joint as a result of wear and tear is termed as Janusandhigata Vata. In old age, all Dhatus are deranged leading to Vata Prakopa and making the individual prone to many Vataja diseases. Sandhigatavata is one of such disease commonly affecting a large number of individuals. Sandhigatavata can be compared with Osteoarthritis of contemporary medical science. Osteoarthritis is the most common form of arthritis affecting the weight bearing joints of the knees, hips, lower spine and peripheral joints of fingers and toes. According to World Health Organization (W.H.O) Osteoarthritis is the second commonest musculoskeletal problem in the world population (30%) after back pain (50%). The reported prevalence of O.A from a study in rural India is 5.78 %. Only 25-30% of OA are symptomatic even though prevalence rate is about 80% at age of 65 years. 
Signs & symptoms of osteoarthritis: The symptoms of Osteoarthritis can include: Pain, Stiffness, A Grating or Grinding Sensation when the joint moves (Crepitus), Swelling (either hard or soft). Sometimes the knee may either lock or give way when you put weight on it.
Almost anyone can get osteoarthritis, but it’s most likely if:
• you’re in your late 40s or older 
• you’re overweight
• you’re a woman 
• your parents, brothers or sisters have had osteoarthritis 
• you’ve previously had a severe knee injury 
• your joints have been damaged by another disease, for example rheumatoid rheumatoid arthritis arthritis or gout.
Signs & symptoms of sandhigatavata: The signs and symptoms of Sandhigatavata is Shotha (swelling) Vatapurnadritisparsha (crepitation), Sandhishotha (swelling), Prasaran Akunchan Svedana (difficulty in flexion and exteention) Hantisandhi (destroy of joint), Sandhishula(joint pain) . The main symptom of Sandhigata Vata according to Ayurveda is Vatapurnadrutisparsha and as per modern concept one of the main symptoms of Osteoarthritis is Crepitus which is similar to Vatapurnadrutisparsha The term Sandhi means Sandhana' i.e. the union of two or more structures together. When the Vata Dosha is increased it is prone to get lodged in the Asthis(bones) and Sandhis(joints).
These signs and symptoms of Sandhigatavata closely resembles with Osteoarthritis which is due to destruction of articular cartilage, synovial fluid and synovial cavity of large joints. Most commonly affected joints are knee joints. It limits daily activities such as walking, dressing, etc.
Ayurvedic line of treatment of sandhigata vata:
 Among Swedakarmas mainly Valuka Sweda, Jambeera Potli Sweda, Patra Potali Sweda, Janu Basti etc are indicated
 Virechan yogas mentioned for Sandhigata Vata like Trivritadi churnam, Hareetaki prayog, Aragvada palavaprayog, Eranda Kwatha pryog, Eranda taila prayog etc. are used.
 Vasti:- treatment of O.A. can be overcome by Anuvasana vastis with vatanasaka tailas like Nirgundi, Saindavadi tailas etc. Niruhavasti formulations. with Dashmula Kwath, Maharasnadi Kwath, Rasna Erandamula kwath, Tikta Ksheera Basti etc. are indicated.
 Some of the important Sandhigata Vata (O.A.) Nasak guggulu, vati, kwatha are as follows Rasnadi guggulu drugs, Rasona panda, Vatari guggulu, Yogaraja guggulu, Rasnadi kwath, Vyadhi sardoola guggulu, Rasna saptaka kwatha, Siva guggulu etc. 
 External lepas, tailas for symptomatic relief; Himsradilepa, Satapushpadilepa, Vija yabhairava tailam, Sainda vadi tailam.
 Rasa Aushadies used in Sandhigata Vata (O.A.):- Ekanga Ver Rasa, Vatagajendraras, Amapramathini Vatika, Mahavat Vidhamsa Rasa, Amrita manjariras etc. Even pathya & apathyas are mentioned in Ayurvedic classics.
 Acupunture: A cure depends upon how well the cause of the disease is understood and in consequences to what extent it can be eliminated. Acupuncture should be used where it can give better & long lasting results.
 Cupping: Wet cupping creates a mild suction by leaving a cup in place for about 3 minutes. The practitioner then removes the cup and uses a small scalpel to make light, tiny cuts on your skin. Next, he or she does a second suction to draw out a small quantity of blood.
Treatment for osteo-arthritis: According to modern point of view main goals of therapy of O.A are:
• Relief of pain 
• Reduction of inflammation. 
• Preservation of Functional capacity
In medical science potent Analgesics, Anti-inflammatory drugs and also corticosteroids are generally prescribed for this disease. But these drugs are not so effective and pose increased risk of gastric erosion, hepatic and Nephrotoxicity etc. adverse effects. And also it is clearly said that, current treatment of Osteoarthritis is purely to pacify symptoms because there is no disease modifying Osteoarthritis drug yet. Intra articular steroids are widely used in Osteoarthritis particularly for the knee, these injections may provide marked symptomatic relief for weeks to month.
Pathya: Pathya is referred to the Ahara and Vihara, which causes pacification of the disease. Apathya is referred to the Ahara and Vihara, which causes complications and aggravate the disease. Ahara is the base and cause for the Strength, Complexion and Vitality of the living beings. It has the ability to promote health as well as to control the disease Pathology. The benefits of food like health, strength, longevity and energy are achieved only when the food is consumed by the person according to its Swabhava, Samyoga, Samskara, Matra, Desha, Kala, Upayokta and Upayoga Samstha.  Otherwise it will end up in manifestation of diseases.
 List of pathya ahara helpful in the disease sandhigata vata: Purana Shali (Old variety of Rice), Laghu Rakta shali (Red variety of Rice), Shasthika shali (Rice harvested in 60 days), Yava (Barley), Chanaka (Chickpea), Kulatha (Horsegram), Shruta Sheeta Jala (Luke Warm Water), Panchkolashruta Jala (Water with Panchakola), Shunti siddha jala (Ginger Water),Purana Sidhu (Old Wine), Gomutra (Cow’s Urine), Lasuna (Garlic), Ardraka (Wet Ginger), Sunthi (Dry Ginger), Takra (Buttermilk), Patola (Bottlegourd), Karavellaka (Bitter gourd), Varthaka (Brinjal), Nimba patra(Neem leaves), Shigru (Drum Stick), Jangala Mamsa(Forest meat). 
List of apathya ahara harmful in the disease sandhigata vata:
• Navanna (New variety of Rice), Masha (Black gram), Taila (Oil), Dushita Jala(Polluted water), Sheeta Jala (Cold water), Nutana Madya(New Wine), Aluka (Potato),  Dadhi (Curd), Guda (Jaggery), Matsya (Fish), Anupa Mamsa (Marshyland Animal meat).
• Dravyas possessing Guru (heavy), Snigdha(oily), Ati Drava (watery), Picchila (slippery) and Abhishyandi (sticky) Guna are considered as Apathya for Sandhigatavata. For better understanding, the Pathya and Apathya for the patients so as to reduce the severity of the disease. 
• Consumption of incompatible food items i.e. Viruddha Ahara should be strictly avoided since, it is considered to be a chief etiological factor of the disease.  
• Most of the vegetables are good to reduce the formation of vata. However, they should be consumed warm and along with some spices to counteract their cold nature.
• Cold beverages, Cold water, Ice cream should be avoided as they can precipitate the disease.  
• It is better to avoid excessive water intake after consuming food as it interferes with the concentration of the digestive enzymes and slows down the digestive process.
Conclusion: In modern science, mainly analgesics, Non steroidal anti inflammatory drugs or surgery are options for the management of Osteoarthritis. These treatments don’t give satisfactory relief and also causes some adverse effects. Ayurveda is the science of life and longevity. Ayurveda has a ray of hope to such patients because of its holistic approach of cure and prevention of disturbance in physiology. 
Note: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. The drugs described in this article are for general information/educational purpose only. Anyone should not use these without consulting a qualified Ayurveda doctor/physician.

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