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ASTHIKSHAYA (OSTEOPHOROSIS)- AN AYURVEDIC PRESPECTIVE

ASTHIKSHAYA (OSTEOPHOROSIS)- AN AYURVEDIC PRESPECTIVE
By Nagaland Post | Publish Date: 7/15/2019 12:19:51 PM IST

 WHEN DIET IS WRONG, MEDICINE IS OF NO USE. WHEN DIET IS CORRECT, MEDICINE IS OF NO NEED.-  AYURVEDIC PROVERB

WHO defines osteoporosis on the basis of bone density. Low bone mass is an important feature. Total and regional as well as mineral and osteoid bone mass are reduced. There is micro architectural deterioration of bone tissue leading to increased bone fragility. Fragility means compromised bone strength which reflects integration of two main features, bone density and bone quality. Increased bone fragility leads to increase in fracture risk. 

Osteoporosis is an important ailment commonly overlooked by clinicians. Being usually asymptomatic, it is also called as a “silent killer disease”. Patients are usually unaware of their disease until fracture occurs. Patient lands up in a hospital after an unexpected fracture. Kshaya means loss , decline, decay, diminution. Dalhan has aptly defined kshaya as ‘swapramanhaani’. These three Sanskrit words together are more than sufficient to explain the present concept of asthikshaya. Various terms such as asthisaushirya, asthidaurbalya, asthishieeran , asthishunyata and asthimardav appear in Ayurveda texts to describe asthkshaya.

WHO defines low bone mass on the basis of T score i.e. standard deviation (SD) of bone mineral density (BMD) with reference to mean of young adult population.

0.00 to –1.00 Normal

-1.00 to -2.5 Osteopenia

< -2.5 Osteoporosis

CLINICAL FEATURES: There are no specific clinical features of osteoporosis except

• back pain

• propensity for fracture after trivial trauma.

• Wrist and hip fractures cause considerable morbidity.

• Hip fractures at this age have 15-25% mortality in one year and 70% of survivors have compromised function.

• Vertebral fractures, though usually painless, cause kyphosis (loss of height-widow’s hump), disability, reduced quality of life and reduction in vital capacity of lungs. 

As there are no specific features of osteoporosis, the subtle features of Asthi khaya described in Ayurveda need to be carefully looked for. These features are as follows:

• Falling of hair (alopecia) 

• Falling of lanugo hair (Loma) 

• Loss and breaking of nails 

• Loss of facial hair 

• Loss and breakage of teeth

• Fractures Laghuta of heel, ankle, etc 

• Fatigue Dryness Laxity of joints (shaithilya) 

• Bone pains (shool, toda) 

• Lack of vigor 

• Inactivity Inability to bear pain.

AYURVEDIC REVIEW: First we will review about Asthidhatu & then Asthivikara. 

Asthi Dhatu: Asthi is derived from the root “As+kthin” meaning to stay or in the sense of stability. Asthidhatu is the fifth dhatu among seven dhatus. Nails & hairs are mala of Asthidhatu.

Asthivikara: In Ayurveda there is no exact clinical entity mentioned in samhitas like Osteoporosis but it can be correlated to Asthikshaya, Asthisaushirya Asthikshaya- 

Symptoms in Asthikshaya: There is Pains, Deformity in Kesha(Hair), Nakha(Nail), & in Majjakshaya (Marrow) there is Asthisaushirya, timiradarshana (Giddiness). 

Asthisaushirya: Asthisaushirya means porous bones. Hemadri commented on word “Saushirya” as Sarandhratwam which means with pores. This condition explained in context of Majjakshaya(Marrow). From these above references we can discuss the Osteoporosis under Asthisaushirya & Asthikshaya

AYURVEDIC MANAGEMENT-

• Nidan Parivarjana: Avoidance of factors that aggravating Asthikshyaya i.e. vatakara aharvihar & ativyayam. According to modern science, factors aggravating Osteoporosis should be avoided eg. Smoking, alcohol, sedentary lifestyle, exercise, poor diet etc.

• Abhyantar Chikitsa: The following herbs are useful in strengthen the bones & also useful in fractures. Asthishrikhanla (Cissusquadrangularis)- 13 One of the synonyms of Asthishrinkhala is “Asthiyuka” which means it helps in maintaining the conjugation of Asthidhatu. It contains calcium oxalate as chemical constituent. 

A) Ashwagandha- (Withania somnifera): Ashwagandha is useful in kshyayavastha by itsBalya and Rasayana property. Thus it is beneficial in Asthikshaya.

B) Arjuna (Terminalia Arjuna): It is useful in fractures by its ‘Sandhaniya’property.

C) Gandha Tailam- Gandha Tailam is kalpa described by Vagabhatacharya in the treatment of Asthibhagna. It is used in the form of abhyantarapana, nasya. It is useful in strengthens the bones.Thus it will be beneficial in prevention of Osteoporosis.

• Panchakarma Upakramas:

A) Basti Chikitsa- Basti is one of the best shodhana chikitsa of Vatadosha. Basti acts on Asthivaha & Majjavahasrotas. Thus, Basti plays an important role in strengthen the bones and act as preventive measures for Osteoporosis.

B) Matra Basti- Charakacharya described in Sidhhisthana , Matrabasti is the most useful in Vataja Vikara & Bhagna Vikara.

C) Other Upakrama- In Asthibhagna Bandhana, Sechana, Lepana, Nasya, Abhyanga, are also useful. In acute pain of Asthivikara, Sechana (Taila dhara), Bandhana, Vedhana karma, Raktamokshana plays important role to reduce the pains. Sechana is done by vataghna sidha tailam, Nyagrodhadi kshayam. Lakshyasidhha dugdha is taken internally for strengthen the bones.

PATHYAPATHYA- The most important factor for preventing osteoporosis is Diet. The food that you eat can affect your bones. The sedentary lifestyle effects on your bones. Eating foods with a lot of salt causes to lose calcium can lead to bone mass loss. So avoid the junk foods, salty diet for healthy bones.

CONCLUSION:  In old age to prevent osteoporotic fractures Ayurvedic measures are useful. There are many upakramas(procedures) like Basti, Lepa, Tailadhara are useful for strengthen the bones. From these upakramas the Basti plays important role in strengthen the bones. Basti is the way to reach up to Asthidhatu as it is induced through Purishadharakala. 

According to modern science there are some contraindications, for Hormonal Replacement Therapy, Bisphosphonates. So in these conditions we can treat Osteoporosis through Ayuevedic treatment. The major risk of fracture in Osteoporosis can be avoided through Ayurvedic treatment modalities as prevention.

NOTE: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. contact 9483328411. 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.

Dr. Imlikumba, B.A.M.S, MD(Panchakarma), PG Dip Yoga, Dip in Accupunture., Health Naturally Clinic, Mercy Building: Kevijau colony, Dimapur: Nagaland

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