Ayurveda, the ancient science of life has in store a huge armamentarium of herbs and therapeutic procedures which may benefit patients of arthritis if taken under supervision of qualified and expert personnel.

1. Ayurvedic
Management of
Arthritis
Dr. Pradeep Dua
Central Council for Research in Ayurvedic Sciences
(CCRAS)
February 14, 2011

2. ‘Health’- Ayurveda Perspective
Samadoshaha samagnischa samadhatumalakriyaah;
Prasannatmendriyamanaah svastha ityabhidhiyate.
(Sushruta Samhita)
Ayurveda defines health as balance of the three dosas
(biological humors), the agni (digestion and metabolism), the
dhatus (tissues) and the malas (excretion),as well as the
sensorial, mental and emotional and spiritual well being
(prasanna). Thus Ayurveda presents the most complete
definition of health which is in coherence to that of W.H.O.

3. objectives of Ayurveda
“swasthasya swasthya rakshanaam,
aturasya vikara prashmanam”
To maintain the health of the healthy
To treat the ailing
Ayurveda is essentially the science of life and longevity. It
presents a sound concept of aging, its prevention and
management. Ayurveda specially incorporates Rasayana
Tantra as one of its Astanga specialities, which is exclusively
devoted to nutrition, immunology and geriatrics.

4. The Dimensions of Geriatric Care
 Geriatric Care has two distinct dimensions,
* Promotion of health and longevity,
* Management of diseases of old age .
 The conventional modern medicine is apparently strong in
terms of the second dimension whereas, Ayurveda is notably
strong in terms of the first dimension as it has rich potential to
promote health of the elderly, besides the scope of rejuvenation
and promotion of longevity.
 The foremost classic of Ayurveda ,the Caraka Samhita begins
its deliberations in its very first chapter with Deerghanjivitiya
Adhyaya.

5. Forecasted Percentages of the Elderly
(65+ years)
 During last few decades there has been a noticeable rise in
the average life expectancy of the people in India and now
there is an obvious shift in the age distribution denoting
population-aging.
Country/ Region Year 1950 -% Year 2000-% Year 2050-%
World 5 6.9 19.3
Africa 3.2 3.3 6.9
Latin America 3.7 5.4 16.9
China 4.5 6.9 22.7
India 3.3 5 14.8
Japan 4.9 17.2 36.4
Europe 8.2 14.7 29.2
U.S.A. 8.3 14.7 29.2

6. Ageing Scenario in India:
 The ten most common diseases are
 1. Hypertension 7.Cataract
 2. Osteoarthritis 8.Diabetes
 3. Dyspepsia 9.Constipation
 4. Depression. 10.Ischaemic heart disease
 5. Benign prostatic hypertrophy
 6. Chronic obstructive pulmonary disease

7. Osteoarthritis
 ‘Osteoarthritis’ is 2nd
commonest(30%)
musculo-skeletal disorder in the world after
‘Back ache’ (50%)-W.H.O.
 ‘Osteoarthritis’ clinically presents as joint pain
and crepitus, mostly in the elderly people.

8. Risk factors:
 Genetic factors
 Age
 Obesity
 Occupation related mechanical stress
 Repetitive stress
 Joint damage (Trauma, Sepsis)
 Bone/ Joint related congenital defects
 Crystal accumulation in articular cartilage
 Prior inflammatory joint disorder
 Metabolic/ endocrine disorders.
 Quadriceps weakness

9. Ctd.
 Obese persons have
a higher risk of
developing
‘Osteoarthritis’.
 5% reduction in
weight decreases
the risk of
‘Osteoarthritis’ by
50%.

10. Clinical Features -‘Osteoarthritis’:
Symptoms-
 Pain (in or around the affected joint); often
aggravated by joint use and relieved by rest.
Gradually, the pain becomes persistent and in
advanced cases, the night pain may be
troublesome.
 Morning stiffness (in the involved joints) may
last up to half an hour.

11. Ctd.
Signs-
 Bony swelling
 Synovial effusion
 Crepitus (sensation of bone rubbing against the
bone, on movement)
 Restricted movements
 Joint deformity
 Muscle weakness and wasting

12. MISERABLE OLD AGE
 Mamsakshaya –
Sandhivedana (Arthralgia)
 Asthikshaya –
Asthitoda (Osteodynia)
 Majjakshaya –
Asthisoushirya
(Osteoporosis)

13. Ayurvedic Management:
Preventive:
 Sadvrutta / svasthavratta
 Rasayana
Curative:
 Medicines (Single Herbs & Compound Formulations)
 Panchakarma
 Diet & Lifestyle
 Home Remedies

14. Sadvrutta / svasthavratta
 ‘svasthavratta’- a comprehensive schedule of health
regimen for preservation of health as a code of health
conduct
 Dinacarya /Ratricarya - daily code of health conduct
 Rtucarya- conduct in relation to various seasons
 Sadvrtta- Details about life style, diet, exercise, personal
and social hygiene
 Pancakarma- periodical biological cleansing
 Rasayana- restorative remedies for rejuvenation
(promotion of health & longeivity)

15. Rasayana
 Rasayana
(Rasa = nutrition + Ayana = circulation & promotion)
specially deals with the science of nutrition, geriatric
care and rejuvenation. Rasayana signifies not a single
drug or medication, rather refers to a rejuvenative
regimen which of course uses rejuvenative remedies
or drugs, dietetics and overall healthy life-style and
positive psychosocial conduct. The use of Rasayana
measures and remedies produces best qualities of
Dhatus, i.e. body-tissues

16. Ctd.
 An important text of Ayurveda, namely Sarangadhara
Samhita describes the process of aging depicting the
features of specific bio-losses occurring during
different decades of life due to aging. These
descriptions are relevant even today if the chronology
is corrected with present life-span of man. This is
specially significant because it can provide a
guideline for selection of age-specific organ-
protective Rasayanas to restore the age-related bio-
losses during different decades of the life span as a
measure to retard aging.

17. Ctd.
Decade Age related Bio-loss Restorative Rasayanas
0-10 Baalyam Gradual Loss of childhood Vacha, Gambhari
11-20 Vruddhi Gradual Loss of growth Amalki, Bala
21-30 Chhavi Gradual Loss of lusture Haridra, Kumari, Louha
31-40 Medha Gradual Loss of intellect Brahmi, Shankhapushpi
41-50 Tvaka Gradual Loss of skin glow Kumari, Somaraji
51-60 Drishti Gradual Loss of vision Triphala, Jyotishmati
61-70 Shukra Gradual Loss of virility Ashvagandha, Kapikacchhu
71-80 Vikuma Gradual Loss of strength Amalki, Bala
81-90 Buddhi Gradual Loss of cognitive ability Brahmi, Mandukaparni
91-100 karmeindriya Gradual Loss of locomotive ability Amalki, Bala, Ashvagandha

18. Medicines
 Single drugs
S. No. Drug Dosage Vehicle
1 Shunthi Churna 1-3 gm Milk
2 Eranda Mula Kvatha 10-30 ml Water
3 Nirgundi Kvatha 10-30 ml Water
4 Rasna Kvatha 10-30 ml Water
5 Rasona Ksheer Paka 30 ml milk

19. Ctd.
 Compound formulations
S. No. Drug Dosage Vehicle
1 Maharasnadi Kwath 10-30 ml Shunthi churna
2 Rasna-erandaadi Kwath 10-30 ml Water
3 Dashmula Kwath 10-30 ml Water
4 Rasnadi Guggulu 500 mg – 1 gm Luke warm water
5 Mahayogaraja Guggulu 500 mg – 1 gm Luke warm water
6 Yogaraj Guggulu 500 mg – 1 gm Luke warm water
7 Mahanarayan Taila For external application
8 Vishgarbha Taila For external application
9 Panchanga Taila For external application
10 Narayana Taila For external application
11 Mahamaash Taila For external application
12 Vatgajaankusha Rasa 125 mg Rasna kwath

20. Panchakarma
1. Snehana: Massage with medicated oils such as
 Mahanarayana taila
 Dashmula taila
 Mahamasha taila
 Vishagarbha taila etc.
2. Swedana
 Ekanga or sarvang sweda (Hot fomentation) with decoction
of Nirgundi, Dashamula, Eranda and Bala etc.
 Patra pinda sweda (made from Nirgundi, Datura, Eranda,
Chincha, etc.)
3. Basti
 Anuvasana basti with Narayana taila and niruha basti with
dasamula kwatha.

21. Ctd.
 Upanaha sweda and;
 Joint specific Oleation (Janu vasti / Kativasti)
-Reduces synovial Inflammation & Pain
-Drains Effusion
-Regains Mobility

22. Ctd.
Pizhichil—Sarvanga Dhara:
i.e. Warm Medicated Oil Bath
-Reduces pain & inflammation
-Restores mobility & range of movement
-Prevents contracture
-Minimize deformity

23. Ctd.
Pottali Svedana—Bolus Sudation:
 Patrapotali Sweda-
Medicinal leaves bundle
 Churna Pinda Sweda -
Herbal powder bundle

24. Ctd.
SHASHTIKA PINDA SWEDAM
i.e. rice bolus sudation
 Vatapittahara sweda
 Improves muscle bulk, strength & tone
 Energize the old

25. Ctd.
 OSTEO NUTRITIVE ENEMA-
i.e. Thiktha saadhita ksheera vasti
 Milk processed with Bitter Drugs (like
Panchatikta) , kshira and ghrita.
 Remarkable relief in conditions like Avascular
necrosis of head of femur, Lumbar spondylosis,
Generalised osteoporosis, etc
 Anuvasana with Panchathikta ghritha guggulu

26. Diet & Lifestyle
 Do’s / Pathya:
 Masha [Black Gram], Palandu [Onion], Rasona [Garlic],
Sunthi / Ardraka [Ginger], Mulaka [Radish], Kushmanda
[Pumpkin], Mudga [Green gram] in regular diet.
 Fruits like Dadima [Pomegranate], Amra [Mango],
Draksha [Grape], etc.,
 Adequate rest to joints
 Regular, slow and gentle exercises
 Maintenance of posture and flexibility of the involved
joints.
 Reduction in weight
 Gentle massage with medicated oils

27. Ctd.
 Don’ts / Apathya
 Pungent and astringent or salty food and Yava
[Barley] etc.
 Exposing to too cold atmosphere and
consumption cold water, chilled drinks, etc.
 Excessive exertion, awaking up to late night and
day sleep, long walks
 Suppressing of natural urges

28. Ctd.
Counseling:
 Patients are advised to maintain a healthy weight
 Exercise should be done regularly
 Avoid over exertion
 Always sit in a right posture
 Eat freshly cooked food items
 Take diet rich in antioxidants
 Exercise for knees – Quadriceps exercise (patient is asked to
lie on bed and arise the legs by slowly with knees in extended
position gradually, some weight may be put on ankles and
same exercise to be repeated)

29. Home Remedies
 Hot fomentation followed by local massage of affected joint with
oil (Tila taila/ Sarshapa taila)
 Ardraka swarasa (Zingiber officinale) 1 tea spoon daily with honey
2 times a day for 15 days.
 Shunthi churna 1 gm , twice daily with milk for 15 days
 Take equal quantity of thymol, menthol, camphor oil and sesame
oil and gently apply over affected joints.
 Boil 15 – 20 Harsingar (Nyctanthes arbortristis) leaves in 4 cups of
water till one cup remains and take 1 cup twice a day for 15 days.
 Four Lasuna (Allium sativum) bulb-lets boil in 1 cup milk then
taken twice a day for 15 days.
 Take leaves of Eranda/Nirgundi/ Dhattura, apply some sesame
oil; heat the leaves and then apply over affected joints twice daily.
 Shunthi powder for local application.

30. duadrpradeep@gmail.com
09811190570