Feasibility of Ayurveda for Management of Osteoarthritis (Knee)

The primary objective of all systems of medicine is to provide accessible and affordable health care services to all people so that they can maintain good health.

In India Ayurveda one of the oldest codified medical system in the world was evolved through intuitive, experimental & perceptual methodology in India. The main objective of Ayurveda is to promote health thereby preventing the ailments and to relieve the humanity from all categories of miseries, i.e. physical, mental, intellectual and spiritual. In view of the potential of Ayurveda, it has been realized that Ayurveda can also contribute substantially to the success of the present health care delivery system.

There is well developed cross-referral system and the patients of fistula-in-ano, chronic rheumatic diseases, residual psychosis & anxiety disorders, chronic colitis, IBS,liver disorders, degenerative brain diseases & neuropathy and terminally sick patients of all kinds who are declared incurable and/or financially unable to afford modern medicine for treatment are referred to the Ayurveda. Both allopathy and alternative systems have their strengths and shortcomings. But the emerging trend fuses the best of both to serve the suffering humanity better. With specialization, dependence on sophisticated diagnostic and treatment methods, health budgets of families. The people, groping for a safer, cheaper alternative, try out traditional systems and newer modes of healing.

However, information about which system is most effective in what kind of health problem, is very inadequate. In the face of such a lack of knowledge, a patient falls back on allopathy seeking for instant relief. Though there are no easy answers to the above problem, communication between the experts of all the systems, appraisal of the available information, sharing of research experiences and evidence- based results can provide better understanding about the strengths and weaknesses of allopathy and complementary systems, which array an entire spectrum from traditional, time-tested systems and solve the problem. Many allopath’s are coming up with their open minds to consider the merit of the Indian systems of medicine and also suggest appropriately to their patients in for its utilization in certain diseases. They also acknowledge the importance of diet, lifestyle - social and psychological factors. The trend is leading to integrated medicine, harnessing the best from all systems and prescribing the remedy with available options to serve the patient best.

Osteoarthritis (OA) is a chronic condition of the joints in which the cartilage cushioning the ends of the bones gradually loses its elasticity and wears away. Without the protective cartilage, the bones begin to rub against each other, causing stiffness, inflammation, and loss of movement. It can occur in any of the body’s joints but most often develops in the hands and weight-bearing joints, including the knees, hips, and spine (usually in the neck or lower back).

Osteoarthritis is the most common form of arthritis worldwide, with symptoms ranging from minor discomfort to debilitation. For people coping with advanced osteoarthritis, the effects are not only physical but also emotional as pain and decreasing mobility can limit the ability to work, participate in daily activities with friends and family, and enjoy life.

Current conventional medical treatments focus on pain reduction and control of inflammation; however, these approaches have no effect on the natural course of the disease. The most common medications prescribed for osteoarthritis are, at best, moderately effective. In addition, side effects of these treatments can be quite significant, and at times life-threatening. Often times, the ultimate treatment for a disabling joint is joint replacement, with the inherent risks and cost that come with surgery. If current trends continue, it is estimated that 600,000 hip replacements and 1.4 million knee replacements will be carried out in the U.S. alone in 2015.

Ayurveda has best remedies and treatments to offer towards effective management of osteoarthritis knee. ‘Sandhigata Vata’ a painful condition of the joints can be compared to Osteoarthritis due to proximity of symptoms.When SandhiVata occurs in knee joint(janu sandhi),it is called ‘Janu Sandhi-gata Vata’.

Ayurvedic treatment for arthritis and its therapies for arthritic conditions should always be individualized.

Classical descriptions of arthritic diseases cannot be accurately matched with the disease entities currently described in Western medicine.

Inspection (Darshanam), Palpation (sparshanam ) and Clinical interview (prashna) will lead to an individualized diagnosis. But in the modern medicine , syndromes described in modern rheumatology are more standardized by definition based upon laboratory results.

Ayurveda offer a unique perspective on arthritis through the concepts of agni and ama. Due to vitiation of agni, ama or partially digested or undigested nutrients is produced and achieves toxic nature. This accumulates in the gut and is then spread through subtle channels of the body and reaches the joints with the help of Vatha. Modern medicine has validated the link between arthritis and the gut as the cause of various forms of seronegative arthritis and post-infective and reactive arthritis.

Different preventive and palliative treatment and procedures like panchakarma are advocated for the management of osteoarthritis by Ayurvedic physicians by considering the prakriti (pscycho-somatic constitution of the individual) age,tolerability etc. of the patients, stage of the disease and the season etc.

The Ayurvedic treatment for arthritis is in one way a partnership between practitioner and patient. Both palliative and deeper therapies should form part of the plan. Osteoarthritis is manageable rather than curable.

Depending upon the individual’s stage of progression of the disease the prognosis can be made. Aim of knee pain treatment in ayurveda can be disappearance of symptoms, reduction of symptoms, non- progression of the disease or, in the worst case, slower rate of disease progression. It is important for the patient to understand the goals and to appreciate the potential outcome of their efforts.

There are also several studies that show decreased inflammation and joint swelling after administration of Ayurvedic Supplements like Yogaraj Guggul tablets and Ashwagandha Powder for internal use and Narayan taila for local gentle massage followed by hot fomentation has shown progress in improvement for patients.