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Ankylosing Spondilitis In Ayurveda – Pathogenesis, Therapy


By Dr Raghuram Y.S. BAMS, MD (Ay) & Dr Manasa, B.A.M.S

Ankylosing spondylitis (AS) is a uncommon sort of arthritis that causes ache and stiffness in your backbone. It primarily impacts the backbone and sacro-iliac joints or decrease again. This lifelong situation, often known as Bechterew illness, often begins in decrease again. It might probably unfold as much as neck or injury joints in different components of the physique. (Read more here)

“Ankylosis” means fused bones or different laborious tissue. “Spondylitis” means irritation in spinal bones, or vertebrae. Extreme instances can depart your backbone hunched.

There’s no remedy for AS. However remedy and train can ease ache and assist preserve your again sturdy.

An inflammatory illness, signs of ankylosing spondylitis (AS) embody ache, stiffness, and lack of mobility. The illness entails erosion of bone and elevated bone formation within the backbone, resulting in bone fusion. In superior instances, this will result in spinal deformity.

AS mostly happens in males of their teenagers and 20s, however it might probably have an effect on anybody of any age. It tends to be milder when it does happen in girls, making it tougher to diagnose.
Learn – Cervical Spondylosis: Ayurvedic Treatment

Ankylosing spondylitis in Ayurveda

Amavata – (Prishtagata / Katigata / Grivagata Amavata) – Amavata positioned in again, lumbo-sacral / pelvis or neck (cervical) areas are the suitable phrases for Ankylosing spondilitis in Ayurveda. Amavata has been in comparison with Rheumatoid Arthritis however the time period Amavata may be extensively utilized to many painful circumstances other than RA, together with AS. Within the pathogenesis of Amavata, it’s mentioned that the vitiated doshas get lodged within the trika sandhi i.e. lumbo-sacral joints and Sacroiliac joints following which they create stiffness in your entire physique (backbone too). Similar is the reason of amavata. Stabdhata i.e. stiffness will happen because of ankylosis and spondylitis. Jadya has been talked about as one of many signs of amavata, which describes stiffness and lack of mobility. ‘Saruja Shotha’ is one more symptom which implies painful swelling in physique components (ache and irritation).
Learn – Amavata: Causes, Pathology, Treatment, Panchakarma, Medicines

Fashionable science tells us that there isn’t a remedy for amavata. Ayurveda says that ‘sa kastah sarva roganam’ i.e. amongst all illnesses amavata is troublesome to deal with. Ayurveda opines that the progressive stage of amavata afflicts a number of joints like these of palms (higher limb), toes (decrease limb), head (cervical, atlanto-occipital), ankle, sacro-iliac, lumbo-sacral, knee and hip other than many issues and systemic signs which makes the illness troublesome to remedy or incurable. Ashu daurbalya (tiredness and fatigue), bahumutratam and vid vibaddhatam (extreme urination and constipation – change of bladder and bowel conduct), hridgraha (stiffness within the cardiac area – consultant of valvular circumstances and involvement of cartilages between breastbone and ribs in ankylosis) are additionally defined in Amavata simply as in Ankylosing spondylitis.  

Dandapatanaka – It’s a situation defined within the context of Vata issues. It’s mentioned that if vata and kapha get aggravated within the nerves, the physique will change into stiff similar to a stick. This most likely signifies the mechanism of ankylosis and lack of actions. We can’t examine this situation strictly as a result of AS is just not neurological. However this situation shall be thought of for remedy particularly when vata signs dominate the illness and there may be extreme stiffness and rigidity of physique joints and muscle tissue. Grasp Charaka explains the identical situation within the title Dandaka. On this, the vitiated vata causes stiffness / rigidity of joints of hand, legs, head, neck, again and pelvis. He tells that the physique turns into stiff like stick and it’s incurable. Fashionable texts take into account it as incurable.

Prishta-Shiro Graha – Among the many signs of Vata dysfunction, grasp Charaka mentions prishta shiro graham i.e. stiffness of the again and head (cervical backbone). In whole they point out stiffness of the decrease a part of the backbone and cervical backbone that are the signs of AS.
Learn – Effective Ayurvedic Therapies For Low Back Ache

Samprapti – pathogenesis

The ama carried and displaced by the drive of vayu will get settled within the kapha locations, primarily the joints of the physique. The immaturely shaped ama is carried additional into the arteries by the vata. The ama is by all of the three vitiated doshas enters varied channels of circulation and takes many vicious kinds. It instantly causes weak point and heaviness within the chest. This ama turns into answerable for manifestation of many illnesses sooner or later of time. The ama and vata collectively vitiated will enter the pelvic area (sacro-iliac and lumbo-sacral areas). They then trigger stiffness of the physique and trigger amavata.

Dosha – vata pradhana tridosha
Dushya – rasa, rakta, asthi, mamsa
Srotas – annavaha, raktavaha, rasavaha, asthivaha, mamsavaha
Srotodushti lakshana – vimargagamana (motion in irregular pathways)
Vyadhi Marga – Madhyama (since joints are concerned)
Agni – Agnimandya (weak digestion in abdomen)
Ama – sama (related to ama)
̶ Udbhava sthana (seat of origin) – amashaya (abdomen)
̶ Sanchara Sthana (motion) – sarvanga (all by way of the physique), dhamani (arteries), srotas (all channels of transportation)
̶ Vyakta Sthana (seat of manifestation) – asthi, sandhi
̶ Sadhya Asadhyata – Kashtasadhya (curable with issue)
Learn – Stiff Neck Causes, Ayurvedic Treatment And Remedies

Therapy rules

1. Amavata Chikitsa – Line of treating amavata
a. Fundamental rules –
Langhana (swedana),
Swedana (sudation),
tikta-katu deepana (digestion selling medicines and herbs having bitter and pungent style),
̶ virechana (purgation) and
̶ vasti (enema)

b. Exterior remedies –
̶ Abhyanga – natural oil therapeutic massage
̶ Swedana – sudation – churna pinda sweda (natural powder bolus fomentation), patra pinda sweda (bolus sudation with medicinal leaves), valuka sweda (sand mattress sudation)
̶ Dhara – stream pouring of medicated liquids over the physique, primarily fermented natural liquids (dhanyamladhara)
̶ Upanaha and lepa – poultices and anointment of medicated pastes utilizing compounds like Rasnadi, Kottamchukkadi, Grihadhoomadi, Ellumnishadi and Dashanga Lepam

2. Ideas of treating in excessive vata circumstances / vata issues

̶ Snehana – inner and exterior oleation (like therapeutic massage, showering of medicated oils over the physique to lubricate the joints, tub bathtub with medicated oils and so on)
̶ Swedana – bashpa sweda (steaming), pinda sweda (bolus fomentation) and so on
̶ Snigdha Virechana – unctuous purgation utilizing compounds like gandharvahastadi taila
̶ Vasti – medicated enemas

Panchakarma

Virechana and Vasti are the most effective therapies for Amavata.

Virechana shall be given as krama virechana (purging after giving oleation and sudation) or nitya virechana (each day purging with medicated oils in small doses). This relies on the amount of morbidity within the physique, doshas concerned and tolerance and power of the sufferers. One of many beneath talked about compounds shall be chosen for virechana –

Trivrit Lehya
Gandharvahastadi Kashayam
Gandharvahastadi Eranda Tailam
Nimbamritadi Eranda Tailam
Hingutriguna Leham
Hingutriguna Tailam
Shaddharana Churnam
Kalyana Gulam
Narayana Churnam

Vasti i.e. medicated enemas are unparalleled within the remedy of amavata and vata issues. When administered after virechana the outcomes are many fold.

Decoction enemas shall be given with one of many Erandamuladi Kashaya Vasti (the most effective among the many lot), Dashamula Kashaya / Kshira vasti, Vaitarana Vasti (one other finest), Mustadi Yapana Vasti and so on. Brihat Saindhavdi Taila or Guggulutiktakam Ghritam can be utilized for giving anuvasana or matra vasti.

Upakarmas

Valuka Sweda – in presence of stiffness and ama signs
Dhanyamla Dhara – in presence of ache, irritation and stiffness
Churna Pinda Sweda and Patra Pinda Sweda
Abhyanga and ama – for lubrication of joints and muscle tissue, as soon as ama is relieved

Medicines

Rasnapanchakam Kashayam
Rasnasaptakam Kashayam
Amrutottaram Kashayam
Simhanada Guggulu
Ajamodadi Churnam
Guggulutiktakam Ghritam
Rasnadi Ghritam
Yogaraja Guggulu
Maharasnadi Kashayam (for nourishing)
Rasnaerandadi kwatham (illness modifying)
Amavatari Ras

Vital herbs and dietetic inclusions

· Barley
· Horse gram
· Shyamaka – Setaria italic
· Kodrava – Paspalum scrobiculatum
· Rakta shali – Crimson rice
· Drumstick
· Punarnava – Boerhavia diffusa
· Bitter gourd
· Pointed gourd
· Ginger
· Scorching water
· Garlic processed in buttermilk
· Jangala mamsa – meat of animals residing in desert and dry lands
· Water processed with Panchakola churna

Avoidable weight loss plan in RA –
· Curds
· Fish
· Jaggery
· Milk
· Flour of black gram
· Contaminated water
· Wind blowing from east
·Mutually incompatible meals
· Asatmya bhojana – meals that doesn’t swimsuit us
· Forcibly controlling the pure physique urges or reflexes
· Behavior of awakening all through the night time
· Meals heavy to digest
· Meals which trigger blockage in cells and channels of the physique

Proprietary Medicines

Pill Actiflex
Capsule Amavatari
Capsule Arnopen
Arthozen
Capsule Dazzle
Pill Myostal
Orthofit
Penwel
R-Compound
Pill R-Pairyn
Capsule Remorin
Capsule Rheumarthro with Gold
Pill Rumalaya / Rumalaya Forte ya)
Capsule Arjit Forte
Capsule Arthrum
Tablet Shallaki

Click to Consult Dr Raghuram Y.S. MD (Ayu) – Skype

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