AMAVATA (RHUMATOID ARTHERITIS)

DESCRIPTION

Rheumatoid Arthritis (RA) is a chronic, progressive autoimmune disease that causes inflammation (swelling) and pain in the joints, around the joints and joint deformity. The RA has been described as Amavata in Ayurveda, where the vitiated Vata and Ama affect the lining of the joints, causing Shula (pain) & Shotha (swelling) in the affected area. Ama is a maldigested product, which is not good for the body. This Ama gets localized in the body tissue or joints, and lead to pain, stiffness, swelling, tenderness, etc. In Ayurveda, Nidana Parivarjana (avoid the causative factors) is considered as the first line of management for any disease. Virechan is a Shodhana process (which eliminate vitiated dosha and toxins from the body) to balance Dosha in the body mainly Pitta Dosha. Hence, this included both the treatment that is Nidana Parivarjana and Virechanakarma to manage Amavata.

Nidana of Amavata

According to Madhava Nidana the specific etiological of amavata include 

• Viruddhahara 
• Viruddhachesta 
• Mandagni 
• Nishchalata 
• After exertion immediately taking Snigdha Ahara are the main factor responsible for the production of Amavata.

Pathogenesis of Acute Ama Formation

Intake of etiological factor > Diminished Function of Jatharagni  > Incomplete Digestion of Ingested Food  >      Gastrointestinal Manifestation > Appearance of Acute condition > Like Alasaka & Visuchika  

Pathogenesis of Gradual Ama Formation

 Intake of etiological factor  >  Agni Dushti  > Improper digestion/indigestion of even light food > Fermentation of ingested food  > Formation of Toxin > (Amavisha) in GIT  > Circulation of Amavisha in blood with help of Vitiated Vata > Dushti of Dhatwagni and Bhutagni  > Sthansanshraya of Ama in Sandhi  

SIGN AND SYMPTOMS

• Fever 
• Pain and inflammation of one or more joints particularly of hands, foot, tarsals, knee, thigh and sacrum
• Scorpion bite like pain in affected joints
• loss of appetite
• Indigestion
• Vague pain in different parts of the body 
• The feeling of heaviness in the body
• lack of initiative 
• Disturbance in sleep habit
• Stiffness in chest 
• Constipation 
• This disease leads to the disability

TYPES

1. Vata Pradhana Amavata: In this type of ama Vata Shula will be present, and Vata Amavata is mainly predominant.
2. Pitta Pradhana Amavata:  In this type, Daha and Raga are present in the joints.
3. Kapha Pradhana Amavata: In this type Staimitya, Gourava & kandhu present in the body. 
4. Vata Pitta Paradhana Amavata: In this type combined symptoms of both pitta & Vata seen.
5. Vata Kapha Pradhana Amavata: In this type combined symptoms of both Vata & Kapha seen.
6. Pitta Kapha Pradhan Amavata: In this type combined symptoms of both pitta & Kapha seen.
7. Sannipatika Amavata: In this type combined symptoms of both all doshas seen.

Do’s:

The important Pathya Ahara (dietetics) includes-

• Dhanya (cereals): Purana/Shasti Shali (rice), and Yava (Barley).
• Pulses:  Kulattha (horse gram), Kalaya (Pisum sativum), Kodrava (Paspalum scrobiculatum)
• Shaka (vegetables): Shigru (drum stick), Ardraka (ginger), lashuna (garlic), Karavellaka (bitter guard), Patola (pointed guard), Mulaka (radish)
• Liquids: Boiled water, Panchakola Siddha Jala.
• Cow products: Takra (buttermilk) and cow’s urine.

Don’ts:

Apathya / Contraindicated foods and activities

• Food: Guru Ahara, Viruddha Ahara, Dadhi, fish, raw sugar, Masha, dustajala (contaminated water)
• Activities: expose to eastern direction wind, Vegadharana – suppression of natural. Urges. Atichankramana – excessive walking.

TREATMENT

Amavata management includes Shamana chikitsa (conservative treatment) and Shodhana chikitsa (detoxifying treatment).

SHAMAN CHIKITSA

Depending upon the stages acute or chronic and Doshas, many measures are advised such as 

• Langhana 
• Deepana 
• Pachana 
• Snehapana 
• Swedana 
• Virechana 
• Basti (enema therapy) for the elimination of Doshas from the body.

Drugs used in the management of Amavata possess:

• Rasa (taste) – Katu (pungent) and Tikta (bitter) 
• Veerya potency – Ushna (hot) 
• Guna (quality) – Laghu (easily digestible) and Tikshna
• Detox Premium Powder – Detox premium powder is a composition of herbal ingredients that detox your body by removing the toxins naturally. It contains ingredients like jahar mohra, akik pishti, gandhak rasayan, shankh bhasma, moti pishti, kamdudha ras, etc. It is the best medicine in reducing the redness, tenderness, stiffness, swelling in the case of rheumatoid arthritis.
  Recommended Dosage – Take 1 sachet twice daily with normal water.
•  Trikatu Syrup: – Trikatu combines the goodness of Black pepper, Ginger and, Long pepper to create an herbal remedy for digestive ailments, sluggish metabolism, obesity, and high cholesterol. This syrup has best results in anti-inflammatory, pain-relieving, and expectorant. It also help to tackle the weight problems or obesity. It can modulate your body’s immune response while cutting the characteristic inflammation associated with the rheumatoid arthritis.
  Recommended Dosage –Take 2 teaspoonful twice a day before meal with normal water.
  
• Panchasakar Churna – As its name describes the churna has made up of a total of 5 natural ingredients – Swarna patri (Cassia angustifolia), Shunthi (Zingiber officinale), Haritaki (Terminalia chebula), Shatapushpa (Foeniculum vulgare), and Saindhava lavana (Rock salt).  This churna is very beneficial to decrease the effect of aggravated Vata dosha thus relieves the excessive pain, discomfort, tenderness, etc. This wonderful remedy also corrects the digestive problems and other associated symptoms of Rheumatoid Arthritis.
  Recommended Dosage – Take 1 tablespoon with lukewarm water at bedtime.
• Rasayan vati – Rasayan vati is herbo-mineral ayurvedic formulation, which is 100% natural. Rasayan vati contains various herbs such as Aswagandha, Shilajeet, Amla, Kesar, Musali, Shatavar, Brahmi Abhrak Bhasam, Swarn Makshik Bhasam, Yashad Bhasam, Mukta pisti, Praval pisti, Jaiphal, Vang Bhasam, Dalchini, Javitri, Gokhru, Kaunch Beej, Saunth, Mirch, Pipli, Amla, Kesar, Manjith, Anant Mool, Brahmi, Musali, Swarn Vang, etc. These ingredients show antioxidant, aphrodisiac, anti-inflammatory, antipyretic, analgesic, immuno-modulator properties.
  Recommended Dosage – Take 1 tablet twice daily with normal water.
  
• Nerve up tablets – Nerve up tablets help in balancing the vata doshas and kapha dosha, and acts as nervine stimulant. It shows effective results in improving the central nervous system. It contains natural ingredients like shudha kuchla, shudha shilajeet, abhrak bhasma, praval pishti, shankh bhasma etc. These contains natural vatahar properties and helps in curing vata disorders, speed up physical and mental processes. It act as Respiratory stimulant, helps in Joint pain, Inflammation, Stiffness, Gout, Arthritis, Bodyache, Erectile dysfunction, and Body weakness.
  Recommended Dosage: Take 1 tablet twice daily.
  
• Sheet dhara syrup – It works on all the three doshas of body but mainly act on pitta dosha. It contains Ajwain, Kapur (camphor) and Mint leaves that help reduce Acidityand burning sensation in chest region with its cooling effects. It relaxes your mind also maintains Bloodpressure. CAC Sheet dhara help in controlling mood swings by which many women are affected nowadays. It also controls burping, nausea and bloating. Acid Reflux, Burning sensation in chest region, Bloating, Nausea, Burping, Hiccups, Maintain blood pressure, Control mood swings, Stomach ulcers, Improves Appetite.
  Recommended Dosage: Take 1/2 or 1 teaspoon of sheet dhara twice daily empty stomach.
  
• Pain-O-kill Tablets – As the name suggests these tablets will kill the pain naturally. The herbs present in the formation of these tablets are Ashwagandha, Hadjod, Punarnava, Nirgundi, Methi, Garlic, etc. These herbs in combination show antioxidant, analgesic, anti-inflammatory, immuno-modulator properties. The regular use of these tablets reduce body pain and acts on its root cause.
  Recommended Dosage: Take 1 tablet twice daily with normal water.