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Individuals between the age group of 30 to 75 years of both genders having clinical features of Sandhigatavata as described in Ayurvedic classics,[ 9 ] as well as clinical features of osteoarthritis. Car and Engine Scanner. No adverse reaction of any procedure or oral medicaments were found during treatment, either as inpatients or as outpatients. Krishna Kumarsinhji Bhavsinhji died at Bhavnagar on 2 April , aged 52 after a reign of 46 years. Abhyanga reduces the provoked Vata , which is responsible for the decay in the Dhatus and for manifestation of features like pain, stiffness, and crackes. Patients who had an association with other diseases like diabetes mellitus, hyper or hypothyroidism.
Requirement Frequency One Time. Thank You. Mriduvirechana mild purgation with Eranda Sneha seed oil of Ricinus communis Linn.
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Koshtha was assessed on the basis of the patient's bowel habits and sensitivity. Patients of Mridu Koshtha were given 30 ml of Eranda sneha and patients of Madhyama and Krura Koshtha were given 35 ml of it. After a rest for one day, the following therapies and medicaments were administered. Abhyanga oleation therapy with Narayana Taila Vata alleviating medicated oil [ 13 ] for 11 days. Bashpasvedana fomentation therapy with evaporation with Nirgundipatra [ 14 ] fresh leaves of Vitex nigundo Linn. Niruha Basti proctocolonic administration of decoction of Dashamula Kvatha decoction of Dashamula for one day before lunch following Abhyanga and Svedana followed by Matra Basti of 40 ml Narayana Taila immediately after supper was given for nine days.
Yogaraja Guggulu ,[ 15 ] 1 g, thrice a day, with warm water. Ashvagandha Churna root powder of Withania somnnifera Dunal. Jalaukavacharana leech application was done on the patients on the eleventh day, if pain and stiffness were not relieved after Snehana , Svedana , Mriduvirechana , and Basti.
This was repeated if required on the fifteenth day. All formulations like Narayana Taila , Eranda Sneha , Dashamula Kvatha , Yogaraja Guggulu , and Ashvagandha Churna were prepared as per the standard guidelines under the supervision of the subject experts. Fresh leaves of Nirgundi were collected from the medicinal plant garden in the campus. On the day of Mriduvirechana , the patients were kept on semi-liquid recipe containing equal quantity of rice and mung beans in the evening.
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After this, patients were kept on usual food recommended by classics for the patients of Vata related diseases, that is, Mudgayusha mung bean soup , chapatis of wheat flour, boiled vegetables, and rice. They were instructed not to take sour, fermented, or spicy food and to avoid Atishrama heavy work , Ratrijagarana night vigils and Divasvapa daytime sleep.
Improvement in range of movement was assessed before and after treatment with Goniometer. The improvement was assessed on the basis of relief in the clinical features of the disease before and after treatment. The demographic data of this study suggested that osteoarthritis is prevalent in It was observed that highly significant results were found in all clinical features [ Table 4 ].
Highly significant results were found even after 15 days of treatment first follow-up with most of the features, while a significant result was found in the symptom of Sandhisphutana [ Table 5 ]. It was observed that relief, in percentage, found in patients after 45 days second follow-up was almost the same as that taken on the first follow-up [ Table 6 ].
Highly significant relief was found in flexion of the knee joint and significant relief in the extension of the knee joint [ Table 7 ] and after 15 days first follow-up [ Table 8 ].
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It was observed that extension of the knee joint was improved to The improvement in knee flexion movements was statistically highly significant. It was observed that a minor difference was found in the mean scores of clinical features after 15 days of treatment as indoor patients and in both follow-ups [ Figure 1 ]. Sprarshasahatva was relived by It was observed that a minor difference was found in the mean score of range of movement of the knee joint after 15 days and in followup [ Figure 3 ].
It was observed that the percentage of relief in extension of the knee joint was Effect of therapy on range of movement of knee joint after 15 days of indoor treatment. Comparison of percentage improvement in degree of range of movement of knee joint osteoarthritis. In the present study, it is observed that most of the female patients developed Sandhigatavata during the menopausal period. This supports estrogen deficiency as a risk of OA. This also supported a previous clinical study conducted, showing a marked reduction in pain and improvement in movements.
Treatment of Sandhigatavata usually begins with a basic process like Mriduvirechana. It cleanses the body to restore patency of the Srotasa , which improve the access of healing material as well as nourishment to the body components. In addition, this also helps in maintaining or restoring the optimum equilibriumin Tridosha.
Eranda Taila is indicated for Mriduvirechana in Vatavyadhichikitsa. Eranda Taila has Vatahara [ 21 ] action and it is the best among the medicaments used for Virechana purgative therapy. Taila oil used in Abhyanga has Snigdha unctuous , Guru heavy , and Mridu soft properties, which are opposite to the properties of Vata.
Abhyanga reduces the provoked Vata , which is responsible for the decay in the Dhatus and for manifestation of features like pain, stiffness, and crackes. According to modern studies, massage stimulates blood circulation and assists the lymphatic system, improving the elimination of waste throughout the body. Absorption through the skin can be enhanced by suspending the drug in an oily vehicle and rubbing it on the skin.
Svedana is specially indicated in symptoms like Sankocha contraction or flexion , Ayama extension , Shula pain , Stambha stiffness , Gaurava heaviness , and Supti numbness. Svedana has actions like Stambhaghna cures stiffness , Svedakarakatva creates perspiration , Gauravaghna cures heaviness , and so on. Upanaha poultice sudation is a type of Svedana indicated in classics[ 26 ] as one of the components in the treatment of Sandhigatavata. Moreover heat applied with Nirgundipatra upanaha increases the local circulation and thus the rate of drug absorption.
Nirgundi possesses Vedanasthapana analgesic and Shothahara anti-inflammatory actions. This Basti given for one day before Matrabasti , cleanses the colon and prepares a good atmosphere for the Matrabasti material to come in contact with the colon wall and exert its medicinal effect. Matrabasti is a form of Sneha Basti. It is convenient and comfortable in administration.
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It nourishes the body, promotes the strength, and cures Vata -related diseases. The colon is considered as main seat of Vata , and Vata -alleviating substances administered through the rectocolonic route in Matrabasti are able to have their optimum effect on the seat of Vata. Charaka Samhita mentions that if a disease does not respond to the application of opposite principles like Shita—Ushna cold—hot or Snigdha — Ruksha unctuous — dry , vitiation of Rakta Dhatu must be considered.
Hence, in the present study Raktamokshana blood-letting has been done by applying Jalauka leech in 31 patients, as it is easy and does not produce complications. Although Sandhigatavata is essentially a Vata -disorder affecting the Sandhi structures, secondary involvement of the Rakta Dhatu is possible in these 31 patients, which is evident with the classical Upashaya - Anupashaya test described earlier.
According to conventional medicine also, this is not purely a degenerative condition. This is why the earlier name osteoarthrosis is now accepted as osteoarthritis. It contains Tridosha Shamaka pacifier of three Doshas , that is, Vata , Pitta , Kapha and Rasayana rejuvenative actions and it is recommended for the management of all Vata Rogas. It helps in prevention against degenerative changes that may occur in bones and joints due to arthritis.
Guggulu reduces inflammation and joint stiffness as well as pain associated with arthritis, and increases joint mobility. In addition, the Guggulu has been shown to be a potent inhibitor of the enzyme, Nuclear Factor Kappa-light-chain-enhancer of activated B cells NFKB , which regulates the body's inflammatory response. There are several studies that show decreased inflammation and joint swelling after administration of the extracts of Guggulu resin.
Taila sesame oil itself is a potent Vata -alleviating substance. Its Vatashamaka action is enhanced when it is processed with Vatashamaka drugs like Patala Stereospermum suaveolens DC. Narayana Taila can be administered through any route in Vata Roga. It possesses Shothahara anti-inflammatory , Vatahara , Vedanasthapana , Shulaprashamana analgesic , and Rasayana rejuvenative actions.
In the assessment during the first outdoor follow-up it was observed that marked improvement was reduced in comparison to improvement found after 15 days of indoor treatment in the patients, while patients with moderate improvement remained the same in both the follow-up assessment periods [ Figure 5 ]. This shows that the indoor treatment consists of manual therapies and least activities, as indoor patients contributed to marked and faster improvement in the first fortnight, which reduced initially at home, due to the absence of manual therapies and possibly increased activities, but became steady later on.
It is an incurable, but manageable disease, which is why the repetitive use of manual therapies is needed for a long time.