Ayurveda has a detailed description of the structure and functions of 360 bones and 210 joints. The formation of fluid inside the joints is also described. Various rheumatological syndromes described in Ayurveda include Sandhigata Vata (degenerative-noninflammatory joint disease), Aam Vata (inflammatory joint disease, swollen joints), Vata Rakta, Asthikshaya (osteoporosis, osteomalacia), Kroshtuksheersha, Grudhrasi, Avabahuk, and Vishvachi. Management principles remain the same though details of some of these diseases are unavailable. Fasting and diet modifications are essential constituents of therapy. Basti (rectal administration of drugs) is also crucial in the management of rheumatological conditions.
Many plants and formulations have shown promising results in reducing swelling and pain in arthritis. However, more clinical studies with a larger sample size are necessary to establish evidence on the efficacy of these drugs.
Ayurveda plants for Arthritis:
| Guggulu (Commiphora wightii) | Nirgundi (Vitex negundo) |
| Bhallatak (Semecarpus anacardium) | Pippali (Piper longum) |
| Ginger (Zingiber officinalis) | Rasna (Inula helenium) |
| Ashwagandha (Withania somnifera) | Guduchi (Tinospora cordifolia) |
| Turmeric (Curcuma longa) | Eranda (Ricinus communis) |
| Amalaki (Emblica officinalis) | Triphala |
Ayurveda formulations for Arthritis
| Aam Vata (Inflammatory arthritis) |
Sandhigata Vata (Noninflammatory arthritis) |
|---|---|
| Yogaraj Guggulu | Gokshuradi Guggulu |
| Arogyavardhini | Nirgundi tail |
| Eranda shunthi | Dashamoola kwath |
| Sinhananda Guggulu | Ashwagandha choorna |
| Vishatinduka vati | Chandraprabha vati |
| Rasnasaptak kwatha | Dashanga lepa |
| Ajmodadi churna | Trayodashanga Gugguluc |
| Khandashunthyavaleha | Bhallatakasav |
| Bhallatak ksheerpak | Abha Guggulu |
| Vatavidhwans | Mahavatavidhvansa |
| Mahayograj Guggulu |
(All drugs must be used on prescription from a qualified Ayurveda professional)
Adverse events and other issues
Heavy metal contamination: Lead, mercury, and arsenic are toxic metals used in Ayurveda drugs. Innumerable Ayurveda drugs contain mercury. Lead is a constituent of Mahayograj Guggulu and Vatavidhwans - drugs used in arthritis. Various purification processes are described in Ayurveda literature before the medicinal use of raw metals. The reported incidence of adverse events appears to be small compared to the estimated consumption of these drugs. Like vegetables, lead is found in pure herbal formulations due to environmental contamination ( due to pesticides, fuel, rubber, paints, plastic, and others).
Drug interactions: Ginger and garlic are associated with an increased risk of bleeding. They must be consumed with caution along with painkillers and steroids.
Adulteration: Many reports indicate the addition of steroids in dispensed herbal products. Charak calls such physicians as Chadmachar (dishonest, deceptive, fraudulent, feigned) doctors. A therapist who assures a complete cure, asks to stop prescription medications, insists on the secrecy of prescription, prescribes very severe diet restrictions, does not possess a practice license, asks for advance payment, and requests sexual relationship is considered dangerous (Arthritis Foundation).
Cost of Therapy: Higher price does not necessarily mean effective treatment. Many of the therapies appear too expensive and lead to diversion and wastage of valuable resources.
Delay in diagnosis: There is enough evidence to suggest that conditions such as early rheumatoid arthritis and joint pains due to SLE, vasculitis, and other inflammatory connective tissue diseases require early diagnosis and aggressive modern therapy. Unfortunately, practitioners of complementary medicine are not trained in contemporary rheumatology diagnosis. Delay in seeking rheumatology advice can be detrimental and even be life-threatening in these situations.
Instructions for patients using herbo-mineral formulations
- Take drugs after food. Do not take on an empty stomach unless specifically prescribed.
- Use for a limited period not exceeding 3-4 months.
- Do not use these drugs in children, pregnant women, and older people.
- Please do not use them in patients with anemia and kidney failure (Check blood before starting the drug).
- Do not take unlabelled drugs with unknown contents.