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Arthritis, Osteoarthritis (OA)

Disease having similar symptoms in Ayurved - Sandhivata, Sandhigatavata, vata vikar

•What is osteoarthritis (OA)?
•What are the causes of OA?
•What are the sign and symptoms of OA?
•Treatment of osteoarthritis
•Ayurvedic insight of osteoarthritis? Do’s and Don’ts

What is osteoarthritis?
Osteoarthritis is a disease of cartilage. It is one of the inevitable processes of aging affecting
mainly the joints, which subjects to most wear and tear. The weight bearing joints which are
subjected to abnormal stress by faulty posture or deformity are especially vulnerable.

The word Arthritis means inflammation (swelling) of the joints but in osteoarthritis the basic
defect is the degeneration of cartilage through the process of inflammation.
The ends of the bone in joints are capped with cartilage. The cartilaginous caps rub against
each other with movement of the joints. Healthy cartilage allows bones to glide over one
another. It also absorbs energy from the shock of physical movement.
Cartilage is almost like a wet rubber with the characteristics of a spring than that of a calcified
bone.

In OA cartilage cap begins to erode and break or even a piece of the bone may erode from its
surface. At the end of the split, the degenerated cartilage destroys and exposes the end of
the bone itself. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs,
also referred to as osteophytes) to form around the joints.
Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such
as the hips and knees.

What are the causes of OA?

The causes of osteoarthritis are varied. OA is classified in main two subtypes as:

•Primary osteoarthritis-
Osteoarthritis which has no known cause is referred to as primary osteoarthritis.
Primary osteoarthritis is mostly related to aging. With aging, the water content of the cartilage
increases, and the protein makeup of cartilage degenerates.
Repetitive use of the worn joints over the years can irritate and inflame the cartilage.

•Secondary osteoarthritis-
Secondary osteoarthritis is caused by another disease or condition.
Conditions that can lead to secondary osteoarthritis include -

1.Endocrine: People with diabetes may be prone to osteoarthritis. Other endocrine problems
also may promote development, including acromegaly, hypothyroidism, hyperparathyroidism,
and obesity

2.Post traumatic: Traumatic causes can be further divided into macro trauma or micro trauma.
An example of macro trauma is an injury to the joint such as a bone break causing the bones
to line up improperly (mal alignment), lose stability, or damage cartilage.
Micro trauma may occur over time (chronically). An example of this would be repetitive
movements or the overuse noted in several occupations.

3.Inflammatory joint diseases: This category would include infected joints, chronic gouty
arthritis, and rheumatoid disease.
4.Metabolic: Diseases causing errors of metabolism may cause osteoarthritis. Examples include
Paget's disease and Wilson disease.

5.Congenital or developmental: Abnormal anatomy such as unequal leg length may be a cause
of osteoarthritis.

6.Genetic: A genetic defect may promote breakdown of the protective architecture of
cartilage.

7.Neuropathic: Diseases such as diabetes can cause nerve problems. The loss of sensation
may affect how the body knows the position and condition of the joints or limbs. In other
words, the body can't tell when it is injured.
8.Other:  Nutritional problems may cause osteoarthritis. Other diseases such as hemophilia and
sickle cell are examples.
What are the Signs and Symptoms of OA?
Osteoarthritis affects different people differently. It may progress quickly, but for most people,
joint damage develops gradually over years.
The most commonly affected joints are those at the ends of the fingers (closest to the nail),
thumbs, neck, lower back, knees, spine and hips and symptoms vary accordingly.

The Warning Signs of Osteoarthritis

•Stiffness in a joint after getting out of bed or sitting for a long time
•Swelling in one or more joints
•Initially joints may ache after physical work or exercise, later on, joint pain may become more
persistent.
•Crunching feeling or the sound of bone rubbing on bone
General Signs of Osteoarthritis (OA)
•Joint pain is usually less in the morning and worse in the evening after a day’s activity
•Deterioration of coordination, posture and walking due to pain and stiffness
•The affected joints "creaking" or "cracking" when moved. Joint grating sensations
•There may be some redness and slight swelling on the surface of the affected joint.  The
involved joint may be tender to press
•Stiffness after periods of rest that goes away quickly when activity resumes
•Morning stiffness, which usually lasts no more than 30 minutes 
•Joint locking sensation 
•Joint symptoms worse in cold or damp weather 
•Reduced range of motion of the affected joints 
•Other common symptoms:  Fever, Weight loss , Fatigue, Rash, Itching 
•Other effects are:  Depression, anxiety, feelings of helplessness, limitations on daily activities,
job limitations

What is the treatment of osteoarthritis?

•Rest- The pain relieves from resting.
•Exercise - maintain your muscle strength and the body flexibility. Your involved joints should
be moved through their full range of motion at least once every day.  Be sure that all your
movements are slow and gentle; never exercise beyond the point of tolerance
•Posture and flexibility - Good posture and flexibility will delay the loss of function of joints
that are involved in osteoarthritis.
•Heat - Heat or sudation is often helpful in relieving pain.
•Surgical treatment: - Sometimes the removal of cartilage fragments and repair of the
structure, significantly improves the function. In some instance, joints that are severely
damaged can be replaced e.g. knee replacement, hip replacement


Goals of Osteoarthritis Treatment

•control pain
•improve joint function
•weight control
•Achieve a healthy lifestyle
•exercise
•rest and relief from stress on joints
•Minimal use of medications to control pain

Don’ts

•Avoid additional injury or shock to the joints through exercise
•Avoid foods, which can trigger arthritic pain. E.g. sour things like tamarind, lemon, curd, cold
water and soft drinks etc
•Don’t suppress natural urges
•Avoid excessive exertion, awaking at night and sleeping at day, long walks, cold-water
swimming, cold-water bath etc.
•Avoid crash diet and total oil free diet as your body requires certain amount of fats for
smooth functioning
•Avoid excess use of OTC calcium drugs
•Avoid alcohol or tobacco in any form
•Avoid Certain pulses and cereals, e.g. cowpeas, kidney beans, gram, peas, green peas etc
•Avoid hot, spicy and fried foods, sweets, foods like cabbage, tur dal ( pigeon peas),
Cauliflower, spinach, broccoli, sprouts and potatoes
•Stop Cigarette smoking, the toxins in smoke cause stress on connective tissue, leading to
more joint problems
•Avoid excess use of steroids , antibiotics, painkillers
• Avoid too much tea, coffee, white sugar, yogurt, chocolate, cocoa etc
• Avoid mental tensions like anxiety, fear, stress and grief
•Avoid excess exposure to cold wind or AC

Do’s
•Know your specific type of arthritis, what happens with your type of arthritis, your treatment
options, and your prognosis
•Try to control your triggers
•When your knees are involved, go for non weight bearing exercises such as swimming, water
sports, etc.
•Protect yourself from humidity, excess cold
•Bring down your weight
•Meditate and do yoga to overcome stress
•Immobilize the joint that is very painful or inflamed with devices such as cervical collar,
splints, slings etc
•Do hot fomentation as heat relieves pain, stiffness
•Tub bath of warm water or medicated decoction for affected joint
•Poultice can reduce pain
•Sesame oil, mustard oil, castor oil, use internally or externally as per physician’s advice.
•Add cow’s ghee in your diet
•Opt for leech therapy in swollen and tender joints,  it gives immediate relief
•Some of ayurvedic medicines can be used to relieve pain, swelling, stiffness are mahayogaraj
guggulu, yogaraj guggulu , simhanad guggulu, rasnadi guggulu, vatavidhwansan rasa, bruhat
vat chintamani rasa , panchatikta ghrita, dashamoolarishta, maharasnadi kadha , ajamodadi
churna etc
•Dashanga lepa, paste of duruharidra, raktachandna, allum and shringa , dry gigger paste can
be applied locally
•Medicated oils which can be used regularly for local applications are mahanarayan oil,
dashamoola oil, mahamasha oil, nirgundi oil, bala oil, chandan bala lakshadi oil or plain sesame
and mustard oil
•Follow regular Basti (enema therapy) treatment as its highly effective as preventative and
curative measure

Keywords
osteoarthritis, degenerative joint disease, DJD, OA, hypertrophic arthritis, knee joint
replacement, hip replacement, total hip replacement, osteophytes, arthritis, joint pain, joint
inflammation, joints, joint cartilage, loss of cartilage, joint space, subchondral cysts, 
Osteoarthritis remedies, natural remedies for osteoarthritis, ayurvedic remedies for
osteoarthritis, osteoarthritis causes, causes of osteoarthritis, joint function; articular
cartilage; cartilage degeneration; symptoms of joint disease; inflammatory mediators;
mediators of inflammation; joint treatment, sandhigatvat , sandhivat ,vat disease,
panchakarma, basti , massages, hot fomentation, poultice, oils, ayurvedic cure, leech therapy