E-ISSN:2456-3110

Review Article

Janusandhigata Vata

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 11 NOVEMBER
Publisherwww.maharshicharaka.in

An efficacy of different Taila used in Janubasti in the management of Janusandhigata Vata - A Systemic Review

Ramteke MG1*, Umretia B2

1* Mayuri G Ramteke, Post Graduate Scholar, Department of Rasashastra and Bhaishajya Kalpana, Government Ayurved College, Vadodara, Gujarat, India.

2 Bharti Umretia, Reader and Head, Department of Rasashastra and Bhaishajya Kalpana, Government Ayurved College, Vadodara, Gujarat, India.

Background: Janusandhigata Vata, a pathological condition similar to osteoarthritis of the knee, primarily affects elderly persons due to Dhatukshaya, resulting in pain, swelling, and restricted movement, significantly impacting daily activities. Currently, the treatments of knee osteoarthritis are often symptomatic, expensive and have side effects, making Janubasti a valuable alternative, especially in developing countries. Numerous studies have explored the clinical efficacy of various Taila (medicated oils) used in Janubasti for treating Janusandhigata Vata. This review aims to analyze the effectiveness of these medicated oils in the management of the condition.

Objective: To review the articles published on Janubasti for the evaluation of the efficacy of various medicated oils utilized in Janubasti for the management of Janusandhigata Vata and improving the healthcare practice.

Materials and Methods: The articles are screened from different electronic databases including MEDLINE, Google Scholar, PubMed Central, etc. and clinical trials published till September 30, 2024. using a strategy designed to optimize the open labelled parallel arm randomized clinical trial. The search terms used were Janusandhigata Vata, Janubasti, Taila, arthritis, osteoarthritis.

Results: For this purpose, 343 articles were searched, 172 were screened after removal of duplication, 131 were excluded, 42 full text articles were assessed for eligibility. Out of 42 articles 5 were included in review.

Conclusion: Janubasti is one of the modalities of treatment commonly adopted in the management of Janusandhigata Vata. Research has shown that Janubasti with Taila gives encouraging results in relieving the signs and symptoms of Janusandhigata Vata.

Keywords: Sandhigata Vata, Snehana (Oleation), Medicated oil, Knee osteoarthritis

Corresponding Author How to Cite this Article To Browse
Mayuri G Ramteke, Post Graduate Scholar, Department of Rasashastra and Bhaishajya Kalpana, Government Ayurved College, Vadodara, Gujarat, India.
Email: 		Ramteke MG, Umretia B, An efficacy of different Taila used in Janubasti in the management of Janusandhigata Vata - A Systemic Review. J Ayu Int Med Sci. 2024;9(11):163-175.
Available From
https://jaims.in/jaims/article/view/3773

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-10-13 2024-10-23 2024-11-04 2024-11-13 2024-10-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.20

© 2024by Ramteke MG, Umretia Band Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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DiscussionConclusionReferences
Mayuri GR et al. Different Taila used in Janubasti

Introduction

Sandhigata Vata is a one of the eighty types of Vata Vyadhi described in various Ayurvedic treatises. The foremost description of Sandhigata Vata is given in Charaka Samhita. Vatapurnadritisparsa (feeling hollowness), Shotha (swelling) and Prasarana Akunchana Vedana (pain during flexion and extension of the joint) are the clinical features of Sandhigata Vata.[1] Sthansamshraya of vitiated Vata Dosha at Janu Sandhi (knee joint) results in the development of a disease termed as Janu Sandhigata Vata. This condition is closely simulating with knee osteoarthritis. The line of treatment for Sandhidata Vata is mainly focused on the alleviation of Vata Dosha. Acharya Charaka explains that vitiated Vata Dosha can be best treated with the use of oil.[2] Use of Snehana with Swedana over the affected part is also advised in the treatment of Vatavyadhi which alleviates pain, stiffness and improves flexibility.[3]

Snehana (Oleation) is one of the best treatments for Sandhigata Vataja Vyadhi because of the Drava, Sukshma, Sara, Snigdha, Manda, Mridu, Guru and other properties of Sneha Dravya which are just opposite to Vata Dosha and pacifies Vata disorders. This treatment modality harnesses the therapeutic properties of various oils to provide relief from pain, inflammation, restricted mobility in the knee joint and nourish emaciated tissue Janu Basti is a specialized procedure in Ayurveda, especially indicated for Janusandhigata Vata in which different types of medicated oils are used as external application. Thus, it can be considered as Bahirparimarjana Chikitsa.[4] Though there is no direct reference and description of Janu Basti in classical Ayurvedic texts, it acts as a supportive ayurvedic therapy.

Current medical approaches to osteoarthritis are categorized into non-pharmacological, pharmacological, and surgical interventions, all of which predominantly offer symptomatic relief and are associated with adverse side effects. Additionally, these treatments can be prohibitively expensive or inaccessible, particularly in developing countries. In this context, the application of various medicated oil in Janubasti therapy emerges as a viable treatment option. Despite extensive research on osteoarthritis, the search for more effective interventions continues to be pertinent.

Numerous studies have been conducted nationwide to evaluate the clinical efficacy of Janubasti preparations in treating Janusandhigata Vata. The present review aims to analyze the effectiveness of various medicated oils utilized in Janubasti for this condition, thereby enhancing healthcare practices.

Materials and Methods

A systematic search was conducted across various electronic databases, including MEDLINE, Google Scholar, PubMed Central, Cochrane Library and Ayush Research Portal, for indexed research and clinical trials published until September 30, 2024. The search utilized a strategy optimized for open-label parallel-arm randomized clinical trials, employing keywords such as "Janu Sandhigata Vata," "Janubasti," "Taila," "arthritis," and "osteoarthritis."

Out of 343 articles initially identified, 172 were screened following the removal of duplicates, with 131 excluded based on eligibility criteria. A total of 42 full-text articles were assessed for inclusion in which Janu Basti and other procedures are used in the management of Janusandhigata Vata presented in table no.1.

Table 1: Showing Janu Basti and other procedures used in the management of Janusandhigata Vata

SNAuthorTreatment givenConclusion
1.Kaushik Raman et al.[5]Janu Basti - Mahanarayana Taila followed by Dashmoola Kwatha Nadi - SwedanaMahanarayana Taila Janu Basti followed Dashmoola Kwatha Nadi-Swedana is very effective in the management of Janusahdhigata Vata.
2.Dr. Savan Kumar et al.[6]Eranda Taila as Shamana medicines.Significant improvement for first year and no signs & symptoms of Sandhivata were noticed after use of castor oil for 2 consecutive years.
3.Asha MR et al.[7]Group A: Janu Basti - Moorchita Tila Taila followed by Patrapinda Sweda.
Group B: Janu Basti - Moorchita Tila Taila followed by Atasi Upanaha Sweda.		Group A - highly significant changes in Vatapurna Drithisparsha, Sandhi Shotha and Prasarana Akunchana Vedana and significant improvement in Sandhi Shoola.
Group B - Vatapurna Drithisparsha, Sandhi Shotha and Sandhi Shoola showed highly significant changes and Prasarana Akunchana Vedana showed significant changes.

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Mayuri GR et al. Different Taila used in Janubasti
SNAuthorTreatment givenConclusion
4.Dr. Manjula Vishal Matekar et al.[8]Janu Basti – Sahachara TailaEfficacy of Janubasti with Sahachara Taila is statistically significant in the symptoms viz-. Shula, Shotha, Sparshasahatva, Akunchan Prasaranjanya Vedana, Sandhispuṭan and Skashtacalan.
5.Babul Akhtar et al.[9]Group A: Abhyanga - Bala Taila + Nadi Swedana with Dashamoola Kwatha + Panchatikta Ghrita Guggulu
Group B: Abhyanga – Bala Taila + Nadi Swedana with Dashamoola Kwatha		In both the groups (A & B) i.e. 15.38 % & 7.14 % patients achieved complete remission, while 61.54% & 14.28 % patients found in maximum improvement and 23.07 % & 64.28 % were having moderately improvement. No patients found mild improvement in group A whereas 14.28 % mild improvement in group B. No patient found unchanged in both the groups.
6.Dr. Shilpa Santosh Tonde[10]Janu Basti - Mahanarayana Taila
Nadi Swedana - Dashmoola Kwatha		Mahanarayana Taila Janu Basti followed Dashmoola Kwatha Nadi-Swedana is very effective in the management of Janu Sahdhigata Vata.
7.Ashivini et al.[11]Group A: Janu Basti - Chinchadi Taila, Shunthi Choorna for Amapachana.
Group B: Janu Basti - Rasona Taila, Shunthi Choorna for Amapachana		Rasona Taila i.e. group B has provided better relief.
8.Ritika Khajuria et al.[12]Janu Basti – Tila Taila
Abhyanga - Tila Taila
Nadi Swedana - Nirgundi Patra Kwatha		Better relief in the signs and symptoms mainly in pain, stiffness, tenderness, swelling, and crepitus.
9.Reshma A et al.[13]Janu Basti - Sahcharadi Taila
Nadi Swedana - Dashmoola Kwatha Tab. Asthiposhaka
Cap Shallaki 400mg
Panchtikta Ghrita Guggulu		Significant relief in bilateral knee joint pain.
10.Dr. Priyanka et al.[14]Group A: Anuvasana Basti - Kshirabala Taila
Group B: Arohana Anuvasana Basti - Kshirbala Taila
Adjuvant therapy
a) Sarvaang Abhyanga - Kshirabala Taila.
b) Sarvaang Bashpa Swedana - Dashmoola Kwatha.		Group A - no patient shows any marked improvement.
Moderate improvement was found in 35% patients and mild improvement in 12% patients. 5% patients remain unchanged.
Group B – Marked improvement in 15% of the patients, moderate improvement in 60% patients, mild improvement in 25% and 4% patient remains unchanged.
11.Deepak Yadav et al.[15]Abhayanga - Murchhita Tila Taila. Nadi sweda
Anuvashana Basti - Murchhita Tila Taila
Basti - Dhanwantri Taila Tab. Yogaraj Guggulu with lukewarm water		Substantial positive change in signs and symptoms.
12.Vadeyara Vidya et al.[16]Matra Basti - Mahanarayana Taila 30 ml, Guggulutiktaka Ghrita 30 ml, Gandha Taila 10 ml. Godhuma Upanaha. Lakshadi Guggulu with Luke warm water.Pre - test assessment - 19 subjects (63.4 %) had extreme feeling of knee joint pain, 9 subjects (30%) had moderate pain and 2 subjects (6.7%) had mild pain in. Post- test assessment - 1 subject (3.4%) had severe pain; 5 subjects (16.7%) had moderate pain, 14 subjects (46.7%) had mild pain and 10 subjects (33.4%) had been completely relived from pain.
13.Girde Samir et al.[17]Snehana and Swedana.
Hapushadi Yapana Basti.		Significant (P<0.05) result was found in all cardinal symptoms of Sandhi Shoola, Sandhi Shotha, Vatapurna Druti Sparsha, Graha (Restricted movement).
14.Hemant Shridhar Paradkar et al.[18]Gel capsules of Shatapaki Balashwagandhadi Taila.62.92 % reduction in Sandhi Shoola, 55.17 % in Sandhi Shotha, 56.82% in Akunchana Prasarana Vedana, 60 % relief in Sandhi Sphutana and 67.57 % in Sandhi Graha on the 30th day of treatment.
30% achieving excellent, 40% good, 26.67% moderate relief and 3.33% No result.
15.Hema Dipak Hire et al.[19]Gandha Taila Cap 300 with warm water.Janusadhishool - Relief of 80%.
Janushotha - Moderate,
Pitting disappears rapidly.
Crepitus – absent.
Prasarana Akunchana Sanvedana – pain present.

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SNAuthorTreatment givenConclusion
16.Dr. Ajit Shivaji Bagade et al.[20]Group A – Panchatikta Ghrita Guggulu Vati (PTGG)
Group B – Gandha Taila – 10 drops.		Group A had better result than group B. Moreover, the phytochemical analysis has zoomed that the PTGG is chemically more effective as it has flavonoids which is proved for analgesic & anti-inflammatory action
17.Dr. Suresh Govind Dahiphale et al.[21]Snehapana - Brihat Vishnu Taila in Shaman Matra.
Anupana – Mudgayusha		Pain (VAS scale), Crepitus, Akunchana Prasarana Pravritti, Vedana before treatment was 7, 2, 2 and after treatment it was 2, 1, 0 respectively.
18.Dr. Pankaj Kumar Katara et al.[22]Group A: Snehapana – Ksheera bala Taila
Group B: Matra Basti - Ksheerbala Taila after local Abhyanga and Nadi Swedana.		Group A is better than group B.
19.Neetha Abraham et al.[23]Pana (internal administration) - Prabhanjana Vimardana Taila
Anupana - Mudga Yusha.
Janu Pichu - Prabhanjana Vimardana Taila.		Prabhanjana Vimardana Taila was found effective in reducing pain, swelling, tenderness and crepitus of knee joint, changes in joint measurements and range of movements of knee joint. Also, patient felt noticeable change in morning stiffness.
20.Sarvesh Kumar Singh et al.[24]Group A: Janu Basti - Sahachara Taila.
Group B: Matra Basti - Sahachara Taila.
Oral administration in both group - Adityapaka Guggulu		Group B has provided better relief than group A.
21.Shikha Desai et al.[25]Abhyanga - at Nabhi, Parshva, Prastha, Ubhayapada with Murchhita Tila Taila and Nadi Sweda.
Anuvashana Basti:
Murchhita Tila Taila– 120 ml.
Navaprasrutika Basti - 864 ml.
Shamana Chikitsa - Tab. Yogaraj Guggulu.		No pain, swelling, crepitations present during follow-up. Panchakarma together with oral medication is effective in management of Janu Sandhigata Vata. Murchhita Tila Taila Anuvashana Basti and Navaprasrutik Basti has been found to be a powerful Pachaka.
22.Savita Mordi et al.[26]Janu Basti – Devadarubaladi Taila.Out of 30 patients,12 patients (40 %) had got good response, 17 patients (56.66 %) had moderate response and 1 patient (3.33%) had mild response.
23.Dr. Santosh Chavan[27]Group A: Janu Basti - Tila Taila and ultrasound therapy
Group B: Only Janu Basti with Tila Taila		Group A demonstrated significant improvements in pain reduction, increased joint mobility, and enhanced physical function compared to Janubasti alone.
24.Dr. Rakesh[28]Group A: Janu Basti – Maha vishagarbha Taila and Tab. Glucosamine sulfate 500 mg 1 TID.
Group B: Janu Basti - Mahavishagarba  Taila and  Cap. Asthishrinkhala 500 mg 1 TID.		Group A shows better result compared to Group B.
25.Gyan Prakash Sharma et al.[29]Group A: Patra Pottali Sweda - Nirgundi Patra.
Group B: Janu Basti - Dashamoola Bala Taila
Group C: Combined therapy (Patra Pottali Sweda & Janu Basti)		Group C was more beneficial seen rather than group A and B. Symptomatically pain was reduced 75% and range of motion was positive 75% in Group C. In Group A and B result of walking distance and tenderness was also beneficial. So, in present trial Group A & Group B are mild beneficial, statistically significant & Group C is moderate beneficial, statistically highly significant.
26.Dr. Abhishek Sharma[30]Group A: Ekangdhara - Sahacharadi Taila
Group B: Janubasti - Sahachradi Taila		Group B is better than group A.
27.Dr. Manjula Vishal Matekar[31]Group A: Janu Basti- Sahachara Taila
Group B: Agnikarma – Tamrashalaka		Both groups showed an equal effect.
28.Khushali D Zalavadiya et. al.[32]Balaashwagandha Taila for Local Abhyanga followed by Swedana.
Rasnadi Kwatha - 10gm BD
Lashunadi Vati - 2 BD
Ashwagandha Churna- 2 gm
Rasayana Churna - 1 gm
Godanti Bhasma - 500 mg
Yogaraja Guggulu 2 TDS		75% improvement within 3 months.

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SNAuthorTreatment givenConclusion
29.Ritesh Roy et. al.[33]Janu Pizhichil (oil bath for knee joint),
Panchtikta Ksheer Basti.
Panchatikta Ghrita Guggulu.		After 1 month, the patient got significant relief clinically, and a significant improvement was observed in the radiological findings, especially in terms of maintenance of good joint space and absence of overlapping.
30.Kure Varsha Nivruttirao et. al.[34]Atasi Pinda SwedanaStatistically highly significant effect in reducing the symptoms of Janu Sandhigata Vata
31.Borkar S. et. al.[35]Abhyanga – Tila Taila
Swedana – Mashadi Upanaha		Mashadi Upanaha Sweda is very effective in the management of Niramavastha of Janu Sandhigata Vata.
32.Anil Mungarwadi[36]Group A- Sthanika Abhyanga with Ksheerabala Taila. Kukkutanda Sweda with its Twak by Pottali method.
Group B- Sthanika Abhyanga with Ksheerabala Taila. Kukkutanda Sweda with its Twak by Bandhana method		Group B (Bandhana method) is better than Group A (Pottali method) in Janu Sandhigata Vata in the factor like Janu Shopha, there is no difference in Lakshanas like Janu Shola, Atopa, tenderness, ROM in between the groups statistically.
33.Alka Mishra et al.[37]Janu Basti - Ksheerbala Taila.
Nadi Sweda – Dashamoola Kwatha
Marma Therapy- stimulation of four Marma points of the leg, i.e. Kshipra, Gulpha, Indravasti and Janu.		Marma Therapy with Janu Basti showed encouraging result.
34.Sayujya. P. S.[38]Pana - Palashatwagadi Kashaya with Saindava Lavana
Janu Veshtana - Nirgundi Taila		Palashatwagadi Kashaya and Nirgundi Taila was found effective in reducing pain, tenderness and crepitus of knee joint. Also, patient felt noticeable change in morning stiffness.
35.Yamini Sabharwal et. al.[39]Group A: Abhyanga, Baspa Swedana. Matra Basti - Kshira Bala Taila
Group B: Abhyanga, Baspa Swedana. Matra Basti - Ketakadya Taila 		Statistically significant effects were seen in both the groups in symptoms including Sandhi Shoola, Akunchan Prasaranajanya Vedana, Sparsha Asahatva, Sandhi Sphootana, and ROM.
36.Prasanth D[40]Group A: Janu Basti - Murivenna
Group B: Janu Pichu – Murivenna		Janu Basti significant amount of relief in the signs & symptoms of Janu Sandhigata Vata in comparison with Janu Pichu.
37.Om Virbhadra Chitte et al.[41]Group A: Yoga Basti – (Niruha Basti – Navaprasrutika Basti,
Anuvasana Basti - Murcchita Tila Taila) and
Janu Basti - Sahacharadi Taila
Group B:
Only Yoga Basti		On statistical comparison, group A showed better results than group B.
38.Dr. Manohara. B. Havinal[42]Group A:
Janu Basti – Trisatiprasarani Taila
Group B:
Janu Seka – Trisatiprasarani Taila		Group A is better than group B.
39.Prashish Pipare et al.[43]Abhyanga - Dashamoola Taila.
Nadi Swedana - Dashamoola and Nirgundi Kwatha.
Janu Dhara - Dashmoola Taila.
Lepa - Haridra +Sunthi + Saindhav.
Hingwashtakchurna, Yogaraja Guggulu, Avipattikara Churna.		Pain, swelling, crepitus, walking speed, Tenderness before treatment was 3,1,3,3,2 and after treatment is was 0,0,3,0,0 respectively.
40.Md Tanzil Ansari et al.[44]Matra Basti - Mahanarayana Taila Janu Basti - Mahanarayana Taila
Rasnasaptaka Kwatha, Mahayogaraja Guggulu.		Signs & symptoms: Before treatment Sandhi Shoola, Sandhi Shotha, Sandhi Stambha, Prasarana Akunchanayoh pravrittishcha Savedana, Sandhi Atopa was 3,2,2,3,2 and after treatment it was 1,0,0,1,1 respectively.

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SNAuthorTreatment givenConclusion
41.Asif Mohammed et al.[45]Group A: Abhyanga - Svadanstra Taila
Group B: Snehapana - Svadanstra Taila		Group B is better than group A.
42.Archana Meena et al.[46]Group A: Shatavari Guggulu
Group B: Shatavari Guggulu
Janu Basti - Sahachara Taila.		Group B is more effective than group A.

Table 2: Showing details of the research works on Janu Basti used in the management of Janusandhigata Vata

SNAuthorCaseTreatment givenConclusion
1.Asha MR et al.[47]Sample size – 20 (10 patients of either group)
Age: 30 to 70 years.		Group A: Janubasti - Moorchita Tila Taila followed by Patrapinda Sweda for 20 min.
Group B: Janubasti - Moorchita Tila Taila followed by Atasi Upanaha Sweda for 12 hours Duration: - 7 days		Group A - highly significant changes in Vatapurna Drithisparsha, Sandhi Shotha and Prasarana Akunchana Vedana, and significant improvement in Sandhi Shoola.
Group B - Vatapurna Drithisparsha, Sandhi Shotha, and Sandhi Shoola showed highly significant changes and Prasarana Akunchana Vedana showed significant changes.
2.Dr. Manjula Vishal Matekar et al.[48]Sample size – 20 (10 patients of either group)Janubasti – Sahachara taila 120 ml for each Janusandhi
Time: - After Breakfast
Duration: - 30 minute for 7 days.
Follow Up: - 15th & 30th Day from the 1st day of Janubasti		Efficacy of Janubasti with Sahachara taila in Janusandhigata Vata is statistically significant as P<0.0001 in the symptoms viz-. Shula, Shotha, Sparshasahatva, Akunchan, Prasaranjanya Vedana, Sandhispuṭan and Skashtacalana.
3.Ashivini et al.[49]Sample size – 60
Two groups – 30 in each group
Age: 40- 80 years both the sex A Randomized Comparative Clinical study.		Group A: Janubasti - Chinchadi Taila Shunthi Choorna for Amapachana.
Group B: Janubasti - Rasona Taila Shunthi Choorna for Amapachana Duration of therapy - 7 days		Marked relief (above 75%)
A - 16.66%, B - 93.33% Moderate relief (50% - 75%)
A - 56.66%, B - 6.66% Mild relief (25% - 50%)
A - 26.66%, B - 0 No relief (below 25%)
A – 0, B - 0
The data shows that Rasona Taila i.e. group B has provided better relief in the disease Sandhigata Vata.
4.Prasanth D[50]Sample – 30 (15 patients in each group)
Age: 30-70 years		Group A - Janubasti - with Murivenna for 45 minutes,
Group B - Janu Pichu - Murivenna for 45 minutes for Duration - 7 consecutive days		Janu Basti gives significant amount of relief in the signs & symptoms of Janu Sandhigata Vata in comparison with Janu Pichu.
5.Dr. Manohara. B. Havinal[51]Sample – 30 (15 patients each.)Group A: Janubasti-Trisatiprasarani Taila
Group B: Januseka – Trisatiprasarani Taila		Group A - shows more net mean effect and long-lasting effect even in follow-up period.
Group B - shows less variations.

Inclusion Criteria

1. Any clinical trial which has study type of open-label parallel-arm randomized clinical trials.
2. Any clinical trial evaluating medicated oil only for external use.
3. Article published from 2007 to 30th September 2024.
4. No restriction regarding country, patient age, race, gender and language.

Exclusion Criteria

1. Articles having management of Janusandhigata Vata with Janubasti along with other procedures.
2. Any clinical trial of Janusandhigata Vata with internal medication and other Panchakarma

3. Articles without full text available.
4. Articles having single case study, case reports, case series, and systematic review studies.

Based upon these inclusion criteria, only 5 research works met with the criteria as presented in table no.2.

Results and Discussion

A search in PubMed revealed 10 articles on Janusandhigata Vata, while Google Scholar identified 179 articles related to Sandhigata Vata. The Cochrane Library contained 11 articles on Sandhigata Vata; however, none were accessible.


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Mayuri GR et al. Different Taila used in Janubasti

CAMQuest yielded 17 articles on arthritis, but none specifically addressed Janusandhigata Vata or Janubasti. The DHARA portal found 94 articles related to osteoarthritis. No research was identified in the Ayush Research Portal or ClinicalTrials.gov. In contrast, the Clinical Trials Registry India (CTRI) listed 11 registered clinical trials concerning Sandhigata Vata. The screening process of articles according to the Prisma guidelines for systemic review on the role of Janu Basti in the management of Janusandhigata Vata is presented in figure no

jaims_3773_00.JPG
Figure 1: PRISMA flow diagram (study selection and inclusion process)

Out of the 343 articles retrieved, 41 full text articles and 1 dissertation work were assessed of which the summery is given in table no. 1. Five articles met the eligibility criteria for assessment and were included in the study. Detailed descriptions of these research studies are presented in table no. 2.

After reviewing these articles, a variety of Taila (medicated oils) like Mahanarayana Taila, Eranda Taila, Moorchita Tila Taila, Sahachara Taila, Bala Taila, Chinchadi Taila, Rasona Taila, Sahacharadi Taila, Ksheerabala Taila, Dhanvantari Taila, Mahanarayana Taila, Gandha Taila, Shatapaki Bala Ashvagandhadi Taila, Brihat Vishnu Taila, Prabhanjana Vimardana Taila, Devadaru Baladi Taila, Tila Taila, Mahavishagarbha Taila, Dashamula Bala Taila, Bala Ashwagandhadi Taila, Nirgundi Taila, Ketakadya Taila, Murivenna Taila, Trishatiprasarani Taila, Dashamula Taila and Svadamshtra Taila are utilized for therapeutic procedures such as Janu Basti, Abhyanga, Pana, Janu Seka, Janu Pichu, Basti, Matra Basti and Yapana Basti.

These oils, infused with medicinal herbs, are specifically chosen to address pain, inflammation and joint stiffness associated with Vata imbalances. Among them, Mahanarayana Taila, Moorchita Tila Taila, Sahachara Taila, Chinchadi Taila, Rasona Taila, Sahacharadi Taila, Ksheerabala Taila, Mahanarayana Taila, Devadaru Baladi Taila, Tila Taila, Mahavishagarbha Taila, Dashamula Bala Taila, Murivenna Taila and Trishatiprasarani Taila have been specially indicated for Janu Basti.

From research study no. 1 and 2, it can be asserted that Sahachara Taila is highly effective in Janubasti for the management of Janusandhigata Vata. In study no. 3, the data indicates that Rasona Taila, utilized in Group B, resulted in significantly greater relief from Sandhigata Vata compared to Chinchadi Taila in Group A. The sudy findings suggest that Rasona Taila is more effective in managing the symptoms associated with Sandhigata Vata. In study no. 4, the findings indicate that Janu Basti with Murivenna for 45 minutes over 7 consecutive days resulted in a significant reduction in the signs and symptoms of Janusandhigata Vata compared to Janu Pichu with Murivenna administered under the same conditions. These results suggest that Janu Basti may be a more effective therapeutic intervention for managing Janusandhigata Vata. In study no. 5, group A, which received Janubasti with Trisatiprasarani Taila, demonstrated a greater net mean effect and sustained benefits during the follow-up period compared to Group B, which underwent Januseka with the same oil. Although Group B exhibited less variability in responses, the results suggest that Janubasti may provide more effective and lasting relief for the management of the condition studied.

Other than articles which were included in study, one dissertation work was found by Dr. Abhishek Sharma (2016). In which, Group A received Ekangdhara with Sahcaradi Taila while Group B underwent Janubasti with Sahcaradi Taila. Comparative analysis revealed that Group B (Janubasti) was more effective in reducing the clinical features of the disease. Statistical evaluation that the improvement observed in Group B was significant. Dr. Santosh Chavan et al. [52] A randomized controlled trial was conducted. Group A received Janubasti with Tila Taila followed by ultrasound therapy, while Group B received only Janubasti with Tila Taila.


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The findings revealed that the combination of Janubasti followed by ultrasound therapy resulted in significant improvements in pain reduction, joint mobility, and overall physical function compared to treatment with Janubasti alone. Dr. Manjula Vishal Matekar[53] were given Sahachara Taila Janu Basti group A & Agnikarma with Tamrashalaka on maximum tenderness on anterior part of Knee joint in group B. In group A, marked improvement was seen after 7 days of treatment. There was no relapse of symptoms till second follow up. Agnikarma was found highly effective in Shula, Shotha and Sparshasahatva. Janubasti and Agnikarma were found equal effect in relieving the signs and symptoms of Janu Sandhigata Vata.

Probable Mode of Action of Janu Basti (Local Oil Dipping at Knee Joint) On Janu Sandhigata Vata

When the procedure starts, medicated oil crosses the cell membrane through the skin, and the functions of phospholipids will increase and act as a carrier for various cellular elements or impurities which are responsible for the formation of diseases. The lukewarm oil will increase the temperature to more than 2 to 3 in the localized area, by which vasodilatation will happen and the blood circulation will increase and necessary oxygen and nutrition materials are supplied and the free radicals which are responsible for the disease will be removed. This therapy produces a sedative effect because of the pharmacological action of the used medicine like anti- inflammatory action. Analgesic action, muscle relaxant, etc and acts as a counter-irritant which is the thermal stimulus and may affect the pain sensation. It also induces muscles relaxation and increases the efficiency of muscle activity as the increased blood supply ensures the optimum condition for muscle contraction; it nourishes the muscle, bone and nerve, cartilage and lubricates the joint, and stops the degeneration of the knee joint because of its therapeutic action of the medicine and procedure. [54] Taila serves as a fundamental component of Janubasti therapy, providing multiple benefits that contribute to the alleviation of symptoms associated with Janusandhigata Vata. Through its warming, lubricating, and therapeutic properties, Taila not only enhances local blood circulation and joint function but also plays a critical role in balancing Vata Dosha, making it an essential element in the management of knee osteoarthritis in Ayurveda.

Conclusion

The comparative analysis of various medicated oils used in Janubasti reveals significant variations in therapeutic efficacy. These findings underscore that Janubasti represents an effective therapeutic modality for managing Janu Sandhigata Vata, with appropriate medicated oils demonstrating promising results in alleviating the symptoms associated with this condition. Janubasti with specific oils, particularly Rasona Taila, yields substantial improvements in clinical outcomes. Also, Among the various Taila utilized, Sahachara Taila and Sahacharadi Taila is employed more frequently for Janu Basti. Its repeated use in various therapeutic procedures underscores its effectiveness in addressing the underlying pathophysiology of joint disorders. Continued research is essential to further validate these interventions and optimize treatment protocols for patients suffering from this debilitating condition.

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