E-ISSN:2456-3110

Case Report

Osteoarthrosis

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 9 SEPTEMBER
Publisherwww.maharshicharaka.in

Clinical Case Study on Osteoarthrosis: Integrative Treatment and Functional Improvement

Jamra B1*, Singh D2, Jain R3
DOI:10.21760/jaims.9.9.53

1* Babita Jamra, Post Graduate Scholar, PG Department of Rog Nidan and Vikruti Vigyan, Pt Khusilal Sharma Ayurvedic College and Hospital, Bhopal, Madhya Pradesh, India.

2 Devjinder Singh, Post Graduate Scholar, PG Department of Rog Nidan and Vikruti Vigyan, Pt Khusilal Sharma Ayurvedic College and Hospital, Bhopal, Madhya Pradesh, India.

3 Rajesh Jain, Lecturer, PG Department of Rog Nidan and Vikruti Vigyan, Pt Khusilal Sharma Ayurvedic College and Hospital, Bhopal, Madhya Pradesh, India.

Osteoarthrosis (OA) is a prevalent degenerative joint disease characterized by the progressive breakdown of articular cartilage and changes in subchondral bone, leading to pain, stiffness, and reduced joint function. Its management involves a combination of pharmacological and non-pharmacological approaches aimed at alleviating symptoms and improving quality of life.[1] Sandhivata is a term used in Ayurveda to describe a condition resembling osteoarthritis, characterized by joint pain, stiffness, and swelling. It is considered to be caused by an imbalance in the body's Doshas (humors), particularly Vata Dosha, leading to degeneration of the joints and surrounding tissues.[2] Routine full-body massage (Abhyanga) using warm, therapeutic oils aids in nourishing the tissues, improving circulation, and balancing Vata Dosha. Basti is a vital therapy for managing Vata-related conditions.

Keywords: Sandhivata, Janu Basti, Abhyanga, Knee Pain

Corresponding Author How to Cite this Article To Browse
Babita Jamra, Post Graduate Scholar, PG Department of Rog Nidan and Vikruti Vigyan, Pt Khusilal Sharma Ayurvedic College and Hospital, Bhopal, Madhya Pradesh, India.
Email: 		Jamra B, Singh D, Jain R, Clinical Case Study on Osteoarthrosis: Integrative Treatment and Functional Improvement. J Ayu Int Med Sci. 2024;9(9):326-331.
Available From
https://jaims.in/jaims/article/view/3839

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-08-09 2024-08-23 2024-09-03 2024-09-13 2024-09-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.31

© 2024by Jamra B, Singh D, Jain Rand 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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Introduction

Osteoarthrosis (OA) is the most prevalent type of arthritis and a major contributor to disability worldwide. It is a degenerative joint condition characterized by the gradual erosion of cartilage within the joints, which results in pain, stiffness, and reduced joint function. Although OA primarily affects weight-bearing joints such as the knees, hips, and spine, it can also involve smaller joints like those in the hands.[3]

The development of OA is driven by a complex interaction of mechanical stresses, biological processes, and environmental influences. Key to the disease process is the deterioration of cartilage, which is accompanied by changes in the underlying bone, inflammation of the joint lining, and the formation of bone spurs.[4]

Several risk factors are linked to the onset and progression of OA, including aging, obesity, previous joint injuries, and genetic predisposition.[5] The impact of OA on a person’s quality of life can be profound, leading to reduced mobility and independence, and affecting overall daily activities.[6]

Effective management of OA involves a multifaceted approach aimed at relieving symptoms, enhancing joint function, and slowing the progression of the disease. Treatment strategies typically include medications such as analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), alongside non-drug interventions like physical therapy, lifestyle changes, and sometimes surgical options.[7]

In Ayurveda Janu Basti is an advanced treatment specifically designed to address knee joint pathology. It involves applying warm, medicated oil to the knee within a protective ring made of dough. This therapy is especially beneficial for balancing Vata dosha, which is often associated with conditions such as osteoarthritis or degenerative issue. Janu Basti provides targeted relief by alleviating pain, reducing stiffness, and decreasing swelling. It also restores natural lubrication to the joint and enhances mobility.

Case Report

A 59-year-old Female patient came to the IPD of Pt. Khushilal Sharma Govt. Ayurveda Institute, Bhopal with

Demographic data

  • Age: 59 years
  • Sex: female
  • Religion: Hindu
  • Education: Matric
  • Occupation: House wife
  • Marital status: Married
  • Socio-economic status: LowerMiddleclass

Presenting complaints with duration

SNComplaintsDuration
1.Pain in both knee joint, aggravating with knee bending climbing stare and physical activity, relived with rest3 years
2.Early morning stiffness ≤ 20 min.2-Year
3.Pain in neck and lower back, shoulder joint MCP (metacarpophalangeal joint)2- year

Examination
General examination
Pulse: 79bpm
B.P: 120/80 mm of Hg
Temp.: 98.4°F
R.R: 18/M
Pallor: absent
Icterus: absent
Cyanosis: absent
Odema: absent
Clubbing: absent
Lymph node: not palpable

Ashtasthana Pariksha

Nadi: Vataj, KaphajShabda: Spashtha
Mutra: Samyak Pravruti Sparsha: Anushnasheeta
Mala: Samyak Pravruti Drika: Samyaka
Jihva: Niram  Aakriti: Madhyam

Systemic Examination
Gait: Normal gait

Examination of Knee Joint

SNFeatureRight KneeLeft Knee
1.Crepitation++++++
2.Warmness++
3.Tenderness++++
4.OdemaAbsentAbsent
5.Ant.Drawer TestAbsentAbsent
6.Post.Drawer TestAbsentAbsent
7.Pattelar Tap TestAbsentAbsent
8.Flexion60°50°
9.Heberden’s NodePresentPresent
10.Bauchard’ NodeAbsentAbsent

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Babita Jamra et al. Clinical Case Study on Osteoarthrosis

Heberden’s Node
jaims_3839_01.JPG

Examination of Spine

Inspection
Cervical Spine: lordotic curvature seen
Dorsal Spine: No Kyphosis
Lumbar Spine: lordotic curvature seen

Palpation
Cervical Spine: Tenderness over C6, C7 vertebrae
Lumbar Spine: Tenderness over L4-L5, L5-S1 vertebrae

Investigation : X Ray Both Knee Joint (AP/Lat View)
jaims_3839_02.JPG

X Ray Cervical Spine (Lateral View)
jaims_3839_03.JPG

X Ray Lumbar Spine (Lateral View)
jaims_3839_04.JPG


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Shaman Aushadh

SNMedicineDoseDurationAnupana
1.Lakshadi Guggul 250 mg bd3 monthsLeuk warm water
2.Yograj Guggul 250 mg bd3 monthsLeuk warm water
3.Ashwgandha Churn
Kaprdika Bhasama
Mukta Sukti 		3 gm
250 mg
250 mg 		3 monthsWith milk
4.Artilon One bd3 monthsLeuk warm water
5.ManyawinOne bd3 monthsLeuk warm water
6.BonihealOne bd3 monthsWith milk
7.Dashmul Katutray Kwath 20 ml bd2 monthsLeuk warm water
8.Saralvirechan Churn10 gm hs2 monthsLeuk warm water

Panchkarama

SNProcedureAushdhaDuration
1.Sarawang Abhyanga Swedan Kottamchukadi oil15 Days
2.Greeva Basti Kottamchukadi oil15 Days
3.Janu Basti Kottamchukadi oil15 Days

Effect of therapy on symptoms of Osteoarthrosis

SNSymptomsBTAT
1Pain in both knee joint91
2.Early morning stiffness ≤ 20 min.70
3.Pain in neck and lower back, shoulder joint MCP (metacarpophalangeal joint)80

Numeric Pain Rating Scale (NPRS)
jaims_3839_05.JPG

Discussion

Discussion on Shaman Aushad

Lakshadi Guggul

  • Anti-inflammatory: The combination of herbs helps to reduce inflammation, making it beneficial for conditions like arthritis.
  • Pain Relief: Guggul and turmeric have analgesic properties that can help alleviate joint pain.

Its formulation is designed to balance Vata, alleviate Pitta, and reduce Kapha.

Yograj Guggul

  • Joint Health: Helps in managing joint pain, stiffness, and inflammation, particularly those related to Vata
  • Muscle Health: Supports muscle strength and function, making it beneficial for conditions like muscle weakness or stiffness.
  • Yograj Guggul is highly effective in managing Vata It helps to reduce dryness, stiffness, and pain by providing warming and lubricating effects.

Ashwagandha Churna

  • Anti-anxiety and Stress Relief and It is known for its calming effects, which help in reducing symptoms of anxiety and stress.
  • Ashwagandha is considered to balance all three doshas (Vata, Pitta, and Kapha).
  • It is particularly useful for balancing Vata and Pitta Doshas.

Muktashukti

  • Muktashukti is traditionally used to support bone health and strength. The calcium and other minerals in the pearl shell are thought to contribute to bone density and overall skeletal health.

Kapardika Bhasm

  • Calcium Source: The calcium content in Kapardika Bhasma supports bone health and may help in conditions related to bone weakness and joint pain.
  • Calming Effect: Kapardika Bhasma may have a calming effect on the nervous system, making it beneficial in managing stress and anxiety.

Artilon

  • Artilon primarily used to support joint health and manage symptoms of arthritis, including pain, inflammation, and stiffness.

Manyawin

  • Manyawin Tablet is an Ayurvedic formulation designed to support joint health and manage arthritis-related symptoms. It combines various herbs known for their anti-inflammatory, analgesic, and overall supportive properties.

Boniheal

  • Boneheal is formulated to support bone density and strength, making it beneficial for managing osteoporosis and other bone-related conditions.
  • Reduces joint pain and inflammation, improving mobility and comfort in conditions like arthritis.

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Dashmul Katutray Kwath

  • Reduction: The formulation contains several anti-inflammatory herbs that help in reducing inflammation throughout the body, including in the digestive tract and joints.
  • Cleansing: Supports detoxification processes in the body, helping to eliminate toxins and improve overall health.

Saralvirechan Churn

  • Purgative Effect: Helps in the cleansing of the intestines by promoting bowel movements.
  • Detoxification: Assists in the removal of toxins from the digestive tract.

Discussion on Panchkarma

Sarvang Abhyanga Swedan

  • Improved Circulation: It enhances blood circulation, aiding in nutrient delivery and waste removal.
  • Muscle and Joint Health: Regular Abhyanga can relieve muscle tension, stiffness, and joint pain.
  • Relief from Muscle and Joint Pain: Swedan is beneficial in reducing stiffness, pain, and inflammation in muscles and joints. The heat helps to relax muscles and increase flexibility.

Greeva Basti

  • Relieves Neck Pain: Greeva Basti is highly effective in alleviating chronic neck pain, stiffness, and discomfort. The warm herbal oil or decoction penetrates deeply into the muscles and joints of the neck, providing relief from tension and stiffness.

Janu Basti

  • Pain Relief: Janu Basti is highly effective in alleviating knee pain, stiffness, and inflammation. The warm oil penetrates deep into the joint, providing lubrication and nourishment to the knee structures.
  • Improves Flexibility: Regular sessions of Janu Basti help to improve flexibility and range of motion in the knee joint. It reduces stiffness and enhances the elasticity of the muscles and ligaments around the knee.
  • Nourishes the Joint: The medicated oil used in Janu Basti nourishes and strengthens the knee joint tissues.

It promotes regeneration of cartilage and improves the health of ligaments and tendons.

Kottamchukadi Oil

  • Kottam (Saussurea lappa): Anti-inflammatory and analgesic, beneficial for joint disorders.
  • Chukku (Zingiber officinale): Ginger, known for its warming and anti-inflammatory properties.
  • Ajamoda (Apium graveolens): Celery seed, helps in reducing pain and inflammation.
  • Taila (Sesame oil): Base oil, enhances absorption of herbal constituents and provides nourishment to tissues.

Conclusion

In the present case, the Ayurvedic diagnosis of (Sandhivata) is made for Osteoarthrosis. This case study reveals that Ayurvedic treatments, such as Shaman Aushadh and Panchakarma procedure can effectively alleviate osteoarthrosis as demonstrated by the notable improvement in the patient's symptoms. The significant decrease in knee joint pain and lower back and cervical pain, morning stiffness, along with the overall enhancement in the patient’s quality of life, highlights the effectiveness of these remedies.

These results suggest that Ayurvedic medicine and Panchakarma could serve as a valuable alternative for managing osteoarthrosis particularly for those who do not achieve satisfactory results from conventional therapies. Additional research is needed to validate these outcomes and refine treatment approaches for wider use.

References

1. Felson, D. T., Lawrence, R. C., & Dieppe, P. A. (2016). Osteoarthritis: New insights. Annals of Internal Medicine, 161(4), 336-344.
2. Sushruta Samhita. (2006). Sushruta Samhita: The Treatise on Surgery. Translated by K. K. Pandey. Chaukhambha Orientalia.
3. Hunter, D. J., & Bierma-Zeinstra, S. M. A. (2019). The Lancet, 393(10182), 1745-1759.
4. Goldring, M. B., & Otero, M. (2011). Inflammation in osteoarthritis. Current Opinion in Rheumatology, 23(5), 471-478.


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5. Loeser, R. F., Goldring, S. R., & Scanzello, C. R. (2012). Osteoarthritis: A disease of the joint as an organ. Arthritis & Rheumatology, 64(6), 1697-1707.
6. Bijlsma, J. W. J., Berenbaum, F., & Lafeber, F. P. J. G. (2011). Osteoarthritis: An overview. Annals of the Rheumatic Diseases, 70(1), 1-8.
7. Zhang, W., Nuki, G., & Moskowitz, R. W. (2015). Osteoarthritis: An overview. Best Practice & Research Clinical Rheumatology, 29(1), 1-15.


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