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Ayurvedic Management of Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is a chronic inflammatory disorder of Joints that causes pain, swelling, stiffness and loss of function in affected joints. Unlike the common arthritis, it is an autoimmune disease, that is, our own immune system mistakenly attacks our healthy cells as in infections, wounds, and foreign objects. In addition to joints, it can also affect other body organs like eyes, heart, lungs etc.
In Ayurveda, RA is called as AMAVATA, where AMA means toxic particles evolved from improper digestion and assimilation. The AMA is, then, emulsified with Vata and gets spread on whole body and localized on joints, hearts, lungs and other parts of body. Our defence mechanism treats the AMA as a foreign body and forms the antibodies in order to fight.  But, when it combines with AMA, it acts as an abnormal immune complex which leads to inflammatory changes and contribute to disease process.

Risk Factors:
Gender: Developing RA is 2 to 3 times more common in women.
Heredity: People may be affected if they have a history of RA in their families.
Age: Although rheumatoid arthritis can develop at any age, it likely to develop between the ages of 25 and 55.
Coffee and Cigarettes: Some studies have suggested that Smokers are also more at risk for developing RA
Diet Habit: According to Ayurveda, it is the main risk factor for developing RA. Untimely and improper diet habit may leads to alteration in digestive power which is responsible for production of AMA.

Signs and symptoms:
•    Involvement of symmetrical joints, morning stiffness, pain and swelling in joints, first involvement of small joints of finger and toes, nodules, deformity are the signs and symptoms of classical RA.
•    Stiffness: Reduced mobility or movement of the affected joints. It is prominently seen early in the morning.
•    Swelling: The area around the affected joint is swollen and puffy.
•    Pain: in Ayurveda, the pain is described as the pain just like scorpion bite.
•    Nodules: These are hard bumps that appear on or near the join, may develop in nearly one-third of people who have rheumatoid arthritis. They often are found in the pressure points in the body like elbows.
•    Joint Deformity: In classical and chronic RA, joint deformity like anterior subluxation of metacarpo-phalengeal joint, ulnar deviation, swan neck deformities etc are seen.

Extra-articular features:
Anorexia, loss of weight, lethargy, fever, depression, anemia, myolgia, pericarditis, cardiomyopathy, pleurisy, carpal tunnel syndrome etc.

Management:
Diet and Life Style modifications.
Patient digestive power is week. So he/she should take easily digestible, light and compatible food mixing with stomachic and digestive herbs like dry ginger, long piper, leadwort, garlic, cinnamon and cloves
Amavata patient's diet should include leaves of Patola, Vastuka, Goshura etc. 
should take old rice, garlic, bitter gourd and horse gram in his/her diet.
Avoid consumption of curd, milk, buttermilk, fish, jaggery, oily foods, junk and fast foods, salty and sour foods, black gram, cold drinks.

•  Always use hot water to bathe
•  Avoid cold breeze and excessive wind.
•  Empty bowels regularly.
•  Do not control natural urges.
•  Avoid late nights and afternoon naps.
• Should take fomentation through warm sand particles packed in a piece of contton.

Drug Therapy:
The aim of drug therapy is increasing the digestive power, removing of toxic or detoxification, correcting the immune response, relief from pain and swelling and minimizing the deformity.
1. Ama-Pachan or Anti-toxic Drugs
These medicines avoid the formation of toxin by enhancing digestive and assimilative power.
a) Panchkola Qwath
b) Amavatari Rasa
c) Agnitundi Wati
d) Chitrakadi Wati
e) Rasonadi Wati

2. Rog Pratirakshytmak or Immunomodulators:
As RA is an autoimmune disease, these medicines are prescribed to correct and enhance the immunity.
a) Aswagandha
b) Guduchi
c) Amrita Guggulu

3. Bedanahar or Anti-inflammatory and Anti-Rheumatic Drugs.
These medicines are effective in pain and inflammation. They help to slowdown the disease progression.
a) Yograj Guggulu
b) Maha Yograj Guggulu
c) Sinhanad Guggulu

Panchakarma or Detoxification Therapy:
Panchkarma is used to clean the body of toxic materials left by disease and improper diet habit. Ayurveda says that imbalanced doshas create waste matter. This waste matter is called Ama in Ayurveda. Ama is a foul smelling, sticky, noxious, substance that needs to be evacuated from the body as thoroughly as possible. Panchakarma permanently eliminates these toxins from the body, allowing healing and restoration of the tissues, channels, digestion and mental functions.

Yoga:
Yoga keeps the body free from impurities that are accumulated inside our body due to our bad food habit, wrong behavior and other external agents. In Ayurveda, various yogic practices are used for keeping equilibrium between the body, mind, and self, in order to establish health and harmony.

Note: photo source:http://www.joint-r3aya.com/images/joints_blackBG.jpg
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