Diseases of the joints can be classified mainly into two categories: 1) Diseases of joints resulting from inflammation 2) Diseases of joints resulting from degeneration. In clinical practice, very often, there is a considerable overlap between the two.
The common joint diseases mainly encountered are as follows:
1) Osteoarthritis: This is known as the ‘wear and tear arthritis’; the commonest presentation being osteoarthritis of the knees. Basically, this condition results from degeneration of the joint cartilage due to trauma, overuse, obesity, or familial tendency. This disease is usually progressive, meaning conservative treatment does not stop it from progressing.
2) Rheumatoid Arthritis: This is an autoimmune disease primarily causing inflammation, pain and swelling in the small joints. Anti-inflammatory drugs, steroids and immune suppressants can bring about a response, but there is no long term cure. Most autoimmune disorders affect the joints in the long run.
3) Spondyloarthropathies: This is a group of joint disorders that usually include ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease associated arthritis, and reactive arthritis aka Reiter syndrome. Most patients have an involvement of the spine, though in a few patients, large joints may be involved. Treatment is mostly symptomatic and supportive.
4) Gout: This is a metabolic disorder with high uric acid being deposited in excess, mainly in the big toe. This can be treated with drugs and diet control.
5) Bursitis: This is inflammation of bursae, which are fluid filled sacs which provide cushioning and sliding surfaces for tendons close to joints. Trauma and overuse are the most likely cause of inflammation leading to bursitis. Treatment is again symptomatic.
Global Burden of Joint Diseases: As per 2019 estimates, nearly 530 million people were affected globally with osteoarthritis, with nearly 65 million cases in India alone. During this same period, 224 million cases were affected worldwide with rheumatoid arthritis. This is the severity of joint disease and the huge burden it places in terms of economic loss, loss of working hours, severe compromise in quality of life, and not to mention the burden in terms of increased morbidity and mortality.
In most households, several senior citizens and middle aged people; also some unfortunate young individuals, are forced to limit themselves to their houses due to severe restriction in activity resulting from joint diseases. The same story plays out even in the houses of health professionals themselves, since conservative allopathic treatment has limited benefit, especially in rheumatoid arthritis, while the surgical treatment of osteoarthritis calls for huge expenses which are beyond the reach of most individuals who are paying for their treatments.
In such a scenario, it would be worthwhile to consider and review the enormous treatment potential of Ayurvedic herbal medicines for all joint diseases.
Ayurvedic Herbal Treatment of Joint Diseases: Ayurvedic treatment for all joint diseases is with three treatment modalities: 1) Local application: Medicines like Narayan oil, Mahamash oil, Vishgarbha oil, and Gandhapuro oil are used as local application and are followed up with medicated steam fomentation usually using Rasna (Pluchea lanceolata) leaves. This is highly effective in reliving joint pain, swelling and stiffness. 2) Oral medications: These include herbs like Guggulu (Commiphora mukul), Rasnamul (Pluchea lanceolata), Guduchi (Tinospora cordifolia), Punarnava (Boerhaavia diffusa), Shunthi (Zinziber officinale), Shallaki (Boswellia serrata), Amalaki (Emblica officinalis), Ashwagandha (Withania somnifera), Bala (Sida cordifolia), Shatavari (Asparagus racemosus), Arjuna (Terminalia arjuna), and Asthishrunkhla (Cissus quadrangularis). These medicines have excellent anti-inflammatory properties, are good immune modulators, and can be given safely for prolonged periods in high doses without serious adverse effects.3) Panchkarma Procedures: Panchkarma procedures like snehan (oleation), swedan (fomentation), virechan (induced purgation), basti (medicated enema), and rakta-mokshan (blood-letting) have immense additional therapeutic value in bringing about remission in very advanced joint disease too.
A combination of these three treatment modalities can help Ayurvedic treatment to bring about a complete remission in most patients affected with rheumatoid arthritis and other types of inflammatory arthritis. Ayurvedic herbs can repair joint cartilage and help heal advanced osteoarthritis and indeed remove the need for joint replacement. Ayurvedic herbal treatment can thus bring about significant improvement in all types of joint diseases. It is the need of the hour to bring about global awareness about the immense treatment potential of Ayurvedic herbal medicines in joint diseases.