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AYURVEDIC APPROACH TO THE MANAGEMENT OF RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, swelling and stiffness in joints. In this condition, the body’s immune response attacks the lining of the joints (synovium). The condition commonly affects the hands, knees and/or ankles, and usually occurs in the same joint on both sides of the body. However, RA can also lead to systemic issues within other parts of the body, such as the eyes, heart and circulatory system and/or lungs. More women manifest with RA than men, and the condition usually develops in middle age. Having a family member with RA increases the will also increase the chance of developing the condition.

The typical presentation of RA begins insidiously, with the slow development of signs and symptoms over a period of weeks to months. Often the individual will first notice stiffness in one or more joints, usually accompanied by pain on movement and by tenderness. The number of joints involved varies, but mostly involves five or more joints.  Occasionally, individuals can experience an explosive polyarticular onset occurring over a 24-48 hour period. Another pattern involves the onset of swelling in one or two joints lasting a few days to weeks, which then goes away, only to return later in the same or other joints, with this pattern increasing over time.

Symptoms can include:

  • Joint pain, tenderness, swelling or stiffness that lasts for 6 weeks or longer
  • Morning stiffness that lasts for 30 minutes or longer
  • More than one joint is affected
  • Small joints (wrists, certain joints in the hands and feet) are typically affected first
  • The same joints on both sides of the body are affected
  • Many people with RA can experience fatigue and some may also experience a low-grade fever

The joints involved most frequently are:

  • Proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the hands
  • Wrists, and small joints of the feet including the metatarsophalangeal (MTP) joints
  • Shoulders, elbows, knees, and ankles
  • Occasionally, the cervical spine can be affected

Nonspecific systemic symptoms can involve fatigue, malaise and depression, which may precede other symptoms of the condition, and can be indicators of ongoing disease activity. Fever occasionally occurs in individuals and is almost always low grade.

Morning stiffness, which persists more than one hour but commonly lasting for several hours, is especially characteristic of rheumatoid arthritis. Its duration is a useful indication of the inflammatory activity/nature of the disease. Similar stiffness can occur after long periods of sitting or inactivity. In contrast to this, those with degenerative arthritis often experience stiffness lasting only a few minutes.

In some cases, other organ systems may also be involved and can then lead to rheumatoid nodules, cardiopulmonary disease, eye disease, Sjogren’s syndrome, and/or rheumatoid vasculitis.


Conventional Treatments:
RA treatment aims towards minimising the level of RA activity in the body and remission if and when possible, minimising joint damage, and (importantly) enhancing both physical function and quality of life. Optimal treatment plans require a program combining medical, social, and emotional support. Treatment approaches include medications, dietary modifications, lifestyle changes, exercise, stress reduction techniques, physical therapy and surgery.


Ayurvedic Approach to Rheumatoid Arthritis (Ama vata):
According to Classical Ayurvedic texts, Rheumatoid Arthritis is referred to as Ama vata, with the condition stemming from causative factors, including the consumption of incompatible foods, inappropriate lifestyle activities, a sedentary lifestyle, intake of excessive heavy and oily foods, eating before the previous meal is digested, strenuous exercise just after eating, as well as stress and emotional disturbances. These factors, subsequently lead to disturbances in digestion, and allow for the build-up of toxins within the digestive tract. Over time these toxins will then be distributed via the bloodstream to the micro-channels within the body, and can then settle within the joints, leading to RA. The condition is seen as a vitiation and disturbance of predominantly Vata dosha (bodily humor) and of Ama (toxic build-up) within the body.


BENEFICIAL AYURVEDIC HERBS FOR RHEUMATOID ARTHRITIS:
Vata Pitta Balancing: Turmeric, guduchi, shallaki, triphala, castor oil
Vata Kapha Balancing: Turmeric, guduchi, shallaki, triphala, guggulu, pippali, ginger, hing, ashwaganda, chitraka, fenugreek, castor oil, nirgundi
Pitta Vata Balancing: Turmeric, guduchi, shallaki, triphala, castor oil
Pitta Kapha Balancing: Turmeric, guduchi, shallaki, triphala, castor oil
Kapha Vata Balancing: Turmeric, guduchi, shallaki, triphala, guggulu, pippali, ginger, black pepper, hing, ashwaganda, chitraka, fenugreek, castor oil, nirgundi
Kapha Pitta Balancing: Turmeric, guduchi, shallaki, triphala, castor oil


Traditional Ayurvedic Treatment(s) for Rheumatoid Arthritis:
Ayurvedic treatment approach(es) are individualised and are fully dependant on a full consultation with an individual, the current imbalances, their age, strength, severity of the condition, and if other conditions are also present. Treatment approaches can include:

  • Panchakarma detox treatments (when deemed appropriate)
  • Avoid causative factors
  • Balance Jataragni (digestive fire) and digestion
  • Remove Ama (toxins within the digestive tract and body)
  • Balance doshic imbalances through diet/lifestyle/herbs
  • Intake of clean, wholefood, organic eating as much as possible
  • Build immunity
  • Abhyanga massage, sweat therapies (swedana), lepas/poultices
  • Oil bastis if required to balance Vata


General Ayurvedic Nutritional Guidelines for Rheumatoid Arthritis:
Ayurvedic nutritional approach(es) are individualised and are fully dependant on a full consultation with an individual. One should eat compatible foods, and in accordance to one's imbalances. Some additional general guidelines include:

  • One should eat the foods that one does not react to.
  • One should eat according to the digestive capacity, keeping meals light, cooked, warm moist and easy to digest. As a guide, eat to fill the stomach 1/3 with solid food, 1/3 with liquid and leaving 1/3 empty to allow room for digestive secretions in the stomach.
  • One should eat at regular times/intervals. Avoid skipping meals.
  • One should eat wholegrains and non-processed foods.
  • Foods to avoid: Cold foods, raw foods, leftover foods (24 hours), frozen foods, cold water, processed and packaged foods, soft drinks, high fat foods, greasy foods. Minimise the intake of sour and hot chilli type foods.
  • One should avoid overeating. Allow 6 hours between meals and snack 3 hours after a meal and eat only if hungry. If digestion is poor, then 4 light meals per day is advisable in place of three regular meals.
  • Breakfast should be easy to digest, lunch the main meal, and dinner should be lighter than lunch.
  • A small amount of buttermilk consumed after meals is advisable
  • Eat home cooked meals, preferably made on the same day as being prepared.
  • Water should be drunk warm in the cooer months and room temperature in the summer months. Avoid chilled water
  • Minimise intake of fish, seafood and yoghurt (buttermilk is an exception)
  • Use all of the five senses at mealtimes. Savour the food that you are eating.
  • Eat in a pleasant environment. Eat seated and try to avoid TV and electronic devices whilst eating.
  • Eat slowly, eat with respect/reverence for what you are eating, chew thoroughly. 


General Ayurvedic Lifestyle Guidelines for Rheumatoid Arthritis:
Ayurvedic lifestyle approach(es) are individualised and are fully dependant on a full consultation with an individual. Some general guidelines include:

  • Allow for sufficient rest and sleep. Go to bed at a regular time each day, and best before 10pm. Avoid also sleeping during the day.
  • Keep to a routine as much as possible during the day.
  • Get sufficient daily activity and exercise, without overdoing exercise. Balanced activity/exercise is healthy, but avoid over-exertion.
  • Avoid stress, anxiety, fear and tension.  Look at counselling for self-care and working through any stress, anxiety, anger or any other mental health and/or emotional issues.
  • Deep breathing for 10 minutes a day is very beneficial. Meditation, yoga and pranayama can also be highly beneficial.
  • Make sure to be well rugged up in winter, especially when going outside.
  • Do not suppress bodily urges (burping, passing gas, bowel movements etc).
  • Avoid smoking and minimise alcohol and caffeine intake.


If you have any concerns about your health please be sure to consult an Ayurvedic Practitioner or your local health physician. See our Ayurvedic Practitioner Services and Consultation Page for more information.

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Disclaimer:
The above information is for information and educational purposes. As such we are not, diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before taking any form of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

 

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