Osteoarthritis is a degenerative joint disease mainly caused by the wear and tear of the joints resulting in loss of the cartilage, loss of resilience and the lubricating mechanism of the joint is impaired. The weight bearing cartilage is undergoing calcification and bony spurs growing around the edge of the joint.

Osteoarthritis is called Sandhigata Vata . This is comprised out of 3 words.
1. SANDHI meaning junction, connection, combination, union. In Ayurveda, shareera sandhi is a technical word indicating that it is the place where two or more bones meet together. The joint may be a fixed type or with less or more movement. (A place where 2 or more bones meet)
2. GATA is a Sanskrit word used to denote an initiation of movement, carrying something along with to reach a particular site, through any particular pathway.
3. VATA – Involvement of the Vata Dosha. Vata is increased and is settling into the bone (asthi dhatu).

Definition of Sandhigata Vata/ Osteoarthritis:
The vitiated Vata when it gets lodged at one or more than one Sandhi (joint) and producing features like
• Sandhi vedhana/ pain in the joint
• Sandhi shosha/ swelling
• Atopa/ crepitus
• Sandhi stabhdata/ Stiffness in the joints.
• The joints feels full of air
• Sandhi vishlesa/ hyper mobility of joints

When these clinical manifestation appear only in Janu (Knee joint) then it is called Janu Sandhi Gata Vata.

Nidana/ Causes for Sandhigata Vata mentioned are

Vihara (lifestyle)
• Divasavapna/ day sleep
• Dhatukshaya/ depleted body tissues
• Ativayayama/ excessive exercise
• Abhighata/ injuries
• Marmaabhighata/ injury of Marma

Ahara (food)
• Kashaya, Katu and tikta/ excess astringent, hot and bitter food
• Ruksha, Laghu, Sheeta, alpa/ drying, light, cold and too little food

Manasika (emotional)
• Chinta/ excessive thinking
• Shokha/ grief
• Krodha/ anger
• Bhaya/ fear

Samprapti Ghatakas/ disease etiopathogenesis

Dosha: vata, vyana vayu vriddhi, kapha kshaya (sleshmaka Kapha)
Dushya: snayu, mamsa, asthi
Srotas: asthivaha srotas
Agni: asthi dhatvagni
Rogamarga: madhyama
Adhisthana: sandhi

Treatment principles:
Since Osteoarthritis is Vata dominant with Asthi/ bone being the main vitiated dhatu (tissue). BRIMHANA (nourishing/ toning) and BALA/ strength increasing are the main line of treatment.

Unless the Osteoarthritis is due to Avarana. In this type there will be excess meda (fat tissue) dhatu. This will cause obstruction for the flow of nutritive materials to the future Dhatus i.e. Asthi (bone), Majja (bone marrow)…. leading to their Kshaya/ depletion. (Su.Sa Su 15/32 – Dal.)
We are not discussing this type here.

Chikitsa/ Treatment of Osteoarthitis

1. Nidana Parivarjana (eliminating causative factors), weight reducing treatment if overweight.
2. Snehana
-Abhyantara Sneha: internal oleation in the forms of pana, bhojana, basti, and nasya
-Bahya Sneha: Abhyanga oil massage and Mardana
3. Svedana/ Sudation this is done with
– Upanaha/ poultice. The poultice is tied at night and taken off in the morning.
– Bandhana/ medicated paste with Vata hara dravya (Vata reducing herbs) is applied.
4. Panchakarma chikitsa is done before BRIMHANA and BALYA treatment. Snehapana with Ghee before snigdha virechana/ purgation. Basti Karma (enema) treatment is also essential.
5. Pathya Ahara/ Vihara – wholesome diet and lifestyle
6. Shamana Yogas
7. Rasayana/ rejuvenation treatment.

Other treatments and beneficial formulations:
• Lepana paste application with Nagaradi lepa choorna
• Janu basti treatment
• Thaila/ oils such as Kethakimooladi thaila, Bala thailam and Murivenna thailam
• Internal medicines Rasnapanchakam Kashayam and Guggulu/ commiphora mukul formulations

If you have any more questions about Sandhigata Vata you are welcome to email us on info@lakshmiayurveda.com.au

With love your Lakshmi Ayurveda team

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