Osteoarthritis which is a common suffering these days could be compared to Sandhi gata vata from Ayurveda’s perspective. Though it is difficult to have a comparative study of two very different systems, but for the ease of understanding and to bring the best out of the two system for achieving a common a goal of curing the ailments, an integration is not a bad idea. Osteoarthritis is a disease characterized by a group of mechanical changes with the degeneration of joints. It is a prevailing disorder in old age people, wherein level of calcium degrades due to an effect of ageing, but other factors like life style, food habits etc. are also equally responsible for the prevalence of this disease.
Ayurveda describes a long list of causative factors responsible for Sandhi Gata Vata. As the name suggests, it is a disorder generated by excess Vata thus also known as Vata Vyadhi. Though vata vyadhi is quite a comprehensive term and it is a group of diseases created by increased Vata out of which one that affects joints specially weight bearing articulations is named a Sandhi Gata Vata. Meaning of word Sandhi is Joint or articulation.
Sandhi Gata Vata can affect any of the joint, but mostly large weight bearing joints like hip, knee and ankle are affected. Vata, which is a factor chiefly responsible for the mobilization in the body when increases in excess starts degenerating the body by means of its property of absorption. Symptoms of increased Vata can be viewed by signs of dryness over the skin, wrinkles, loosening of the joints, muscle wasting, poor strength etc. As per Ayurveda, causative factors responsible for the vitiation of Vata are, too much consumption of food which is dry in nature, and light to digest, to eat small quantity of meals which is insufficient for the body for a prolonged duration, too much involvement in sexual activities, to consume insalubrious diet, to wake up late night and to remain hyperactive and physically involved without taking enough rest. Chronic indigestion, malnutrition, excessive travelling are also few factors responsible for the vitiation of Vata Dosha. Trauma, excessive bleeding, chronic stress are also few other factors that increase Vata. Vitiated Vata when enters into the channels, it initiates many ailments related to Vata, and one of them is Sandhi Gata Vata.
Sandhi Gata Vata mainly represent symptoms pain and stiffness in the joint that may or may not increase with exertion. The joint makes a peculiar crackling sound while moved which is also called as crepitus. Swelling of the joint after exertion with or without the signs of inflammation can also be seen. Sandhi Gata Vata mainly affects spine, hip, knee and ankle joints which undergo a lot of wear and tear generated by body weight.
So obese people are at more risk of having osteoarthritis. Generally pain increases with cold and patient feels relieved by hot fomentation. Diagnoses can be established based on history and clinical examination. X- ray can consolidate the diagnoses and a typical OA(knees) X- ray film shows degenerative changes in the knee joint with joint space reduction and osteophyte formation in the joint.
Management of Sandhi Gata Vata from Ayurveda’s perspective is quite interesting and effective as well. One needs to rule out the involvement of the toxins (ama). Ayurveda reveals that sometimes Ama involvement with excessive Vata generates similar symptoms to the Ama Vata and could be quite confusing to diagnose, this state is called as Sama Sandhi Gata Vata. In such cases fasting remains the first line of action and it is necessary to bring it to the state of Nirama that is free from the toxin. There on line of action remains Oleation and fomentation to the joint, which could be done with the help of Panchakarma. Specific herbal oils are used for the purpose of oleation followed by fomentation with the help of herbal decoction prepared with the herbs that pacify Vata and also relieves the pain. Herbs like cida cordifolia (Bala), Gingiber offcinale (Shunthi), Cedrus deodara (Devdaru) are few that also helps in Sandhi Gata Vata. Food and nutrition is an aspect that can not be set aside while treating osteoarthritis. Life style needs to be corrected to achieve maximum result. It should be kept in mind that it is of utmost important to manage OA and if managed earlier it is better.