After completing the process of evolution of this whole world, Man is the only creation who can get the maximum benefits from its basic intelligence, which make its recognition different from the rest. Apart from the brain, spine and the well coordinated limbs make the existence of man unique. The fine and flexible movements of spine and limbs make many movements and activities possible. These movements and activities occur due to the smooth articulation between the joint of two bones.
Due to present life style and day to day wear and tear, when something goes wrong in the structure and function of the joints, all our activities come to a stay with some symptoms like pain, stiffness etc. This condition of restricted movement of joint is referred as Arthritis. It is the condition which afflicts commonly the joints and the soft tissues of the body, making movements crippled and dependable. Arthritis is a curse to the mankind.
Arthritis is a type of joint disorder which means inflammation of the joint. It may be either in single joint or multiple joint will be involved. There are so many types of arthritis recognized or explained by the modern science. The most common and popular arthritis are: –
- Rheumatoid arthritis
- Psoriatic arthritis
- Gouty arthritis
- Septic/Infective arthritis
According to Ayurveda the concept of arthritis is related to the underlying causative doshas. Any of the dosha either individually or in group manifests the disease. Mainly the Vata dosha alone of in association with pitta or kapha get lodged in the dhatus or tissues, especially in the bones, muscles, joints, soft tissues like tendons, ligaments, joint capsule etc. causes arthritis.
The whole pathology of disease since from the beginning to the last, exhibits some sign and symptoms:
- Stiffness, Malaise and fatigue
- Weight loss (in some cases)
- Sleeplessness (mostly due to pain)
- Muscular pain and weakness
- Joint tenderness
- Difficulty in moving the joint and loss of flexibility of joints
On the basis of cause, arthritis can be divided into two types:
- Primary arthritis
- Secondary forms
Primary arthritis – Is caused due to vitiation of one or more doshas in the body.
Secondary arthritis – Is due to consequence or as a complication, symptom or sequel of some other systemic disorder. In this type of arthritis also, the dosha involvement would be same as in the case of primary arthritis. In secondary arthritis if the main cause is treated effectively, the arthritis will go away.
Involvement of doshas in the functioning of a joint: –
The three doshas Vata, Pitta, Kapha contributes altogether in the normal functioning of a joint. Till these doshas remain in their normal state, they made the functioning normal but as they get vitiated they start affecting this normal functioning and cause the disease to manifest.
For smooth and uninterrupted movement of the joint, they contribute in their specific way as:
Kapha – Kapha dosha has one peculiar property of snighdhata i.e. lubricating in nature. Due to this it provides lubricating to all the joints, which protects the joint from the friction. This also helps in maintaining the integrity and stability of the joint. According to ayurvedic theory, kapha dosha when in normal state provides nourishment to the joint.
Vata – Vata dosha in normal state causes free movements in the body and maintains the flexibility of the joints. Vata performs these free movements due to the lubrication, integrity and stability provides to the joint by the kapha dosha.
Pitta – Pitta dosha in normal condition helps in maintaining the metabolic process taking place in the joints. It maintains the warmth ness of the joint, and maintains the flow of blood and nutrients to the joint. It also keeps infections at bay, destroys pathogens. To some extent, pitta dosha also provides lubrication to the joint along with Kapha. Due to its hot nature pitta dosha also maintains the equilibrium between the two other dosha, vata and kapha.
But when the kapha dosha get vitiated with their causative factors, cause deterioration in the joint and thus looses stability and integrity also, which may cause swelling and effusion in the joint. The lubrication get replaced by the dryness at that time leading to vata and pitta dosha to prevail there, causing more destruction.
Vata dosha leads to structural damage like tendons-ligaments tear, fractures, some times sounds in the joint called crepitus and swelling too.
Vitiated pitta dosha in the pathological process causes lot of inflammations, tendernss like symptoms as in infective and inflammatory arthritis. Both vata dosha and kapha dosha are quite opposite in nature in term of their qualities and functioning. When one dosha increases other gets decreases, if Vata gains a pathological increase, it will dry off the fluidity of Kapha, cause excessive dryness and set in the degeneration process. The joints quickly get damaged on this ground. Pathological reduction of Kapha also provides a suitable environment for aggravation of Vata dosha.
Signs and Symptoms according to the doshas involved:
Arthritis due to vata dosha:
- Severe Pain – vitiated vata dosha causese damage to the joint structure and to the soft tissues. It causes degeneration also. This damage and destruction causes pain of varied intensity. Pain is a common presenting symptom in mostly all types of Arthriti but its intensity varies depending upon the severity of the vata dosha involved.
- Swelling – Mild to moderate swelling can be seen in Vataja type of arthritis. In ayurvedic classics it is termed, VataPurna Driti Ssparsha means the swelling due to vata dosha resembles like a bag or a pouch filled with air.
- Crepitus – Sounds in the joints will be highest in Vata affliction due to severe degeneration, damage, dryness and consequent production of friction in the joints.
- Immobility – Movements will be severely impaired and restricted due to severe damage to the joint structure.
- Pain at particular time–Pain and other sign and symptoms in vataja type of arthritis, mostly exhibited in the evening time, especially at the time when vata naturally get aggravated in the body.
- Season – Generally in Varsha ritu (monsoon season / rainy season), in cold and damp weather vata dosha gets vitiated naturally and especially in this season arthritis related to vata dosha also become worsen.
- Vega – symptoms of Vataja arthritis flare up due to forcible withholding of natural urges, especially for defecation, urination, hunger, sleep, etc.
- Emotions – Many type of emotional factors like anxiety, depressed, stressed, nervousness etc are the conditions which can exacerbate the condition of arthritis.
- Relation to food – Vata or air enterns the hollow space. So empty stomach arthritis of vata origin worsens mostly, more over food substances having bitter, pungent and astringent (katu, tikta, kashaya rasa) tastes worsen the symptoms of arthritis.
- Relation to activity – Excessive and exhausting exercises, excessive indulgence in sexual activities and over exerting activities will worsen symptoms of Vata arthritis.
Pitta type of Arthritis (Involvement of Pitta):
- Burning Pain – When Pitta dosha effects the joint, it produces inflammation. The hotness property of pitta dosha burns the joint and its structures. Which leads to burning type pain.
- Warmth – again due to its hot property, vitiated Pitta will cause increased warmness in the joints. The joint become hot on touch.
- Swelling – In pittaja arthritis, there is swelling also along with the warmness which reflects the involvement of pitta dosha. Here the type of swelling is due to the underlying inflammatory condition not like in the case of kaphaja arthritis, where the swelling is due to accumulation of fluids.
- Redness – The inflamed joints will become some times red in color. This is a reflection of the inflammation taking place in the joints. More redness will reflect more inflammation. This indicated the involvement of pitta dosha.
- Mobility – Movements restricted to varied extent depending on the inflammation. More inflammation causes more burning type of pain and the pain will restrict the movements. But the restriction of movements is not as severe as in Vata type of arthritis which is caused due to joint damage and degeneration.
- Time of Pain – The attack of the symptoms in Pittaja arthritis will be more during afternoon. As the temperature rises with the sun rise and decreases with the sun set, similarly is the pain pattern in pittaja arthritis.
- Season – Generally the pitta dosha gets vitiated in the Sharad ritu (autumn or later summer season), during hot and humid weather, at that time arthritis due to pitta dosha worsen a lot.
- Emotions – In some mental conditions like the condition of anger, jealousy and hatredness, when the pitta gets aggrevetd, pittaja arthritis worsens most
- Relation to food – The symptoms of Pitta type of arthritis will worsen after 1-2 hours of taking food, i.e. when the digestion process is going on and the tastes like Pungent, Sour and salty ( katu, amla, lavna ) tastes will increase or worsen symptoms. Hot and spicy, fried foods will also worsen the pain.
- Relation to activity – Excessive exposure to heat, fire and Sun-light (Sun-heat) will worsen symptoms of Pitta arthritis.
Kapha type of Arthritis (Involvement of Kapha):
- Heaviness – Kapha is a watery element. When Kapha accumulates in excess within the joint spaces it causes effusion. The Kapha involvement indicates accumulation of some fluid in and around the joints. This causes a heavy pain around the joints. The fluid is most often non-inflammatory type.
- Stiffness – This is the hallmark feature of a Kapha joint disorder. The stiffness of the joints and soft tissues is due to accumulation of fluids in the cells. Stiffness or catch will be predominantly sensed around early part of the morning and will come down as the day passes.
- Swelling – Swelling of a severe proportion will be seen in the Kapha type of arthritis. Due to the accumulation of fluids we could observe some shine around the swelling area.
- Coldness – The affected joints are cold on touch. This is because of the cold nature of Kapha.
- Dampness – Feeling of a Wet cloth wrapped around the joint cans be felt from the person suffering from Kapha type of arthritis.
- Mobility: The movements in Kapha arthritis will be restricted due to stiffness caused by fluid accumulation.
- Time of Pain – The complaints will get more during early morning and day time and will gradually come down as and when the Sun-light and heat increases towards the mid day.
- Season – Symptoms aggravate in Vasantha ritu (spring season / Early summer season), during cold and damp weather, cloudy environment and naturally regress in summer and hot season
- Emotions – Extremes of emotions like introversion, depression unable to express etc will support in accumulation of kapha and watery contents in the tissues
- Relation to food – The symptoms of Kapha type of arthritis will worsen after intake of food. Madhura (sweet), Amla (sour) and Lavana (salt) tastes will increase or worsen symptoms. Cold, oily, and stale foods will also worsen the symptoms.
- Relation to activity – Lack of exercises and physical activity
Some times more than one dosha is involved in the pathogenesis of the arthritis. Any of the two and some times all the three dosha will be involved, and manifests the symptoms in mixed type. When vata dosha with pitta is involved in the arthritis, the symptoms exhibited are mixedof vata and pitta symptoms, similarly when kapha and pitta are involved the symptoms are mixed of kapha and pitta. When all the three doshas are involved, symptoms are mixed from the three. But in these conditions the dominant dosha will manifest most of the symptoms and fewer from the collaborated doshas.
Vataja arthritis or the arthritis dominated by vata dosha, will get relieved by:
- Application of herbal oils, abhyanga(massage)
- Application of hot fomentation, swedana (steaming)
- Local treatments like janu basti, kati basti, greeva basti, prusta basti etc
- Panchakarma treatments like basti chikitsa, snigdha virechana, nasya ( bramhana)
- Intake of light digestible food, hot and fresh, more of sweet (madhura), sour (amla) and salt (lavana) tastes
- Oral intake of medicated oils, etc
Pittaja arthritis or the arthritis dominated by pitta dosha get relieved by:
- Application of herbal oils having cold effect, anti inflammatory and soothing effect
- Panchaakarma procedures like virechana, raktamokshana
- Oral consumption of ghee, especially medicated ghee prepared out of herbal medicines having pitta alleviating properties and having bitter taste.
- Intake of light digestible food, cold in nature, more of sweet (madhura), tikta (bitter) and kashaya (astringent) tastes
Kaphaja arthritis and the arthritis dominated by kapha dosha get vitiated by:Hot and warm treatments
- Local applications of herbal paste (lepa), poultices (upnaha) helps in relieving stiffness and pain
- Dry hot fomentations prepared from powder of different herbs
- Panchakarma treatments like vamana, light virechana
- Intake of light digestible food, hot and fresh, more of pungent and spicy (katu), bitter (tikta) and astringent (kashaya) tastes