Panchakarma for Joint Problems

According to CDC data, the number of Americans battling severe joint pain—mostly arthritis related—jumped from 10.5 million in 2002 to 14.6 million in 2014. What made it worse is that one in every four American adults with arthritis reported discomfort measuring higher than 7 on a scale of 0 to 10; zero being no pain to incrementally rising discomfort. What did most people do? They resorted to analgesics, of course. 

But these do not come without their own set of side effects, varying from common and less serious to diabolical. For example, methotrexate given for treating joint problems, can potentially affect the liver, and doctors even recommend taking a liver test before taking the medicine. Long term use of corticosteroids can result in osteoporosis. So, users are asked to examine bone loss. 

On the other hand, joint problems, if not treated on time, can severely affect one’s ability to lead a normal life by causing physical incapacity. In severe cases, patients may have to depend entirely on others for doing the most basic tasks such as bathing, or even pouring oneself a glass of water.

If only everyone knew how to deal with the rising joint issues holistically with non-invasive alternative modalities like Panchakarma. Its therapies treat and eliminate the root cause of discomfort in the joints, rather then just suppress the pain symptoms.  According to this holistic science, accumulation of toxins (ama) and vata aggravation are the main culprits behind the most common joint problems. 

Osteoarthritis

Sandhi is the Sanskrit word for joint. The Ayurvedic term for osteoarthritis is sandhivata—the term implies that vata aggravation is the main culprit behind this most common joint problem. Vata is dry in nature and chronically aggravated vata may be the result of either vata-aggravating foods and lifestyle, or of old age that causes the synovial fluid—the natural lubricant for joints—to dry out over time, increasing the friction between the joints. This friction further damages the protective cartilage that cushions the joints and enables you to move. 

Damaged cartilage brings with it pain, swelling, and reduced mobility. Timely treatment with Ayurveda can help slow down this damage by lubricating the cartilage. 

Rheumatoid Arthritis

After osteoarthritis, the second most common joint problem is rheumatoid arthritis, an autoimmune condition in the body. The Ayurvedic term for the disorder is amavata. Over time, poor lifestyle and dietary habits unfavorable to your dosha type, can lead to accumulation of ama (toxins in the body). Extremely painful in its aggravated form, if not treated on time this disease can lead to complete loss of movement in the affected joints.

Cervical Spondylitis and Spondylitis of the Spine

Spondylitis is one of the most common causes of persistent back and neck pain, and it worsens with age-related wear and tear. Vitiated vata is again the causative behind these problems of the backbone. Imbalanced kapha also adds to the problem, causing stiffness and lack of movement.  

Gout

In Ayurveda, gout is described as vatarakta—caused by vitiated vata dosha, pitta dosha and imbalance in rakta dhatu (blood). Poor dietary choices such as excessive intake of salty and sour foods and improper food combinations, along with a less than ideal lifestyle, lead to elevated levels of uric acid in the blood. Excess of uric acid crystallizes and gets deposited in the areas around the joints, leading to the severe pain, discomfort, and swelling.   

Panchakarma Can Help

In addition to oral administration of medications, Ayurvedic treatments for joint problems include the Panchakarma therapies of snehana, swedana, nasya, vaman, virechan, and medicated enemas.

Snehana 

Snehana is a beautiful word that means oleation. External oleation like Abhyanga (warm-oil body massage) is effective in balancing vata aggravation and providing relief from pain and swelling.  Medicated oils like ksheerabala taila, dhanvantaram tailam, and pind taila (there are specific Ayurvedic oils) are chosen based on season, condition of the disease, and the prakriti of the individual. Pichu is a therapy where a thick layer of cotton soaked in warm medicated oils is placed over the affected joints. Kativasti is an effective form of external oleation in which warm oil is poured into an artificial mould which is sealed with the affected area using a fine paste normally made from black lentils. This process quickly loosens stiff joints and reduces pain and swelling. Similar to kativasti is greeva vasti, which is performed on the neck area for treatment of cervical spondylitis, and janu vasti, which is performed on the knee joint. All these snehana procedures are effective in relieving osteoarthritis and spondylitis. Internal oleation, called snehpan, in which medicated clarified butter is administered orally, is another type of snehan used for treatment of rheumatoid arthritis and gout.

Swedana

Swedana means sweating. Medicated steam baths are the most common form of swedana which helps loosen stiff joints; especially when done after an external oleation therapy like abhyanga. Patra pind sweda is an effective swedana therapy in which a potli or bolus (a round packet of cloth) is made with leaves of specific herbs—based on an individuals prakriti—such as thorn apple, castor beans, tamarind, etc., along with medicated powders and oils. This bolus is applied on the affected area.

Shashtika shali pind sweda is another swedana technique using bolus made of nutritious shashtika rice which is cooked and soaked in medicated liquid. This sudation technique is deeply invigorating and nourishing not only for the joints and bones, but for the muscles as well. Other effective sudation techniques that are helpful in joint problems are Manal Kizhi and Pizhichil.

With manal kizhi, heated sand is used in a bolus to provide heat to affected joints. This technique is helpful especially in treating rheumatoid arthritis. In pizhichil, warm medicated oil is poured on the body in to induce perspiration. These swedana techniques are helpful in treatment of osteoarthritis, rheumatoid arthritis, spondylitis as well as gout. 

Both snehana and swedana are effective in balancing the vata dosha and in getting rid of stiffness, aches and swellings. They are considered poorvakarma—procedures that need to be done before the pradhan karma(the key procedures) of the panchakarma therapies—as they get the long seated toxins loosened up and moving, thereby making it easier to flush them out of the system.

Nasya

Nasya is a process where medications that are administered via the nasal passages affect the mind, prana vata, tarpaka kapha, sadhaka pitta, and majja dhatu. This helps balance vitiated vata and kapha in the upper respiratory system in addition to cleansing the toxins from the respiratory tract. Nasya is helpful in treatment of cervical spondylitis and spondylitis of the spine as it eases the pain and stiffness in the upper part of the body.

Vamana

Vamana is the art of purifying the upper gastro-intestinal tract by inducing controlled vomiting. Excessive kapha dosha is eliminated through this. Toxins are washed out from the respiratory tract and the upper body. This procedure is particularly helpful in cervical spondylitis and also effective in treatment of rheumatoid arthritis. 

Virechana

By means of snehana and swedana and the use of orally administered medications, the liquefied dosha impurities are sent into the digestive system from where they are flushed out of the body through controlled purging, induced by administering oral Ayurvedic medicines, based on your prakruti. 

Virechan is an effective treatment option to relieve pain and discomfort due to gout and rheumatoid arthritis. Vata is regulated after virechan and therefore it also provides relief in other joint problems like osteoarthritis and spondylitis.

Enema

This is the administration of medications through anal route with a purpose to release feces and toxins in a controlled manner that helps provide relief from a condition like rheumatoid arthritis that is born from accumulation of toxins. Enema is most effective in correcting vitiated vata dosha and hence is an effective treatment for vata rakta, i.e., gout and osteoarthritis. 

The extent of the treatment, quantity and types of herbs, the type of the treatment and the techniques of swedan and snehan are all decided by the experts after taking a holistic view  of body type, vikritis, and health conditions of the individual. 

While panchakarma treatments do bring great relief from the ailments, the degenerative joint problems are rarely reversible. The progression of the disease can be controlled by means of treatment but it is wiser to prevent the disease from manifesting in the first place by choosing a healthy, active lifestyle that is aligned with your constitution.