Rheumatoid arthritis (RA) is a common autoimmune disorder that is known to affect mostly the joints. RA has a world-wide prevalence of 0.5 to 1% and women are three times more prone to the get affected than men. Inflammation of the tissue around the joints and inflammatory arthritis are distinguishing features of rheumatoid arthritis but this disease can also cause inflammation of other organs in the body. RA originates gradually with fatigue, loss of appetite, morning stiffness sometimes lasting for more than an hour, general muscle pain and weakness. Sooner or later joint pain appears. Joints become warm, tender, and stiff if they are unused or at rest. Inflammation of the synovial lining produces more fluid and joints start swelling. In RA joint pain often appears   on both sides of the body and may affect wrist, knees, toes, fingers, elbows, ankle or even neck. Since RA also affects multiple other organs of the body, rheumatoid arthritis is referred as a systemic illness and is also called rheumatoid disease. RA is a progressive disease that has the ability to cause destruction of joints and functional disability. Rheumatoid arthritis can be correlated with Amavata in Ayurveda. Rheumatoid arthritis is described as “Amavata” in Ayurveda. The word ‘Ama’ literally means, undigested or toxic product, which is produced in the body due to malfunctioning of digestive fire. This ‘Ama’ is further carried by the vitiated ‘Vayu’ and travels throughout the body and gets accumulates in the joints, which is the seat of ‘Kapha’ (one of the three dosha i.e. Vata, Pitta and Kapha). All the joints are gradually affected, which then results in severe pain and swelling. Pain caused is due to vitiated “Vata” and swelling is due to imbalanced Kapha. If pitta dosha also aggravates then it causes burning sensation all around the joints. Pain of amavata is resembles to pain caused by the Scorpion sting. Modern science blames the weakened immune system to be the causative factor for RA. Ayurveda explains in detail causative factors of amavata.  Incompatible food and habits like consuming fish with curd or tomato sauce with milk, etc. poor digesting capacity, lack of physical activities and sedentary lifestyle, diet including fats in excess, consumption of contaminated water all these may cause amavata. Cardinal symptoms of amavata as explained in Ayurveda classics are:

• Vriscik damsha vata vedana  or Severe pains in the morning
• Sanchari Vedana or Shifting pain
• Stambha or Stiffness of joints
• Jwara or Increase temperature
• Karmahani or Loss of movement
• Sandhi Vikruti  or Joint deformity
• Kshudhamandya  or Loss of appetite

As you can see in the explanation of the disease that RA is not just related to skeletal system it starts from the digestive system. Hence treatment in Ayurveda also starts with increasing the digestive fire. Line of treatment is : Langhana – Means fasting, it is either done by means of complete absence of food, or by intake of green gram, rice porridge. During this period some herbal powders or tablets may be given to increase the digestive fire. Increasing the metabolism will help in proper digestion and this help in proper nourishment of the body tissues. Sodhana chikitsa – It is done through Panchakarma therapy. Therapies like Snehapanam , Virechanam, Vaitharana / Kshara basti, are done to remove the ama. Other upakarmas such as Valukasweda, patra pinda sweda, upanaha sweda, churna sweda, lepa, etc. are done locally to the joints to reduce the symptoms and to improve the circulation. Shamana chikitsa – Internal medicines are given to pacify the aggravated dosha and to correct the metabolism. These medicines may be prescribed for a longer duration to correct the doshas. Some of the medicines that are commonly given in Amavata are Yograj Guggulu, Sihmnaad Guggulu, Rasnadi Guggulu, Arogyavardini Vati, Panchasama Churna, Panchakola churna, Rasnasaptakam Kashayam, Amrutottaram Kashayam, Rasnaerandadi Kashayam, Dashamoola kashayam, Amavatari ras, Saidhavadi taila, etc. The above mentions line of treatment may be given in combination to see more improvements. Few tips to combat RA or Amavata:

1. Avoid cold items, contaminated water, frozen food, as all these increase vata and kapha dosha which intern increases stiffness and pain.
2. Curd in Ayurveda is considered as abhishyanda meaning intake of it causes ama hence avoid curd in amavata especially during night times.
3. Avoid black gram, red meat, fish, junk food, aerated drinks, fried food, and highly rich fatty food.
4. Avoid contrast food items such as fish with milk, fruit milk shakes, etc.
5. If you are diagnosed with RA never do oil massage as it increases pain. In RA dry massage is advised to combat your pain you can use heated crystal salt in a kora cloth like a bundle and warm your joints.
6. Never avoid or delay your natural urges such as urine, motion, sneezing, etc. as avoiding natural urges increases vata and hence pain increases.
7. Avoid day sleeping and late night sleeping. Sleep at regular time.
8. Avoid exposure to cold wind, AC, cold breeze, cold water, excessive stress and anger.
9. Eat warm, light and easily digestible food prepared from wheat, bajra, etc. Increase the use of Methi, ginger, garlic, black pepper and turmeric in the food.
10. Drink hot water.
11. Do regular exercise. Yoga and meditation will definitely help.

Some of the key differences between Amavata (RA) and Sndhigatavata (OsteoArthritis):

Characteristic	Amavata	Sandhivata
Age of onset	Any time of life	After 40s and 50s
Onset speed	Rapid onset may be few weeks to a month	Onset is Gradual
Symptoms	Painful, stiff and swollen joints	Painful joints and tenderness but have little or no swelling, painful movements with crepitation.
Spread of symptoms	Pain is symmetric and and affects small and large joints such as both knee joints, elbow joints.	Symptoms often begin on one side of the body and may spread to the other side. Usually eight bearing joints are affected like knees, hips.
Duration of stiffness	Morning stiffness is longer and pain increases with movement but slowly reduces with time.	Duration of morning stiffness is lesser but pain increases with over activity of the joints.
Other symptoms with joint pain	Fatigue, fever, indigestion, lethargy.	Pain is the only main symptom fever is not present. Systemic body symptoms are absent.

Always remember that amavata starts from your Gastro-intestinal tract so taking care of your GIT with proper and wholesome food can avoid the toxin or ama formation in the body and a good metabolic rate will keep your immune system properly functioning. Following a proper diet and lifestyle can avoid many of the disease. Consulting an Ayurveda physician at the early stages of RA can definitely avoid further complications of Rheumatoid arthritis. More recently, India's premier medical institution, AIIMS, has found certain Ayurvedic formulations far more effective in treating rheumatoid arthritis. According to the study Ayurvedic medicines like Ashwagandha powder and Sidh Makardhwaj, were proven effective in relieving pain in tender and swollen joints, and increased mobility among many patients. The NCBI (National Center for Biotechnology Information) has also published a research paper on teh efficacy of Ayurvedic treatment for RA. The results showed that Ayurvedic treatment was indeed effective in the first cohort of patients who completed treatment. Even patients with severe functional limitations showed significant improvement. Read more here. Note: Never self-medicate or diagnose yourself. Please consult a qualified doctor who can guide you in a proper direction to solve your problem with ease. To explore our various Arthritis management programs avaialble across India, click here or contact us at cs@ayuruniverse.com.