Year - 2026Volume - 4Issue - 2Pages - 74-83
THE ROLE OF AYURVEDIC MANAGEMENT OF KASHERUKAGATVAT (ASTHIMAJJAGATVATA ) W.S.R. TO ANKYLOSING SPONDYLITIS- A CASE STUDY
24 Apr 2026
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About Author
Mangrude D1,Duddalwar D2,Jamdade D3,Jamdade D4,
1 P.G. Scholar, Kayachikitsa Department, DMM Ayurved Mahavidyalaya, Yavatmal, Maharashtra, India.
2 PG Guide and Associate Professor, Kayachikitsa Department , DMM Ayurved Mahavidyalaya, Yavatmal, Maharashtra, India.
3 Professor and P.G.& Ph.D. Guide and H.O. D., Kayachikitsa Department , DMM Ayurved Mahavidyalaya, Yavatmal, Maharashtra, India.
4 Assistant Professor,Dept.of Dravyaguna, DMM Ayurved Mahavidyalaya, Yavatmal, Maharashtra, India.
Correspondence Address
Janaki nagar ,ward no. 17, Tehsil- Sendhwa , District - Barwani ,Madhya Pradesh .
Contact No. : 7697717666, Email : chanchalg2111@gmail.com
Date of Acceptance : 27 Jun 2026
Date of Publication : 30 Jun 2026
Article ID : SD-IJAY_182
How to cite this article : http://doi.org/10.55552/SDNJAY.2026.4209
Abstract
Background: Asthimajjagatvata, as described in Ayurveda, resembles Ankylosing spondylitis, a chronic, progressive inflammatory disorder primarily affecting the axial skeleton. It is characterized by inflammatory low back pain and a strong HLA-B27 genetic association. There is no satisfactory treatment available in modern medicine for this condition. Here, in this case, several Ayurvedic internal medications and the panchkarma procedure were useful to get better results; the patient got relief in symptoms, and there was an increased range of motion as well.
Ayurvedic classifications that can be compared to the AS condition are -
Amavata: Focuses on the role of Ama (undigested toxins) that lodge in joints, causing inflammatory stiffness similar to AS.
Asthimajja gata vata: Describes the deep-seated stage where Vata affects the Asthi (bone) and Majja (marrow) tissues, leading to symptoms like “bamboo spine” and severe functional limitations found in AS.
Objective: To evaluate Ayurvedic management in case of Kasherukagatvata (Asthimajjagatvata) Ankylosing spondylitis.
Method: A 34-year-old female with lower and upper back pain, pain radiating from lower back to legs, restricted movement of lumbar with increased pain, along with morning stiffness, was treated with Sinhnad Guggulu, panchtikta ghrita Guggulu, Aarogyavardhini vati, vatvidhwansa rasa, Ekangvir rasa, and churna combination along with Panchakarma therapies including Matra Basti and Katibasti.
Result: within 30 days of treatment, marked improvement was observed in pain with increased range of motion of the lower back and relief to the patient in the mentioned symptoms.
Conclusion: Ayurvedic protocols, including Panchakarma, are effective for alleviating symptoms in Ankylosing Spondylitis patients. By relieving distorted Vata/Kapha doshas, the intervention improves joint movement, pain relief, and enhances life quality through improved nourishment.
KEY WORDS:- Ayurveda ,Kasherukagatvata ,Asthimajjagatvata, Ankylosing spondylitis
Introduction
Ayurveda defines health as a state of equilibrium of the three Doshas—Vata, Pitta, and Kapha—with Vata considered the chief regulator of all physiological functions. Its vitiation plays a major role in the development of musculoskeletal and degenerative disorders. In Kasherukagata Vata (Asthimajjagata Vata), aggravated Vata localizes in the Asthi (bone) and Majja (bone marrow) dhatus, producing symptoms such as stiffness, joint pain, restricted movements, and spinal deformities. These clinical features closely resemble Ankylosing Spondylitis, a chronic inflammatory disease affecting the axial skeleton. [1,2]
भेदोऽस्थिपर्वणां सन्धिशूलं मांसबलक्षय।
अस्वप्न संतता रुक् च मज्जास्थिकुपितेऽनिले।। (च.चि. २८/३३) [1]
According to the Charaka Samhita, Asthimajjagata Vata manifests through symptoms such as persistent deep-seated pain (Satata Ruk), joint pain (Sandhishoola), crepitus (Asthi Parvanam Bheda), muscular wasting (Mamsa Bala Kshaya), and insomnia (Asvapna). These classical features show strong similarity with Ankylosing Spondylitis. [1,3]
Ankylosing Spondylitis is a chronic autoimmune, systemic inflammatory disorder primarily affecting the sacroiliac joints and vertebrae. It is classified under axial spondyloarthropathies and is strongly associated with the HLA-B27 genetic marker. The disease predominantly affects young adults between 20 and 30 years of age and leads to progressive stiffness, spinal deformity, and reduced quality of life. Common symptoms include chronic back pain, morning stiffness, reduced spinal mobility, and peripheral joint involvement. [2,4,5]
Discussion
In the present era of fast-paced lifestyles, irregular schedules, physical strain, and frequent jerky movements during travel contribute significantly to the rising incidence of spinal disorders. Ankylosing Spondylitis (AS), a chronic inflammatory condition belonging to the spectrum of spondyloarthropathies, is one such disorder. In Ayurvedic literature, AS can be closely correlated with Asthimajjagata Vata, as both conditions exhibit comparable clinical features such as pain, stiffness, and restricted mobility [1,2,6].
In this case, the patient was managed with a combined approach of Sanshamana Chikitsa (palliative therapy) and Sanshodhana Chikitsa (purificatory therapy) for one month. Marked clinical improvement was observed in Sandhishoola, Katistambha, and Prabhate Graha. Additionally, a reduction in lower back pain and improvement in range of motion were noted, indicating enhanced functional capacity and quality of life. [2,4]
The drugs used under Shamana therapy act mainly by the Ama Pachana, Vata – kapha Shamana action.
Individual shaman drug effects –
Sinhnad Guggulu –It contains guggul, shudha gandhak, triphala, Eranda tail, which works by digesting and eliminating Ama, pacifying Vata, and detoxifying the joints. It improves Agni (digestive Fire), reduces inflammation, and relieves pain and stiffness associated with AS.
Panchtikta ghrita guggulu- it contains panchtikta dravya,ghrita, and guggulu; all drugs give a combined effect on joint strengthening, reducing inflammation.
Aarogyavardhini vati– It acts as aampachak, detoxifies the liver, acts as a metabolic regulator, which leads to increased absorption and better action of other drugs.
Vatvidhavansa Rasa
It contains Shudha Parad, Gandhak, Vanga, loha, Shudha Vatsanabh, etc., which are Vatakapha shamak. Vatsanabh is specially Vednasthapak; overall, it acts as an analgesic and strengthens musculoskeletal tissues. Acts as a potent Vata
Kapha pacifier and analgesic, in the condition of AS.
Ekangvir Rasa
Ekangvir Rasa is a classical Ayurvedic herbo-mineral formulation primarily used for treating neuro-muscular conditions and disorders arising from aggravated Vata dosha.
Churna combination
A combination of Dashmool, Rasna, Punarnava, and Ashwagandha acts as a potent vat – kapha shamak and benefits in inflammatory conditions and pain.
Panchsakar churna
It acts as a mild laxative, clears the bowel, and maintains bowel health. It detoxifies the body from the aama (toxins), preventing bloating and constipation. Thus, in an AS patient, it provides relief by aampachan and pacifying the vat – pitta dosha and maintaining the Agni of the patient.
Dashang lepa
It contains ten herbs, including Haridra, Shirish, Kushtha, Ela, Raktchandan, Jatamansi,tagar, Daruharidra, and Usheer.
All these drugs combine to act as an anti-inflammatory, reducing pain and redness on local application.
Shodhana therapy-
Matra Basti
It plays a key role in managing Vata disorders. Administration of medicated oil like Vajigandhadi Taila nourishes Asthi and
Dhatu improves the lubrication of joints and enhances spinal flexibility.
Katibasti
Through localized Snehana and Swedana, it relieves pain, reduces inflammation, and improves circulation in the lumbosacral region. These therapies collectively help in breaking the pathogenesis of Asthimajjagata Vata.[1,7,6]
Conclusion
This case study demonstrates that Ayurvedic management, including Shamana and Shodhana Chikitsa such as Matra Basti and Katibasti, is effective in alleviating symptoms of Ankylosing Spondylitis. By pacifying aggravated Vata and Kapha Dosha and nourishing Asthi-Majja Dhatu, the treatment improves joint mobility, reduces pain and stiffness, and enhances overall quality of life. Thus, Ayurveda offers a promising, holistic approach in the management of AS. [1,2,6]
References
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Agnivesha, Charaka, Dridhabala. Charaka Samhita, Chikitsa Sthana, Vatavyadhi Chikitsa Adhyaya (28/33).
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[2].Ankylosing Spondylitis
Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379–1390.
[3].Tripathi B. Charaka Samhita (Charaka Chandrika Commentary).
Varanasi: Chaukhambha Surbharati; 2013.
[4].American College of Rheumatology
Ward MM, et al. 2019 update of the American College of Rheumatology recommendations for Ankylosing Spondylitis.
Arthritis Care Res. 2019;71(10):1285–1299.
[5]. Principles and Practice of Medicine
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Davidson’s Principles and Practice of Medicine. 23rd ed. Elsevier; 2018.
[6].Singh RH.
Exploring issues in Ayurvedic research methodology.
J Ayurveda Integr Med. 2010;1(2):91–95.
[7].Sushruta Samhita
Sushruta. Sushruta Samhita, Nidana Sthana.
Varanasi: Chaukhambha Sanskrit Sansthan; 2012.