“AYURVEDIC MANAGEMENT OF SANDHIGATVAT W.S.R OSTEOARTHRITIS : CASE STUDY"

About Author

Correspondence Address

Kayachikitsa Department,
Shree Ayurveda mahavidyalay,Nagpur
Contact No. : 9209460566, Email : sawanchudiwal117@gmail.com

Date of Acceptance : 27 Dec 2025

Date of Publication : 31 Dec 2025

Article ID : SD-IJAY_155

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3406

Abstract

Osteoarthritis (OA) is a highly prevalent degenerative joint disorder that significantly affects mobility, functional capacity, and quality of life, particularly among middle-aged and elderly individuals. In Ayurveda, osteoarthritis is commonly correlated with Sandhigata Vata, a condition characterized by pain, stiffness, reduced joint mobility, and functional impairment resulting from the vitiation of Vata in the joints. Although osteoarthritis is a slowly progressive disease, its early symptoms can severely restrict a patient’s ability to perform routine activities.

This case is noteworthy as it highlights the successful management of a patient who presented with severe functional limitation—being unable to walk without support—yet demonstrated marked improvement within 20 days following a structured Ayurvedic treatment protocol involving a combination of Shamana and Shodhana Chikitsa. Such rapid functional recovery in a patient with radiologically mild osteoarthritis but pronounced clinical symptoms underscores the effectiveness of integrative Ayurvedic management in early-stage OA.

Furthermore, this case emphasizes the relevance of individualized, constitution-based treatment approaches in improving mobility and alleviating pain without the need for invasive interventions. It contributes to growing clinical evidence supporting holistic, non-surgical management strategies for knee osteoarthritis, particularly in patients whose clinical symptoms are disproportionate to radiological findings

KEY WORDS:-  Sandhigatvata, Osteoarthritis, Shodhan, Shaman

Introduction

Osteoarthritis (OA) is the most prevalent musculoskeletal disorder, commonly manifesting in old age. It predominantly affects large, weight-bearing joints. Degenerative changes are observed in almost all individuals by the age of 40. Clinically, symptoms of osteoarthritis are seen in approximately 15% of males and 25% of females. The incidence of knee osteoarthritis is notably higher in the Indian population compared to Western populations. The condition leads to functional limitations due to pain during routine activities such as walking, dressing, and personal hygiene, thereby contributing to work-related disability¹.

In Ayurveda, osteoarthritis is correlated with Sandhigata Vata, which is described by Acharya Charaka under Vatavyadhi Chikitsa Adhyaya. The classical symptoms include joint swelling resembling an air-filled bladder (Vatapurna druti sparsha) and pain during flexion and extension of the affected joints².Modern medical management of osteoarthritis has certain limitations. Although various therapeutic modalities such as analgesics, NSAIDs, and surgical interventions are available, they mainly provide symptomatic relief and are often associated with adverse effects on long-term use³. In contrast, Ayurvedic management, including Shamana Chikitsa (palliative therapy) and Panchakarma (detoxification procedures), has shown promising results in the management of this condition.This case study aims to highlight the significant effectiveness of Ayurvedic interventions in the treatment of Sandhigata Vata. The combined use of Shamana and Panchakarma Chikitsa resulted in marked improvement in the clinical signs and symptoms of osteoarthritis.

Discussion

The Chikitsa Sutra (treatment principle) of Sandhigata Vata primarily includes Snehana (oleation), Swedana (sudation), and Basti Karma [8]. The treatment protocol planned for the present case comprised Shodhana Chikitsa in the form of Basti Karma, along with Shamana Chikitsa. The therapeutic principles adopted aimed at Vedanasthapana (analgesia), Shothahara (anti-inflammatory action), pacification of vitiated Vata Dosha, and strengthening and nourishment of the musculoskeletal structures of the lumbar region and lower extremities. The probable modes of action of the applied Shodhana and Shamana therapies are discussed below.

Probable Mode of Action of Panchakarma Chikitsa

1. Snehana

Abhyanga:
In Abhyanga, medicated oil (Taila) is applied to the body with systematic massage. The mechanical pressure exerted during massage increases local muscle temperature and enhances arterial circulation. From an Ayurvedic perspective, Taila possesses Snigdha, Guru, and Ushna properties, which are antagonistic to the Ruksha and Sheeta qualities of aggravated Vata Dosha. Thus, Abhyanga helps in pacifying vitiated Vata, relieving pain, and improving joint mobility [9].

2. Swedana

Nadi Sweda:

Swedana therapy is described as Stambhaghna (alleviating stiffness), Sandhicheshtakara (enhancing joint movement), Srotoshodhana (clearing microchannels), and Kapha-Vata Nirodhana (reducing aggravated Kapha and Vata Doshas) [10]. The application of therapeutic heat liquefies the vitiated Doshas and dilates the Srotas, facilitating their movement toward their normal sites. This results in Srotosanga Vighatana (removal of obstruction in microchannels), thereby reducing joint stiffness and improving functional capacity [11].

3. Dashamooladi Niruha Basti followed by Sahachara Taila Anuvasana Basti

Basti is considered the most effective therapy for Vata Dosha, as emphasized by Acharya Charaka [12]. The active principles (Virya) of Basti formulations are absorbed through the Pakwashaya (colon) and disseminated systemically through various body channels, enabling targeted action at the site of pathology and producing generalized therapeutic effects [13].

Basti helps in removing Kapha Avarana over Vata and directly acts at the primary seat of Vata Dosha. It aids in relieving constipation, edema, inflammation, and degenerative changes through its Srotoshodhana and Vata-Kapha Hara actions. Dashamoola, a Tridoshahara formulation, contributes to anti-inflammatory and analgesic effects. Guduchi exhibits Vedanasthapana and Vataghna properties due to its Snigdha and Ushna qualities, stimulates Dhatvagni through its Tikta Rasa, and nourishes the tissues via Madhura Vipaka [14]. Punarnava possesses Kapha-Vata Hara, Shothahara, and Rasayana properties owing to its Ushna Virya [15]. Ashwagandha, with its Madhura and Ushna attributes, pacifies Vata and exhibits Balya, Vedanasthapana, and Shothahara effects [16].

Anuvasana Basti with Sahachara Taila is absorbed and distributed throughout the body, reaching even subtle channels [17]. Sahachara Taila is specifically indicated for movement disorders due to its Gati Visheshatvam, Vatahara, Brimhana (nourishing), and Pachana properties, attributed to its Madhura and Tikta Rasa [18].

Probable Mode of Action of Agnikarma

Agnikarma employs the therapeutic properties of heat characterized by Ushna, Tikshna, Sukshma, and Ashukari Gunas, which counteract the Sheeta and obstructive qualities of aggravated Vata and Kapha Doshas. Controlled application of heat using a red-hot Shalaka produces Samyak Dagdha Vrana, through which therapeutic heat is transmitted to the Twak Dhatu. This heat acts by removing Srotavarodha, pacifying vitiated Vata and Kapha, and restoring doshic balance.

Additionally, Agnikarma enhances Rasa-Rakta Samvahana (local blood circulation), facilitating the removal of pain-producing metabolites from the affected site. The increased thermal stimulation augments Dhatvagni, promoting proper tissue metabolism, digestion of Ama Dosha, and nourishment of subsequent Dhatus. As a result, stability of Asthi and Majja Dhatus is improved, leading to symptomatic relief. The penetration of therapeutic heat into deeper tissues such as Mamsa Dhatu further neutralizes the Sheeta Guna of Vata and Kapha, thereby alleviating pain and stiffness.

Probable Mode of Action of Shamana Chikitsa

Simhanada Guggulu:

Simhanada Guggulu facilitates digestion of Ama through its Deepana-Pachana action and clears obstructed Srotas. It pacifies Vata and Kapha Doshas, thereby reducing pain, stiffness, and joint swelling. Guggulu is known to exhibit anti-inflammatory and anti-arthritic properties by modulating inflammatory mediators. The mild Virechana effect of Eranda Taila supports metabolic regulation and promotes Asthi-Sandhi health.

Amritarishta:
Amritarishta acts as a Deepana-Pachana formulation, enhancing digestive fire and facilitating Ama digestion, thereby reducing systemic inflammation. It pacifies Tridosha, particularly Pitta, and nourishes Rasa Dhatu, improving strength and immunity. Being a fermented preparation, it exhibits enhanced bioavailability and demonstrates antipyretic, anti-inflammatory, and immunomodulatory effects.

Agnitundi Vati:

Agnitundi Vati improves Jatharagni and Dhatvagni, promoting digestion at both gastrointestinal and cellular levels. It is particularly effective in conditions associated with Vata imbalance, such as Adhmana, Shula, and musculoskeletal pain [21].

Panchasakara Churna:

Panchasakara Churna acts as a Mridu Virechaka, facilitating gentle bowel evacuation by stimulating intestinal motility and softening stools. Its Ushna, Snigdha, and Sukshma properties pacify Apana Vata and relieve Vibandha (constipation), Adhmana, and Anaha. Additionally, it enhances digestive function and promotes proper Anulomana of Doshas, thereby supporting normal digestion and elimination.

RESULTS

Condition of patient improved gradually along with the course of treatment.

Assessement of Results:

SLRT TEST  (AT)

SLUMP TEST  (AT)                 

GAIT (AT) - Normal gait 

Conclusion

Osteoarthritis is a major cause of morbidity and often leads to significant limitations in an individual’s ability to perform daily activities. The present case study demonstrates that the combined application of Shodhana and Shamana Chikitsa was highly effective in the management of Sandhigata Vata. Notable improvements were observed in both subjective symptoms and objective clinical parameters, indicating substantial relief in disease manifestations and a marked enhancement in the patient’s quality of life. At present, the patient is able to carry out her routine daily activities without difficulty.

Although derived from a single case, these findings provide encouraging evidence and highlight Ayurvedic intervention as a promising and viable therapeutic option for the effective management of Sandhigata Vata.

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