A Case Report Depicting the Role of Ayurvedic Interventions in the Management of Amavata ~Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease of the synovial joints. Despite the advances in disease-modifying anti-rheumatic drugs, its long-term management remains challenging. The condition causes severe joint pain, stiffness and progressive disability, limiting a patient’s mobility and independence. Because the aetiology is complex and multifactorial, effective care necessitates a comprehensive, multimodal treatment plan. In Ayurveda, the clinical picture is more similar to Amavata (~rheumatoid arthritis), which is characterised by Sandhi Shoola (~joint pain) and Sandhi Shotha (~joint swelling) along with Stabdhta (~morning stiffness). Findings:A 64-year-old lady presented with a 10-year history of generalized stiffness in multiple joints in a symmetrical pattern of involvement in various small joints with deformities, and investigations showing positive RA factor. She was diagnosed with rheumatoid arthritis and was successfully managed with Ayurveda. Intervention:Shamana Chikitsa (~Pacification therapy) as per the Avastha (~clinical presentation) of the patient for 11 months, along with Panchkarma Therapies. Results: The patient exhibited significant improvement in subjective parameters, particularly Sandhi Shoola (~joint pain), joint swelling, morning stiffness, tenderness and fatigue. Functional status improved with increased ability to walk, joint mobility, grip strength and perform routine daily activities. The clinical diagnosis was confirmed by the evaluation with ACR criteria, including tender-joint evaluation and functional assessment. No further progression of joint deformities was seen. Follow-up showed a favorable declining trend of rheumatoid factor. Conclusion:Combined Shodhana Chikitsa (~purificatory therapy) and Shamana Chikitsa(~palliative therapy) were found effective in providing relief in Amavata (~rheumatoid arthritis), especially in joint pain and functional disability. The therapy was well tolerated, and no adverse drug reactions were reported. The intervention was associated with improvement in joint pain and functional status without clinical evidence of worsening disease severity, joint deformities or functional disability during treatment and follow-up.