Patient consulted Jiva doctor regarding her persistent joint problem. For a few years, she had been suffering from pain in both knees and lower back area. There was swelling and stiffness in her knees along with crepitus sound. Pain in lower back area was localized as she did not feel it is radiating anywhere in her body. Because of irritating joint pain, she found it difficult to move when she woke up in the morning. Also sitting on floor was difficult for her. On consulting orthopedic doctor, three-four years ago she was advised not to sit in squat posture so patient, in general, uses chair for all purposed to lessen unwanted stress on her joints.Patient reported that in the beginning, multiple joints such as her wrist, ankle and elbow were involved but at time of consultation her right knee felt more painful compared to left knee, shoulder, lower back and ankle. She also consulted physiotherapist, but she hardly followed the suggestions. She was also overweight.Specific History (H/O Present Illness)Problem started about five years ago.Physical/ Systemic FindingsBM – normal – regular, Appetite – normal, Urine – normal, Gas – No, Acidity – no, Sleep – normal, sweating – less, Mind – normal.H/O Past illness/ Family HistoryNo history of hypertension, diabetes or thyroid problem.Medical HistoryShe was advised allopathic treatment and physiotherapy for joint problem but that did not help in solving her health issues so at the time of consultation patient had stopped taking all forms of medication. Patient had a gallbladder operation three years ago.
Samprapti Ghataka
Dosha: Vata pradhan kapha dosha Dushya: Ras, meda, asthi dhatu
Srotas: Ras vaha, asthi vaha
Adhishthan: Sandhi
Nidana: Vata increasing diet that contains dry, light, cold items, over thinking, fasting, ignoring natural urges, progressive physical deterioration, overweight etc.
Chikitsa Sutra
• Nidana parivarjan – Avoid things in diet and routine that accelerates progression of disease
• Shaman Chikitsa – Vata-kapha shaman, srotoshodhan, vedna shaman, rasayan
• Shodhan Chikitsa – Some effective and easy to implement methods are discussed to practice at home
• Sattvavjay Chikitsa – Patient education, expectation management and approach of treatment is shared
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Churna Sandhidosha |
Tablets Sandhirog |
Products Maharasnadi |
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Peedantak |
Kamdudha |
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Amlapittantak |
Chandraprakash |
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Rasna |
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Ashwagandha |
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Specific Advice:
Pathya: Patient was advised to consume multigrain diet as per season, increase water consumption, mixture of methi dana, ajvain and saindha namak, dhaniya soaked water helps in relieving burning sensation in the body, gentle massage with lukewarm oil followed by baluka potli fomentation, yoga, physical exercises etc were recommended according to patient’s physical strength. She was also advised to include more of naturally calcium-rich dietary sources.
Apathya: Patient was advised to avoid heavy work, abnormal postures, gas forming foods, cooling potency things, curd, rice, pickles, citrus fruits, chilled water, frozen items, non-veg foods etc.
Modifications/Changes made in prescription during course, Below changed medicines were given as per patient’s feedback:
In Jan 2016
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Churna Sandhidosha |
Tablets Sandhirog |
Products Maharasnadi |
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Peedantak |
Vata |
Shilajeet |
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Amlapittantak |
Gaisantak |
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Rasna |
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Dasavtar |
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In March 2016: All medicines were kept same except, in tablet combination, Gaisantak vati was replaced with Soot shekhar ras.
In April 2016: In powder, Godanti bhasma was given instead of Dashavtar churna and in tablets, Leela vilas ras was changed to Soot shekhar ras. In products, Slim tea was introduced.
In June 2016: In powder, Ushiradi churna was given instead of Godanti bhasma and Dashmool kwath was added in products, rest of medicines were kept same.
In Aug 2016: In powder combination, Godanti bhasma was replaced with amlapittantak rasayan. In products, Ojas capsule was added while all previous medicines were continued without change.
Onwards August 2016 till January, 2017 no change was done in medicine combinations.
Outcome
Patient approached JMRC doctor hoping for relief in the problems that were causing severe inconvenience in her daily activities. Her condition was progressively deteriorating even after conventional treatment.
After following regular medicines and suggested regimen, patient reported very good recovery in all of her complaints. Her complications like pain, swelling gradually decreased which strengthened her joints and helped in making her movement unrestricted and natural. Morning stiffness and complications induced by cold season also became less compared to when patient first consulted Jiva Ayurveda. Based on patient’s recovery, she was advised to taper her medicine dosage.
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