We present the treatment In management of Amavata all the Acharyas (Ancient Physicians) have described the sequential employment of Langhana, Snehana, Swedana, Virechana, Basti and Shaman therapies.
1. Langhana (Light and easy to digest food): This is the first line of treatment. Using easy and light to digest foods such as vegetable or lentil soups added with Dipana (Appetizers) and Amapachana (Digestives) herbs and spices like ginger, pepper, etc to correct the functions of Agni (Digestive & Metabolic fire). Freshly prepared warm and easy to digest food in liquid or semisolid form is advised for a prescribed period of time.
2. Swedana (Fomentation): Dry fomentation using sand or salt is recommended. Upanaha (local medicinal application) can also be done to relieve pain.
3. Snehana (Internal and External Oleation): Suitable medicated ghee / oils are used for internal and external oleation.
4. Virechana (Purgatives): After oleation and fomentation, Purgation with suitable herbs yields best results.
5. Basti (Medicated enema): Various medicated enemas with suitable herbs are beneficial.
6. Shamana Chikitsa : Suitable Ayurvedic herbal formulations are administered. Ayurveda utilizes immunomodulatory and Rasayana herbs which help in correcting the Agni (Digestive and Metabolic fire), eliminating Ama (Amapachana) and pacifying Vata dosha for treating Amavata.
Advise on Diet and Lifestyle
1. Foods which are homemade, freshly prepared and warm, easily digestible, vegetable juices, vegetable and lentil soups, cooking with spices like cumin, coriander, ginger, asafetida, fennel and turmeric is beneficial.
2. Restriction of hot, spicy and fried foods, sweets, Vata aggravating (Wind forming) foods like cabbage, cauliflower, broccoli, lady’s finger and potatoes is necessary.
3. Excessive intake of tea, coffee, fast food, processed food, food additives, non vegetarian food, white sugar, chocolate and cocoa, refrigerated food and drinks, sour curd / yogurt, sour food items like tamarind should be avoided.
4. Excessive alcohol, smoking, sleeping during day time, staying up late in the night and mental tensions like worry, anxiety, fear, stress and grief etc., should be given up.
5. Regular physical exercise and every day gentle massage with oil should form an important part of life style.
6. One should avoid exposure to cold breeze and excessive wind.
7. Bathing with cold water should be avoided. Warm water bath is recommended.
8. It is also advisable to take a gentle walk after every meal.
9. Light exercise is beneficial. An analysis of a Rheumatoid Arthritis case at Chakrapani Ayurveda Center
Panchakarma Treatments :
Yoga Basti (Therapeutic medicated enema for 8 days), Virechana (Purgation) and Nasya (Nasal medication) were the main Panchakarma (Detoxification) therapies administered. Other treatment procedures like Marma Abhyanga (Therapeutic gentle body massage), Swedana (Steam bath), Dhanyamladhara, Katibasti, Greevabasti, Valuka swedana, Upanaha, Pinda swedana, Pizhichil were administered.
Yoga Basti Therapy – The patient was given 5 Anuvasana basti and 3 Niruha basti.
Virechana Therapy – The patient had Krura Koshta (Hard bowels) and Pravara Satva (Good mental tolerance).
She was administered 6 days of Snehapana (Drinking of medicated ghee) in increasing doses followed by Virechana (Purgation). On administration of Virechana, she had 35 bowel movements and suitable Samsarjana karma (Post Panchakarma diet) was given.
Diet and lifestyle during Panchakarma: The patient was placed on a bland diet, lentil soup and cooked vegetables. Rest and proper sleep were advised.
Internal Medicines: Shallaki capsule, Sunthi guggulu, Sinhanada guggulu and customized herbal compound powder consisting of Guduchi, Gokshura, Ashwagandha, Pippalimool, Shatavari and Godanti were given.
At the end of Panchakarma the patient’s condition began to improve, her swelling and pain was reduced and the flexibility of joints improved. Favorable results were obtained with the help of Panchakarma and with her positive attitude and compliance with the treatment program. On discharge, the patient was counseled and advised on the need to follow the healthy and suitable diet and lifestyle. She was made to understand that a return to former habits or excessive levels of stress is likely to cause a resumption of disease activity and need to be disciplined in taking proper care of herself on an ongoing basis. Her health condition was reviewed at periodic intervals.