Rheumatoid Arthritis (Part 1)

Rheumatoid Arthritis – An Ayurvedic Perspective

Ayurvedic Treatment for Rheumatoid Arthritis

If we talk about the entire world population, then 1% of this population is suffering from Rheumatoid Arthritis. Number of females falling victim to this disease is comparatively higher than that of males. It generally starts at the age of 40-50 years but nowadays, irrespective of age anybody can become a victim of this disease.

People generally believe that Rheumatoid Arthritis is an incurable disease, but if we become a little careful about our diet and our physical activity, then it is possible to cure this disease. Let’s have an in-depth discussion about this disease with our expert, Dr. Parmeshwar Arora.

Q. What is Rheumatoid Arthritis?

It is basically a form of Arthritis, which is a disease of joints. In Ayurveda, this disease is known as “aam-vaat”. It is combination of two words “aam” and “Vaat”. “Aam” refers to undigested food. This disease starts with formation of “aam” which actually results from sluggish digestion. If the digestion is sluggish or weak, the food that we eat does not get digested properly and the juice which is released after digestion which gives energy on being absorbed by the body, remain incompletely digested. This incompletely digested food is carried to the places of “kapha” (like heart etc.) by “vayu”. But due to its undigested form, it is not used or absorbed there, thus creating symptoms of virulence. Thus, the disease originates. Since, this disease involves joints and locations of “kapha”, it is considered as one of the forms of arthritis.

Q. If we talk about Rheumatoid Arthritis, there is pain in more than one joints. Why is it so and is it different from other joint pains?

Absolutely. If we try to compare it with other diseases involving joints where there is pain and swelling in joints, it is very different. As I mentioned earlier, this disease originates from sluggish digestion. The undigested juice is carried to different locations through “vaat” but instead of being absorbed, gets accumulated. Wherever there is an accumulation of this undigested juice, it gives rise to the Rheumatoid Arthritis. This is the reason that the patient of rheumatoid arthritis experiences pain in several joints unlike the patients of other forms of arthritis like osteoarthritis, gouty arthritis, septic arthritis, in which there are lesser number of joints involved.

Q. It is generally believed that rheumatoid arthritis mostly affects adults and there too, especially, women. Is it true?

Absolutely, if we talk about gender, it is comparatively more prevalent in women. Rather I would say that a ratio of 3:1 is observed which means there are three female patients against one male patient.

Q. What is the reason behind it?

Again I would say that rheumatoid arthritis originates from sluggish digestion. Comparatively women have more irregular food habits as compared to men. For certain reasons, they don’t eat food at right time. So, they are generally observed to have weak digestion. Due to this, the food that they eat does not get uniformly digested. The improperly digested juice thus released acts as a toxin. That’s why, in allopathy, we term this disease as an autoimmune disease. Rheumatoid arthritis is known as autoimmune disease because the undigested juice released in the body does not get consumed and acts as a toxin or as an antigen which initiates antibodies formation. The antibodies start destroying body’s own cells which is an autoimmune phenomenon.

Since such dietary irregularities are often seen in women, I think this is the only reason that more women fall prey to this disease as compared to men.

Q. As we know, there are many forms of arthritis. How do we differentiate rheumatoid arthritis from other forms of arthritis? How do we know that we are suffering from which specific type of arthritis?

When we observe the symptoms and diagnosis of rheumatoid arthritis, we can very easily differentiate it from other forms of arthritis. We have a set of criteria on the basis of which we decide that whether the patient has rheumatoid arthritis or not. The first criteria is – involvement of more than three joints. This is a kind of disease where more number of joints are involved. Secondly, this disease attacks smaller joints e.g. interphalangeal joints( on the fingers), wrist joints etc.. While other forms like osteoarthritis involves bigger and weight bearing joints (like knee joints), gouty arthritis starts with toe. Thirdly, there is bilaterally symmetrical presentation i.e. if one has pain in a finger joint of one hand, there will be pain in the same joint of other hand also. Fourth, there is formation of rheumatoid nodules on the joints which is not seen in any other form of arthritis. Fifth, the RA factor may be positive. RA factor is a serological test wherein the patient’s blood sample is tested for rheumatoid arthritis. RA factor is positive only in case of rheumatoid arthritis. Further sixth, if we talk about radiological findings, we find decalcification in joints, so, X-ray can also help in differentiating rheumatoid arthritis from other forms of arthritis. Seventh, morning stiffness is very common in rheumatoid arthritis. When patient gets up in the morning his stiffness continues for an hour. Out of these seven points which we call jones criteria, if we find a patient to be positive for any 3-4 points then we diagnose the case as a case of rheumatoid arthritis.

Apart from this, there are difference in symptoms as well. For example, a patient of rheumatoid arthritis will always have a feverish feeling, he will be weak, he will not feel hungry or thirsty, he will have many stomach problems, he will have acute difficulty in walking. So such symptoms are specific to rheumatoid arthritis and not seen in any other forms of arthritis. Thus, as compared to any other form of arthritis, rheumatoid arthritis is more lethal.

Q. If we talk about home remedies, what remedies do we have for rheumatoid arthritis?

If we look at the origin of rheumatoid arthritis, it starts due to sluggish digestive system which results in accumulation of unabsorbed undigested juice acting as a toxin. This juice is nothing but the food that we have consumed…the only problem is that it has not been properly digested . So our first intention is to somehow digest this undigested unabsorbed juice so that it can be consumed by the body and thus the condition toxicity can be settled, For this, we advise langan (a type of fasting) to our patients. See, generally we do not spare our agni. There are agni at different levels (like jatharagni in stomach, dhatvagni, bhootagni at cellular level). Though we have agni (a condition of disease) but still we continue eating and don’t spare agni in our body.

Like, if something wrong has entered our body we don’t give an opportunity to our body to digest it. Basically, langhan has an important role to play…rather I would say that 50% of the treatment is based on langhan. Patient is put on fasting so as to spare his metabolism in order to digest those things which are acting as toxin, in his body, secondly, we ask our patients to consume all those medicines which increase agni of his body (as the unabsorbed juice will be digested with the help of agni) e.g. Trikatu Choorna, which is a combination of dried ginger powder or “sonth”, black pepper and Balinese pepper or “peepli”. The increased agni digests the unabsorbed food in his body. Apart from this, we advise heat application or “swedan”. We specifically advise dry heat application to rheumatoid arthritis patients. We ask them to prepare a small bag of sand, heat it on hot surface of iron or skillet and apply it to his joints. We actually aim at providing warmth to the affected joints. When the joints receive heat, then the unabsorbed juice accumulated in them will get digested and consumed naturally by the body thus releasing the toxicity. So as I mentioned the patient is asked to practice langhan( fasting), teepan(increase agni or heat), and application of external heat.

Apart from this, “Panchkarma treatment” is quite effective for the patients of rheumatoid arthritis. In Panchkarma treatment we perform “virechan” which refers to medicated purgation therapy. During this, the patient is administered castor oil in good amount after teepan, paachan, for purgation (or inducing bowel movement). It is some sort of de-toxification procedure which removes toxins and cleans intestines. This results in opening of blocked pores through which enzymatic secretions take place. It helps in boosting digestion or strengthening agni. So, basically we aim at strengthening the digestive system of rheumatoid arthritis patients.

As far as home remedies are concerned, I would advise Trikatu churna (a mixture of Dried and powdered ginger + black pepper + Balinese pepper). Coming to Ayurvedic medicines, ”aamvatari ras” which is easily available at Ayurvedic medicine shops, can be taken – 2 tablets each in morning and evening. Apart from this, “sanjeevani vati” is found to be very effective in case of rheumatoid arthritis patients. A patient can take one to two tablets of the same in the morning. Besides, it is very important to pay attention to your bowel movement so that the intestines remain clean. For this, the patient should take 2 spoons of “ajmodadi churna” with warm water, at bedtime. Since rheumatoid arthritis may involve many deformities e.g. spider net deformity of palm, jet deformity of thumb etc., I would advise that a patient should personally meet an Ayurvedic doctor, so that his condition and severity of disease can be properly ascertained and depending on them he is prescribed correct set of medicines etc. We have many medicines in Ayurveda and the best part is that Ayurvedic science has a cure for this disease.

Otherwise, the patients of rheumatoid arthritis have to suffer a lot. While treating them, allopathic doctors prescribe steroids (as they have no other option). Antimalarial drug, hydroxyl chloroquine, anti cancerous drugs methotrexate are also used. These medicines are effective but then they have side-effects. Also, since rheumatoid arthritis is a chronic disease – so for how long these medicines can be given. Ultimately, the problems increase. So, it is better to control your diet and practice fasting, heat application etc. These practices relieve the problems and the patient can be permanently cured too.

Q. Doctor, in our discussion today, you have emphasized on fasting, a lot. Why is fasting so important?

To understand the importance of fasting in treating rheumatoid arthritis, we will have to go back to the origin of this disease. In normal life, we cook our food (using heat) so that we can consume it and our body can accept it. When we eat this food, there is another agni or fire inside our stomach, which is called jatharagni. This agni further processes this food so that it is converted to a form in which our body can absorb it and it can be used. Now, as you would have noticed that while cooking if the food does not receive proper heat, it is not uniformly cooked. Similarly, if the internal agni of stomach is not appropriate, then the food that we eat does not get digested uniformly and is still released in the blood (in the form of juice)for absorption by different body parts.

Though this juice is available for absorption, it is not absorbed (as it is not properly digested) and instead gets accumulated in different locations (of kapha) like heart, joints etc.. This acts as a toxin and body produces antibodies against them. Thus, a kind of autoimmune reaction is initiated which gives rise to the condition of rheumatoid arthritis. Fasting helps to spare agni. Agni at different levels is required for digestion at different levels, if the agni is appropriate, there is proper digestion and absorption of food. If there is any undigested food accumulated, our body would need extra agni to digest it. By fasting we are actually, sparing (or giving an opportunity to) the available agni for digesting the accumulated undigested food. Once this undigested juice is sorted, the autoimmune reactions will automatically terminate, as the condition of toxicity or antigenicity will no longer exist, which would mean that the patient would get relief and the disease will be treated.

Q. What is the right method of fasting. For how many days or for what period one should fast and what can be consumed during this period?

See, the initial fasting should be a bit more stricter. One has to be on liquid diet…he can take juices, hot water etc. Such a fast should be practiced for 3-5 days. After this, the patient can move to solid diet but he should consume only half the amount of what he is used to do e.g. if you are used to eating four breads for lunch, eat just two and for dinner if you eat two breads then skip bread and instead only eat vegetables. Besides, one should consume medicine like Trikatu churna which increases agni. Thus, on one hand we are increasing agni and on the other hand we are not providing the food which it would digest so ultimately, this agni would find the undigested juice and digest it. Thus, the patient would get rid of the disease.