Osteoarthritis is the degenerative Joint disease involving the weight bearing joints. Usually occurs after 40 years of age.

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SAMANYA LAKSHANA-

1. Heaviness & inflammation in the joints,

2. Pain during movments of joints,

3. Crepitation during movment of joints(kut-kut sound),

4. Gubbara me pani bharne jaisi awaj aati h.

5. Deformity in the joints.

Clincial Features

- joint pain

- Swelling

- Stiffness

- Sounds while walking

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NIDANA-

- Obesity

- Excess and improper use of joints

- Poor nutrition Improper posture

- Wearing unwholesome footwear

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Essentials of Diagnosis

- Joint pain exacerbates by activity and relieved with rest.

- Stiffness that is self-Iimited upon awakening in the morning or when rising from a seated position after an extended period of inactivity.

- Examinuion notable for increased bony prominence at the joint margins, crcpitus or a grating sensation upon joint manipulation, and tenderness over the joint line of the symptomatic joint.

- Diagnosis supported by radiographic features of joint space narrowing and spur (or osteophyte) formation.

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SAMPRAPTI

Nidana-> vata dosa prakopa-> sandhi me sanchaya-> sandhi, snayu, kandara vikruti-> sandhigata vata

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SAMPRAPTI GHATAKA-

DOSA- vata

DUSHYA- rasa, rakta,asthi

ADHISTHAN- asthi sandhi

SHAROTAS- asthivaha & majjavaha

SHROTO DUSTI PRAKAR- sanga, granthi, vimargaman

AGNI- vishmagni

VYADHI SVABHAV- chirkari

SADHYA-ASADHYATA-yapya/kricchasadhya

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PRICIPAL OF CHIKITSA

- Daha karma

- Snehan

- Upnaha

- Principles of Treatment

- General lines of treatment would be Snehana (olcation), Svedana (fomentation), Mridu Samshodhana (mild bio-purification), Basti (enema) and Vatahara Aushadha (Vata pacifying medicines). Regulation of Ahara and Vihara may also be applicable in Sandhigata Vata.

- As a specific Principles of Treatment, Acharya Sushruta (Su. Chi. 4/8) and Acharya Vagbhata (A.S. Chi. 23/13, A.H. Chi. 21/19 and 22) have described Snehana, Upanaha (poultice), Agnikarma (cautary), Bandhana (bandaging), Mardana(massage) and Svcdana for the treatment of SandhigataVata.

- Svedana (Fomentation)

- Patra Pinda Sveda is done in case of stiffness, pain and swelling.

- Shashtika Shali Pinda Sveda is prescribed in case of pain, periarticular muscle waxing, periarticular muscle weakness and degenerative changes in cartilage.

- Bandhana (Bandage)

- Bandhana is bandaging tightly with leaves of Vata Shamaka drugs on affected joint. This bandaging does not leave any scope For Vata to inflate the Sandhi.

SANSHAMAN CHIKTSA PATRA

1. KAVATHA/KADA-4TSP+4CUP WATER-BOIL-> 1CUP EMPTY STOMACH BOTH TIME)

A. Ashvagandha 100gm + sunthi 50gm + pippali curna 25mg + gokshra 50gm + haritaki 50gm

2. Suddha shilajatu-500mg ( 2times with 1 cup milk)

3. Kshaya janya(osteoporosis)-shit virya rasa

(RASA AUSHADHI-2-3TIMES WITH MADHU CHATAN)

Yugendra rasa-60mg + Giloy-250mg + Mukta praval panchamrit-60mg + Jilajatyadi loha-250mg

4. (ASAV/ARISTA-20ML WITH 20ML WATER)

A. Balarista

B. Ashvagandharista

C. Draksharista

5. (VATI-2VATI BID WITH USHNA JALA)

A. Mahayograja gugglu

B. Vatari gugglu

(vata roga me protin ka sevan na kare)

ADARSH CHIKITSA PATRA

1. triyodasanga gugglu-500mg + rasnadi gugglu-500mg (3 times with ushnodaka)

2. Panchkol curna-2gm + Vatavidhvansak rasa-125mg + Praval pisti-250mg (2 times with madhu)

3. Dasamularista -20ml (2 times with 20ml jala)

4. Haritaki curna-3gm ( before sleep with ushna jala )

NORMAL BMI PATIENT

1. Kokilaksha Guggulu-2tab ( Adhobhakta 2 times with

(anupana-Guduchi ghrita) Guduchi Ghrita-10ml)

2. Ashwagandha churna-2gm + Chopachini churna-1gm + Pippalimula churna-1/2gm + Gokshura churna-1gm + Guduchi churna-1gm ( Adhobhakta 3 times with Milk)

3. Dhanvantaram taila101-10drops (Shamana sneha kala 2 times with 1 cup warm milk )

OBESE PATENT

1. Punarnavadi Guggulu-2tab ( Pragbhakta 3 times with Hot water)

2. Amalaki churna-1gm + Chopachini churna-1gm + Pippalimula churna-1/2gm + Gokshura churna-1gm + Shilajatu-250mg + Guduchi churna-1gm (Adhobhakta 3 times with Triphala kashya 20ml + 1tsf

madhu)

3. Cap. Seacod- 2cap (Adhobhakta 2 times with water )

PATHYA-APATHYA

PRANAYAMA

- Halasana

- Sarvangasana

- Vajrasana***

- Bhdrasana

- Ardhamatasyasana

- gomukhasana

(which is favourable)

DIET AND LIFESTYLE

Pathya(DO):

Ghrita, taila, vasa, tila, wheat, masa, Sali rice, sathi rice, kulatha, sura, parval, sahijana, baingan,lehsuna, anar, pakva aam, nimbu, ber, draksha, madhuk, goksura, dugdha, nariyal jala, gomutra, kanji, imli, anupa & jangam mamsa.

Jala krida, sanvahana, bhumi sayan, daha karma, brihmana karma, dhupa vata nasak karma.

Apathya(DON’T):

Chana, matar, kodo, arhar,dhanya, munga, jamun, supari, karela, patra saka,, kshariya pradartha,,tikshna, dushit jala.

Chinta, ratri jagaran, vega dharana, shram, ansan, stri sangam, hathi-ghoda savari, ek sthana rukna.

1. Daha-agni karma

2. Snehan-(janu basti & janu dhara)

- 11 day janu basti then 11 day janu dhara 40-45 minutes

- Brahman taila prayoga

Ex-A. Muruvanna taila

B. Prasarani taila

C. Sahacharadi taila

D. Dasamuladi taila

E. Bala taila

F. Ashvagandha bala taila

G. Mahamamsa

(janu basti & dhara followed by patrapinda sveda-

Eranda patra + nirgundi + parijata + adusha-10-15min)

3. Upanaha-

Dasamula k dravya + kanji + sneha = upanaha (rat bhar lagakar patt aise bandhe ki hava ati jati rahe)

A. (ABSENCE OF VIBANDHA)

a. Anuvasan-

sahachar taila/dasamula taila-30-60ml + 1gm saindhav + 2gm satpushpa curna (11 day)

B. (PRASENT OF VIBANDHA)

a. Anuvasana- Prasarani taila 30-60ml

b. Niruha basti-

Triphala kvatha-300-400ml + Murchit tila taila-50ml + Gomutra-50ml + Saindhava-5gm-> basti

(Kaal basti (8)

c. After kaal basti

Anuvasan-

sahachar taila/dasamula taila-30-60ml + 1gm saindhav + 2gm satpushpa curna (11 day)

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Vatagajankush rasa-(vatsanabh,mundi,ras sindura

- Mahavata gajankush rasa-(abhrak,vatsanabh)

- Chintamani rasa-(svarn,abhrak,ghrita kumari)

- Vatachintamani rasa-(svarn,praval,mukta,kumari)

- Chaturmukha rasa-(svarn,kumari)

- Yogendra rasa-(svarn,mukta,kumari)

- Vatari rasa-(guggul,triphala)

- Sarvang sunder rasa-(abrak,gandhak,kapilu)

- Vatavidhvansan rasa-(erand,abhrak)

- Trelokyachintamani rasa-(hirak,svarn,kumari)

- Rasraj rasa-(svarn,parad,gandhak,kumari)

- Akangvir rasa-(kapilu)

- Navratnaraj mrigank rasa-(svarn,hirak,pusparag)

- Svarn bhasma

- Abhrak bhasma

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Ashvagandha curna

- Nagradhya curna-(sunthi,kapilu)

- Panchkol curna-(pippali,pippalimula,chavya)

- Narsingh curna-(bhallataka)

- Shaddharan curna-(chitrak,indrayava,patha)

KAVATH/ASAV/ARISHTA-(20-40ML WITH SAMABHAG WATER)

- Maharasnadi kvatha

- Rasnasaptak kvatha-(rasna,erand)

- Rasana dashmula kvatha-(rasna,brihatidvya,sonapatha)

- Masabaladi kvatha-(udad,bala)

- Rasanadi kvatha

- Gokshuradi kvatha-(gokshura,eranda)

GHRITA(20-30ML WITH USHNODAKA)

- Dashamuladi ghrita-(dashmula,ghrita,pushker mula,karcura,tulasi,trikatu)

- Ashvagandha ghrita

- Nakuladhya ghrita-(nevla mamsa,dasamula)

- Changaladhya ghrita-(aja mamsa,brihat panchmula)

- Hansadya ghrita-(hansamamsa,saindhav,eranda)

- Chitrakadhya ghrita-(chitrak,sunthi,rasna)

- Majja sneha-mamsa sneha,dasamula)

- Chatusneha –(triphala,kulatha,sahijana)

TAILA

(ABHYANTAR PRAYOGARTH TAILA(10-20ML WITH DUGDHA,USHNODAKA)

- Rason taila-(rason,tila)

- Mulakadhya taila-(muli svaras,tila taila,bala)

- Bala taila-(bala,dasamula,kulatha)

- Ashvagandha taila-(ashvagandha,kesar,mulethi,sariva)

(ABHYANTER & BAHYA PRAYONARTHA TAILA)

- Narayan Taila-(Bilva,Sayonak,Bala,Ashvagandha)

- Prasarni taila-(gandhaprasarni,chitrak,pippalimula)

- Nakul taila-(yastimadhu,jeerak,dasamula)

- Masa taila-(masa,atish,yava,gokshura)

- Mahamasa taila-(masa,dasamula,ajamamsa)

- Amritadhya taila-(guduchi,tila taila)

(BAHYA PRAYOGARTHA TAILA)

- Vishgarbha taila-9dhatur,kusta,vacha,marich)

- Mahavishgarbha taila-(dhatur,nirgundi,katutumbi)

GUGGALU PRAYOGA-(500 MG-1GM WITH MADHU/JALA)

- Yograj gugglu-(chitak,pippali,gugglu)

- Mahayograj gugglu-(trikatu,triphala,erand,gugglu)

- Kesor gugglu-(triphala,guduchi)

- Singhnada gugglu-(gugglu,tripahal,sarsapa taila)

- Panchmrit loha gugglu-(triphala,gugglu,gandhak)

- Amrita gugglu-(guduchi,triphala,punarnava)

- Satavari gugglu-(satavari, gugglu)

- Lakshadi gugglu-(laksha,gugglu)

ASHAV/ARISTA(10-20ML WITH JALA)

- Dasamularista-9dasamula,puskermula,chitrak)

- Balarista-(bala)

- Ashvagandharista-(ashvagandha,musali,rasna)

- Drakshasava-(draksha,dhataki,nirgundi0

RASAYAN YOGA-(10-15GM WITHDUGDHA/JALA)

- Chayvanprash-(dasamula,amlaki)

- Brahma rasayana-(amlaki,haritaki,dasamula)

- Shilajatu(500mg bid)

- Shivagutika-(haritaki)

KASTA AUSHADHI-

- Nirgundi, bala, gugglu, sunthi, lasuna, bhallataka, hingu, sahijana, rasana, dasamula, ashvagandha, eranda, masa, ghrita, vasa, majja, shilajatu, brahmi, jatamansi, vacha, pippali, konch, satavari, prasarni, devdaru, vidara, kapilu, vidarikand, vatsanabh, dhatura.