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- Pain on multiple joints.
- Pain on upper and lower back regions.
- Numbness on both fingers
- Generalised swelling on whole body.
Brief Relevant Medical History:
A female patient, aged 45 yrs,not a known DM/HTN came to AyurVAID with the above complaints. Pain on larger joints especially both knee joints,shoulder joint ,neck joint and low back region started one year before. Pain was of aching type. Numbness on the fingers of both hands and generalised swelling on whole body is noted since few months. Pain aggrevated during activities and relieved by rest. Morning stiffness is absent.
History of past illness:
H/O of Rheumatic fever.
30 yrs before she had the history of rheumatic fever and was under medication(injection) for 10 years and got completely reduced. Pain on larger joints started 6yrs before and the pain was very mild at that time. Pain aggrevated since one year and came here for treatment.
Aggravating factor- Cold,activities.
Relieving factors: Rest and hot application.
Current medication: Nothing.
|Rogi Bala - Madhyama|
|Roga Bala- Pravaram|
|Nidana Panchaka |
MRI of Lumbar Spine:
Observation: Mild scoliosis of lumbar vertebra is noted towards left. Anterior osteophytes are noted at multiple vertebral bodies. IV disc space appear minimally reduced at LV5-SV1 level.
MRI Cervical Spine
Observation: Anterior osteophytes noted at multiple level. IV disc space reduced between CV5 - CV6 vertebra.
" Dehe srothamsi riktani poorayitwa
(Madhava nidana 22)
Vatavardhaka ahara vihara
Vitiated vata lodges in Sandhi's (larger joints)
leads to sopha,shoola,spandata.
Differential Diagnosis with reasoning
The patient was provisionally diagnosed with Osteoarthritis with differntial diagnosis of Rheumatoid arthritis and Gouty arthritis.
Differential Diagnosis with reasoning
1. Ama vata-
2. Vata rakta-
3. Sandhigata vata-
|Evidence Based Diagnosis with References
Reports led to the diagnosis of Lumbar spondylosis with Cervical spondylosis.
Evidence Based Diagnosis with References
"Vatapoorna druthisparso sopho sandhigato anile
prasaranakunchnayorapravarthi sa vedana"
"Sareeram mandaruksopham sushyathi
spandathe api va
supthastadyo mahathvo va siravate siragate
prasaranakunchanayorapravatha sa vedana"
|Details of Allopathy medicine if continued
Samanya vatha vyadhi chikithsa:
Payase krisare samla lavane sa anuvasanehi
Vatakhne tarpaneschanne susnigdham swedayeth tatah
swabyaktam snehsamyukthesamkaradyaha punah
(Ashtangahridaya vata vyadhi chikitsa 21/1)
“Vasthi vatha haranam”
Objective of treatment:
Our goal was to reduce Pain, swelling and to increase the mobility of joints.
Line of Treatment:
1.To reduce pain and swelling - Danyamladhara,Choorna pinda sweda and lepam.
2. Alleviate vata with matra vasti and madhuthailika vasti
3.To improve the circulation and to increase the mobility of joints - Kayaseka.
Type – OPT
Duration – 15 days.
Chikitsa Paddhati with details of dose of medicine.
Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in joints. Risk factors for osteoarthritis are being over weight, getting older and injuring a joint. So the affected joints should be prevented from injuries, trauma and physical stress.Exercise can strengthen the muscles around the joint and making the joints more stable.
Standardised Outcome Scales Used
|Before treatment||Post treatment|
Patient’s Outcome Scale:
Poor(1); Fair(2); Good(3); Very Good(4); Excellent(5).
|1||Pain on low back||20||1||4||5|
|2||Swelling on whole body||20||1||4||5|
|3||Pain on neck joint||20||1||3||5|
|4||Pain on both shoulders||20||1||4||5|
|5||Pain on both knee joint||10||1||3||5|
After the course of treatment vitiation of vata and kapha is reduced.Pain and swelling on upper low back region is significantly reduced. Pain and swelling on back of neck is reduced. Pain on both shoulders is significantly reduced. Pain on both knee and ankle is reduced. Pain on left calf region is not fully reduced. She is advised to follow up after two weeks and continue oral medicines for these two weeks.
Disclaimer: * Outcomes may vary from person to person