A pre and post test clinical study on the efficacy of a multi modal intervention based on yogaratnakara treatment protocol in knee joint osteoarthritis

Osteoarthritis is the most common joint disease of humans. Among elderly,knee joint OA is the leading cause of chronic disability in developedcountries. Radiographic evidence of knee OA,is more common in womenthan in men1. Osteoarthritis has symptoms like Pain, Functional restriction,Joint line tenderness, Muscle wasting, mild synovitis(warmth andeffusion) and Morning stiffness2. The risk factors for OA includes old age, female sex, race, geneticfactors, major joint trauma, repetitive stress, obesity,congenital/developmental defects, prior inflammatory joint diseaseand metabolic/endocrine disorders 3.Prevalence of OA in India is reported to be in therange of 17 to 60.6% 4 . Dueto the increased prevalence of this disorder it has become a majorproblem and burden over the society, indirectly reduces the workingcapacity of a citizen.

Now-a-days, even in theadult age itself man is suffering from the degenerative changesbecause of the changing lifestyle and food habits. The symptoms of OAis identical to the Sandhigata vata which is of degenerative andchronic rheumatic disease in nature explained by Ayurveda. Thisdisease is known for pain & swelling in the joints giving riseto the restricted movements and disability that hampers the normalmobility which is one of the cardinal function of Vata dosha. Thedisease exhibits end of variety of patterns of joint failure togetheror lesser extent which is always characterized by degeneration ofarticular cartilage. It affects women than men, mainly aftermenopause, due to the hormonal variations.

Sandhigata vata is a typeof vata vyadhi described in all classics of Ayurveda. Charaka wasfirst to describe separately “Sandhigate-anilae†where Susrutha ,Yogaratnakara, Madhava & Bhavaprakasha has described the disease as “Sandhigatavata†. The provoked Vata affects the Sandhi ,which resembles a bag filled with air. Vata purna dritisparsha,Sotha,Vedana on prasarana and Akunchana are told to be thesymptoms by charaka5. Being the disease of madhyama roga marga[since sandhi comes under madhyama roga marga]6 and since it is a dhatukshaya janya vyadhi 7 ,the disease becomes kashtasadhya.

Themedical management now available have many limitations and cannotsatisfy the objectives of an ideal therapy. Many research studieshave been done but most of them havemethodological limitations,and are experimental, focusing on single herbs/ formulations, orsingle therapies. Full line of treatment protocol are not yet donebut which is a necessity to found out , since vata is bali andashukari, single drug or single kriya krama will be insufficient . At present era, since this degenerative disease is more prevalent,which is a cause leading to disability, there is an urgent need foran effective , safe and less complicated treatment.