Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma

Abstract

<i>Amavata</i> is a disease in which vitiation of <i>Vata Dosha</i> and accumulation of <i>Ama</i> take place in joint(s), and it simulates rheumatoid arthritis (RA) at modern parlance. <i>Shamana</i> (conservative) and <i>Shodhana</i> (biological purification of the body) treatments are advised in Ayurveda whereas anti-inflammatory, analgesics, steroids, and disease-modifying antirheumatic drugs are required for its management as per modern medicine, which are not free from side effects. A female was suffering from multiple joints pain with swelling, severe morning stiffness, restricted movements, malaise, and <i>Mandagni</i> (poor appetite) for the past 1½ year, which was classified as <i>Amavata</i>/RA (having 7/10 score as per the RA classification criteria, 2010). After <i>Deepana</i>-<i>Pachana</i> and <i>Snehapana</i>, <i>Virechanakarma</i> was done by the administration of <i>Trivrita Avaleha</i> and castor oil. The assessment was made on the basis of relief in signs and symptoms and serological findings of RA factor, C-reactive protein (CRP), immunoglobulin E (IgE), and erythrocyte sedimentation rate. After <i>Virechanakarma</i>, RA factor reduced from 94.0 IU/ml to 50.0 IU/ml, CRP reduced from 22.7 mg/L to 1.8 mg/L, and IgE was reduced from 680 kU/L to 53.7 kU/L, with remarkable reduction in joints pain and swelling. Further, by avoiding specific <i>Nidanas</i>, i.e., known allergens for food, drugs, and inhalants, the patient has relief in almost all signs and symptoms for the past 1 year of follow-up with least medications. This single case report highlights that <i>Amavata</i>/RA can be managed with appropriate diet regimen, <i>Virechanakarma</i> and can be managed effectively with minimum requirement of medicines.