Ayurvedic Treatment for Reactive Arthritis

Ayurvedic Treatment for Reactive Arthritis

Ayurvedic Treatment for Reactive Arthritis focuses on eliminating the root cause of the disease and repair the damaged joints by providing enough nourishment. Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body, most often intestines, genitals or urinary tract. Reactive arthritis usually targets the knees, ankles and the joints of the feet. Inflammation also can affect the eyes, skin and urethra.

The infection usually occurs days to weeks before the onset of joint pain. In some cases, a preceding infection may only be identified with laboratory testing. In earlier times, reactive arthritis was known as Reiter’s syndrome, manifested as inflammatory conditions of the eye, urethra and joints.

Signs and symptoms of Reactive Arthritis

  • Pain and stiffness in joints, especially knees, ankles and feet
  • Eye inflammation like conjunctivitis
  • Urinary problems like increased frequency and discomfort during urination
  • Inflammation of soft tissues like muscles, tendons and ligaments
  • Swollen toes or fingers
  • Skin problems including a rash on the soles and palms and mouth sores
  • Low back pain

Causes of Reactive Arthritis

Infection by certain bacteria, mainly present in either genital (Chlamydia trachomatis) or bowel (Campylobacter, Salmonella, Shigella and Yersinia).

Pathophysiology of Reactive Arthritis

The bacteria induce (cause) arthritis by distorting the body’s defence against infections, as well as the individual’s genetic environment

Reactive arthritis is a group of disorders based on immunity triggered by a recent infection. Suggested theories say that the T lymphocytes are induced by bacterial fragments like lipopolysaccharide and nucleic acids. It happens when bacteria invaded reach the systemic circulation. Such activated cytotoxic-T cells then attack the synovium and other self-antigens by molecular mimicry. Cytokine response against bacteria is also impaired in reactive arthritis, resulting in the decreased elimination of the bacteria. It is not known why such localization of inflammation occurs.

The prevalence of HLA-B27 is estimated at 30% to 50% in reactive arthritis patients.  The presence of HLA-B27 is thought to alter the self-tolerance of the host immune system, increased TNF-alpha production, promoting the invasion of microbes in the gut, and delayed the clearance of causative organisms.

Diagnosis of Reactive Arthritis

Diagnosis is largely based on the analysis of symptoms and inflammatory conditions

Blood tests are done for any infection and all types of arthritic conditions.

Test for Chlamydia infection

Test for the HLA-B27

Treatments of Reactive Arthritis

Treatment for the infection consists mainly of antibiotics. Other medications used to treat reactive arthritis include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Corticosteroids
  • Topical steroids
  • Rheumatoid arthritis medications such as sulfasalazine (Azulfidine), methotrexate (Trexall) or etanercept (Enbrel)

Physical therapy is found beneficial in the management of reactive arthritis to improve the flexibility of joints & to reduce stiffness.

Prognosis of Reactive Arthritis

Follows a typically self-limited course, with the resolution of symptoms by 3-12 months.

Complications of Reactive Arthritis

  • Recurrent arthritis (15-50%)
  • Chronic arthritis or sacroiliitis (15-30%)
  • Ankylosing spondylitis (30-50% of HLA-B27–positive patients)
  • Urethral stricture
  • Aortic root necrosis
  • Secondary glaucoma
  • Grauer Star
  • Cystoid macular oedema
  • Posterior and anterior synechiae
  • Cyclitic membrane
  • Vitreous opacification
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Sacroiliitis
  • Erythroderma (rare)

Ayurvedic Concept of Reactive Arthritis

Considering the clinical features & presentation, the disease reactive arthritis can be compared with Amavata described in Ayurveda classic texts.

Ayurvedic Nidana of Reactive Arthritis

  • An incompetent and unwholesome diet with opposite potency
  • Improper body postures & movements
  • Loss of appetite & digestive power
  • Exercise immediately after highly unctuous & oily food
  • Sesshafter Lebensstil

Ayurvedic Purvaaroopa of Reactive Arthritis

Dourballya      – Tiredness/Fatigue

Hrudayasya gauravam – Heaviness of chest

Ayurvedic Samprapti of Reactive Arthritis

The ama produced due to defective digestion & sedentary lifestyle gets lodged in the site of sleshma (Kapha) like joints with the help of Vaata and produce symptoms of Aamavaata.

Ayurvedic Lakshana of Reactive Arthritis

  • Angamarda     – body ache
  • Aruchi – Loss of taste sensation
  • Thrishna          – Excessive thirst
  • Alasyam          – Lethargy/laziness
  • Gauravam       – Heaviness of the body
  • Jwara               – Fever
  • Apaaka            – Indigestion
  • Soonata           – Oedema

Ayurvedic Divisions of Reactive Arthritis

It can develop by the vitiation of Vaata, Pitta, Kapha individually (ekadoshaja), or any two of them together(dwidoshaja) or all the three doshas vitiated together(tridoshaja).

Ayurvedic Prognosis of Reactive Arthritis

  • Saadhya          – only one dosha vitiated
  • Yaapya            – two doshas involved
  • Asadhya          – All doshas involved & the disease is affected all over the body.

Ayurvedic Treatment (Chikitsa) of Reactive Arthritis

Ayurveda treatment for Aamavaata is completely different from other joint diseases. Use of any snehadravya like oils/ghee will aggravate all the symptoms of this disease. So, only langhana(weight-reducing therapy like fasting)and Rookshana(drying up therapies with medicines & treatment procedures) are recommended.

Samana

  • Lepana with rookshadravyas like kolakulathadi choorna
  • Parisheka with soolaharakwatha        like dasmoolakwatha
  • Aamapachanam with shaddharanam choornam etc
  • Agnideepanam with gandharvahastadi kwatham etc
  • Vyadhivipareeta chikithsa

Sodhana

  • Langhana
  • Swedana
  • Virechana
  • Snehapanam
  • Vasti especially kshaaravasti

Commonly used Ayurvedic medicines for Reactive Arthritis

Verfügbare Marken

  • Vaidyaratnam Oushadhasala
  • AVS Kottakal
  • AVP Coimbatore
  • Dabur Indien
  • Dhootapapeshwar Ltd
  • SKM Pharmaceuticals
  • Sidheswarar Pharmaceuticals
  • SNA oushadhasala

Hausmittel for Reactive Arthritis

No home remedies are proven to cure reactive arthritis. But a healthy diet and lifestyle will be helpful to improve the quality of life.

Diät for Reactive Arthritis

  • Zu vermeiden sind

Schwere Mahlzeiten und schwer verdauliche Lebensmittel - verursachen Verdauungsstörungen.

Junk Food - stört die Verdauung und verringert die Bioverfügbarkeit des Medikaments

Kohlensäurehaltige Getränke - erhöhen den Säuregehalt des Magens und stören die Verdauung

Gekühlte und gefrorene Lebensmittel - verursachen eine schwache und träge Verdauung durch Schwächung von Agni (Verdauungsfeuer)

Milk and milk products – increase kapha and cause respiratory problems

Quark - verursacht Vidaaha und damit viele andere Krankheiten

  • Noch zu ergänzen

Leichte Mahlzeiten und leicht verdauliche Lebensmittel

Green gram, soups, honey

Frisch gekochte und warme Speisen, verarbeitet mit Kreuzkümmel, Ingwer, schwarzem Pfeffer, Ajwain usw.

Verhaltensweisen:

  • Protect yourself from the cold climate.
  • Vermeiden Sie übermäßige Sonneneinstrahlung, Wind, Regen oder Staub.
  • Halten Sie einen regelmäßigen Essens- und Schlafplan ein.
  • Vermeiden Sie es, Triebe wie Urin, Stuhlgang, Husten, Niesen usw. zurückzuhalten oder zu erzwingen.
  • Avoid a sedentary lifestyle.

Yoga for Reactive Arthritis

Alle Übungen und körperlichen Anstrengungen dürfen nur unter der Aufsicht eines medizinischen Experten durchgeführt werden.

Forschungsartikel on Reactive Arthritis

https://www.ncbi.nlm.nih.gov/books/NBK499831/#_article-28255_s5_

The objectives of this study were to investigate and validate individual variables and to develop a composite score for disease activity measurement in patients with reactive arthritis (REA). In the first cross‐sectional part, the clinical and laboratory evaluation of 45 patients was used to elaborate on the most important individual disease activity measures. In the second perspective part, these variables as well as a composite score for disease activity measurement of REA were prospectively validated in 23 patients at two points in time. The following variables emerged as the most useful for the composite measure: number of swollen and tender joints, patient’s pain and global assessment, and C‐reactive protein. The score was calculated by the simple addition of the individual figures.

It was concluded that DAREA constitutes a reliable score that can easily be assessed on a day‐to‐day office work basis.