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Rheumatoid arthritis is a type of chronic inflammatory arthritis affecting all age groups. Auto immune disorder of the body is the reason for this condition. Unlike the wear and tear in osteo arthritis, severe inflammation happens to the joint capsule in rheumatoid arthritis. At a later stage it also affects the cartilages and bones in the joint. Severe pain after rest,stiffness, swelling, warmth, fatigue, fever, redness and limitation in range of movements are the most common symptoms. It mainly affects the joints of the hand. As the disease progress it affects the wrists, elbows, hip, knee and ankles. Symptoms develops in both sides of the body. Other than the joints, rheumatoid arthritis can also affect organs like skin, eyes,lungs,heart,kidneys and blood vessels. The symptoms may show intermittent remissions and flare ups.

Ayurveda consider this condition as one type of vataraktha (Kaphjam), where the vitiated Vata and rakta along with kapha causes inflammation and degeneration of the joints and its structures. Ayurvedic treatment is very effective in the management of this condition and also to prevent further progressive deterioration of the condition. The treatment includes long term medication and periodical therapy program. Modifications in diet, lifestyle and practise of yoga and meditation will help in effective management and prevent frequent flare ups. Those patients undergoing treatments in other systems of medicines can also undergo Ayurvedic treatment simultaneously. Over a period of time, we may be able to gradually reduce their dependency on strong chemical medications. Adopting Ayurvedic treatments in the early stages will help prevent the development of its effects in other organs and systems.

This being a chronic disease with acute bouts, the line of management will be in two different phases. The phase one is to reduce the acute inflammation and the phase two is to protect the joint structures from degenerative changes. The medicines and therapies are entirely different in both situations. The phase one internal medicines are basically to improve the quality of digestion and to burn the toxins. Therapies at this phase is mostly managed without any medicated oils for pain and swelling. Pouring of warm herbal decoction all over the body (Kashaya dhara) giving focus on the joints, medicated paste application (lepa), medicated paste bandage, application of poultice made with medicinal powders after exposed to the steam coming from specific herbal decoction, application of poultice made of herbal powders or husk after dipped in hot herbal decoction etc are the therapies usually done in managing the inflammatory stage of rheumatoid arthritis. Major Panchakarma procedures like specific enema (vasti) with herbal decoction, enema with specific herbal oil or purgation by giving specific internal medicines are done according to the condition.

Phase two is to prevent degenerative changes in the joints, repairing of soft tissue damages, stabilizing and sustaining the positive changes that brought about in the joint during the initial phase of treatment, and also prevention of relapse of the disease. This includes appropriate internal medications, therapies, follow up medicines, modifications in diet and life style. Therapies like application and massage with poultice made of herbal powders (podi kizhi) heated in warm herbal oil, application and massage with poultice made of herbal leaves (ele kizhi) heated in warm herbal oil, oil pouring all over the body(pizhichil), application of poultice made with cooked herbal grains in a mix of decoction and milk (njavara kizhi) are the therapies usually done. Major Panchakarma procedures like enema with herbal decoction (Kashaya vasti) and enema with herbal oil (sneha vasti) are also done. The medicines and therapies done has specific actions of immuno modulation and disease modification effects. Continuing with internal medications, yoga practise and other dietary restrictions for some time are very important in managing the condition.