Ayurvedic Intervention of Shamana Chikitsa Coupled With Intermittent Shodhana Chikitsa Effectively Reduces the Need for DMARDs in Rheumatoid Arthritis (~Amavata): A Case Report

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by inflammation of synovial joints, leading to pain, swelling, stiffness, and progressive joint damage. Conventional treatment provides symptomatic relief but may cause adverse effects, highlighting the need for alternative approaches like Ayurveda.  A 37-year-old female from Haryana presented with pain and swelling in small joints of bilateral hands and feet, wrists, and shoulders, along with morning stiffness. Examination showed tenderness and restricted, painful joint movements. Diagnosis was based on clinical features and ACR-EULAR 2010 criteria. Laboratory findings were Anti-CCP 169 U/ml, RA factor 135.16 IU/ml, ESR 39 mm/hr, and CRP 2.09 mg/dl. Treatment included Shodhana Chikitsa (Vaitarana Basti, Baluka Sweda, Shunthi Lepa) and Shamana Chikitsa (Singhnaad Guggulu 500 mg twice daily and Dashmool Kwath 40 ml once daily). Mild improvement was seen after first admission. After two months and repeat therapy, significant improvement in symptoms and mobility was observed. Follow-up reports showed Anti-CCP 134 U/ml, RA factor 46.4 IU/ml, ESR 22 mm/hr, and CRP 1.25 mg/dl. Combined Shodhana and Shamana Chikitsa demonstrated significant improvement in clinical symptoms and inflammatory markers, suggesting an effective Ayurvedic management approach for RA.