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
- Cataracts
- 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
Sedentary lifestyle
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
Amruthotharam kashayam
Gugguluthiktakam Kashayam
Rasnadi kashayam
Rasnasaptakam kashayam
Rasnasunthyadi kashayam
Yogarajaguggulu
Kaisore Guggulu
Balarishtam
Shaddharanam choornam
Vaiswanara Choornam
Rasaraja Ras
Vrihatvata Chinthamani Ras
Makaradhwaj Vati
Guggulutiktakam ghrutam
Brands available
Vaidyaratnam Oushadhasala
AVS Kottakal
AVP Coimbatore
Dabur India
Dhootapapeshwar Ltd
SKM Pharmaceuticals
Sidheswarar Pharmaceuticals
SNA oushadhasala
Home remedies 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.
Diet for Reactive Arthritis
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha and cause respiratory problems
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from the cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid a sedentary lifestyle.
Yoga for Reactive Arthritis
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles on Reactive Arthritis
https://www.ncbi.nlm.nih.gov/books/NBK499831/#_article-28255_s5_
- https://doi.org/10.1093/rheumatology/39.2.148
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.
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