More 60% of attendance of our OPD are joint related problems. Long-term treatment and side effects of allopathic drugs attracts more people towards Ayurveda treatment . Fear of transplant and high cost therapy is another cause for common choose Ayurveda .Pain ,Restricted active movement Deformity are the common presting symptom. Effective and safe ayurveda drug with evidence are narrated .

1. Speaker
DR ASHOK KUMAR PANDA, MD (Kayachikitsa) Cal
SR RESEARCH OFFICER(Ayurveda),
CARIHD, BHARATPUR, BBBSR
CCRAS, M/O AYUSH, GOI
• More than 8 years experience
UG and PG teaching
• 12 year Research experience in
CCRAS
• Life member of RSSDI
• 45 research papers published in
peered review journals
• Presented 34 papers in national
and international seminars
• Editor in three journals and
reviewers of 10 journals
• P.I. in Osteoporosis project

2. Clinical Experiences in Management of
Joint pain
Disclaimer
•It is purely academic and
experience of our team.
• Cases are observed and
sharing by me.
•Conflict of interest – Nil
•It is unbiased and not
supported by any pharma.

3. Opportunity
• More 60% attendance of
our OPD
• Long term treatment and
side effect of allopathic
drugs
• Fear of transplant
• Restricted active
movement
• Deformity
• Effective and safe
ayurveda drug

4. Challenges
• 60% cases are Pre-diagnosed
cases and chose our Rx as
last option.
• High expectation
• Poly pharmacy and multiple
diseases
• Highly educated pt
• Pain reduction in young pt
and child
• Long duration of treatment
and unpredictable out come

5. Joint pain found
• Gout
• Psoriatic arthritis
• SLE
• Ankyologing spondilitis
• TB joints
• Fibromyalgia
• Arthritis profile-CBC,
ESR, CRP,ASO, ANA, HLA
B27, anti ccp

6. Examination
• Mono arthritis or poly
• Inflammatory or non
inflammatory
• Pain in articular or non
articular surface
• Morning stiffness
• Crepitation
• Range of movement

7. Pls examine patient

8. Range of medication
• Ama pachaka- Angi tundi, sunthi,
sanjeevani, bilvadi gulika
• Kwatha – Moharasnadi,
Amruttam, kokilayadi,punnavadi
• Gugulu preapration
• Sallaki
• Aswagandha
• Gold nano particle
• Rasa ausadhi- vata gajankusha,
Br vata chintamoni, rasa raj rasa
Siddha makardwaja
• Glucosamine
• Curcumin
• Cannabish prepartions
• Langali
• Hadjud
• Sigru

9. Treatment plan
• Patient centric and personalized
• Prakruti, Dosa avatha, Rogi bala,Roga bala
• Satarpana or Apatarpana
• Deepana and Pachana
• Treatment to local and systemic
• Active and passive exercise
• Panchakarma- Vaitarana vasti

10. Case no-1
• A 47 year old female
came rht knee swelling
and pain . No
• Her ESR-60, ASO positive
with normal uric acid .
• Agnitundi vati
• Sanjeevani, Moha rasnadi
kwatha, triphala gugulu
• Vakuka seka
• Leech thrapy

11. Follow up
• Pain and swelling
reduced after 15 days.
• Leech terapy planed for
3 settings.

12. Case no-2
• 48 year female came to our hospital on
4.4.18
• With ply arthritis , morning stiffness , slight
body swelling, acidity
• Un controlled TSH -15.6
• ESR-60, Hb%-9.8
• CRP +ve
• Urea -14.9
• Creatinine -0.6
• Uric acid-4.2
Folia Med (Plovdiv). 2007;49(3-4):5-12.
• Rheumatoid arthritis and thyroid
abnormalities
• Thyroid dysfunctions in RA patients are most
often of autoimmune nature; they are
accompanied by elevated thyroid
autoantibody titer.
• Saubhaya sunthi
• Moha rasnadi
• Amruttam kasaya
• Swarna gugulu
On 11.12.18
TSH-1.95
• ESR-30, Hb%- 11.2
• CRP – negative .

13. Case-3
• A 22 year male poor
patient came to OPD
with pain and swelling
of both legs since 3
months admitted in IPD
on 22-10-18
• ESR-140, Hb%-8.4
• CRP -4.5(<0.6)
• RA-12(<10)
• TLC-10,700

14. Follow up (25-1-19)
• ESR-70, Hb%-11.2
• CRP -3.1(<0.6)
• RA-10(<10)
• TLC-6100
• Patient remarkably improved with
• Punnava gugulu
• Moha rasnadi+Amruttaram kasaya
• Baluka sweda

15. Case-4
• A 82 year male bilateral
knee pain
• Know case DM and HTN
and controlled with
allopathic drug
• ESR-10
• ASO, CRP, RA-negative
• Uric acid -4.2
• Restricted movement
• pain

16. Medication and follow up
• Br Vata chintamoni Rasa
• Aswagandha
• Triphal churna
• Pain reduce in 30 days
• Mobility improved

17. Case-4
• A 44 year male with
back pain, stiffness
since 6 months on 24-
10-18
• HLA B 27 – Positive
• ESR-36
• With sazo
• Vata chintamoni Rasa

18. Published data
• Indian J Med Res. 2015 Jan; 141(1): 100–106.
Efficacy & safety evaluation of Ayurvedic
treatment (Ashwagandha powder & Sidh
Makardhwaj) in rheumatoid arthritis patients:
a pilot prospective study
• Gajendra Kumar, Amita Srivastava, Surinder
Kumar Sharma,* T. Divakara
Rao,** and Yogendra Kumar Gupta

19. Ashok Kumar Panda (2015) Ayurveda Treatment Outcomes for
Osteoarthritis. J Homeop Ayurv Med 4:e115
• Gold molecule inhibits the release of HMGB1 by interfering with the
activity of two helper molecules that ease HMGB1’s release from
the cell, interferon beta and nitric oxide. High mobility group
protein (HMBG1) provokes inflammation, the key process
underlying the development of rheumatoid arthritis. HMBG1 is a
dual-function molecule, which means that it behaves one way when
it’s inside the nucleus of a cell, and quite another way when it’s
released from the cell. HMGB1 is a key player in transcription, the
process that converts genetic information in DNA to its RNA
equivalent. But when HMGB1 is released from the cell -- either
through normal processes or cell death -- it becomes a stimulus to
the immune system and enhances inflammation. HMGB1 is not
produced evenly throughout the body,” “There is an unusually high
amount of it in the synovial tissue and fluid around the joints --
where arthritis occurs. Gold molecule has also immunosuppressant
effect .

20. Pub data
1“Clinical evaluation of Boswellia serrata (Shallaki) resin in the management
of Sandhivata (osteoarthritis)” Ayu vol. 32,4 (2011): 478-82.
2.Ayurvedic medicine for rheumatoid arthritis: A systematic review
JongbaeParkKMD, PhD⁎†EdzardErnstMD, PhD(FRCP), seminar in Arthritis and
Rhematism, April 2005
3. Effectiveness of an Ayurveda treatment approach in knee osteoarthritis – a
randomized controlled trial, Osteoarthritis and cartilage Vol26, May2018
4. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of
Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized
Clinical Trials, J Med Food. 2016 Aug 1; 19(8): 717–729

21. Mode of action

22. Conclusion
• We most familiar with modern test and
diseases process ,then translate to Ayurveda
theory.
• All of us should prepare data of clinical
success.
• Gold preparation medicine has good efficacy
in OA or RA.