Sandhigata Vata is the type of pathogenesis involved in various disease conditions affecting the joints, e.g. osteoarthritis, rheumatoid arthritis, etc. and causing pain in affected joints.

1. D R . R A J T I L A K T I W A R I M . D . (
K A Y A C H I K I T S A )
A S S I S T A N T P R O F E S S O R I N K A Y A C H I K I T S A
D E P T . I N S H I V S H A K T I L A L S H A R M A
A Y U R V E D I C C O L L E G E R A T L A M ( M . P . )
E M A I L - R A J T I L A K T I W A R I @ G M A I L . C O M
M O B - 9 4 0 6 8 4 1 5 7 4 / 7 9 8 7 2 6 5 9 2 2
SANDHIGATA VATA
(OSTEOARTHRITIS)

2. INTRODUCTION
 Sandhigata Vata is the type of pathogenesis
involved in various disease conditions affecting the
joints, e.g. osteoarthritis, rheumatoid arthritis, etc.
and causing pain in affected joints.1

3. Case Definition:
 Painful condition of joints involving single or
multiple joints restricting the movements, with or
without swelling and crepitus (Sandhi Sphutana).

4. Differential Diagnosis:-
 Amavata
 Vatarakta
 • Katigraha
 • Gridhrasi
 • Ansashoola
 • Krostrukshirsha
 • Ankylosing spondylitis

5. LEVEL 1: AT SOLO AYURVEDIC
PHYSICIAN’S CLINIC/PHC
 Clinical diagnosis:
 On the basis of history and clinical presentation

6. Medicines at level 1 for Sandhivata
Drug Dose form dose administre
tion
indication Anupan
Ashwagand
ha Churna
Churna 3-5 gm Twice daily 2-3 months
With milk
Shuddha
Vishtinduka
churna
250 mg
Twice a day 2 week water
Pippalimool
a Churna
churna 500mg Twice a day 1 month water

7. Sunthi-
Haritaki
Churna
Churna 3-5 gm
Twice a
daily
1 month water
Rasnadi
Kwatha2
decotion 30-40ml
Empty
stomach
twice daily
15 days to 1
months
Dashamula
Kwatha
decotion 30-40 ml Empty
stomach 15 days to
one month
water
Rasna-
Erandadi
Kwatha3
decoction 30-40ml Empty
stoach twice
a day
15 days to 1
month

8. Yogaraja
Guggulu4
vati 1-2 vati
500mg
Thrice a
days after
meals
15 days to
1 months
Simhanada
Guggulu
vati 1-2 After meals
/thrice a
days
15 days to 1
months

9. Abhyanga: Local:
 On the affected joints with warm medicated
oils like Bala Taila, Sahachara Taila,
Vishagarbha Taila, Nirgundi Taila,
Mahanarayana Taila, Brihat Saindhavadi
Taila, Dhanvantara Taila, Kottamchukadi
Taila.
 Swedana: With hot water bag, Nadi Sveda,
Baluka Pottali Sweda, Nirgundi Patra Pinda
Sveda, Parisheka.

10. Pathya-apathya (diet and life style):
 Do’s (Pathya)
 • Ahara: Purana Shali, green gram, milk, grape, Luke
warm water, Paraval, drum stick, garlic.
 • Vihara: Massage, warm water bath, posture correction,
follow the Dinacharya and Rutucharya.
 Don’ts:
 • Ahara: Dried vegetables, lentils, sprouts, raw
vegetables and salads, refined foods such as white flour,
excessive use of leafy green vegetables, mushrooms, peas,
Excessive intake of pungent food, cold drinks, beverages,
chilled food and ice cream, Continuously fasting or taking limited
food for a very long duration.

11. Vihara:
 Inadequate sleep or frequent changes in
sleep pattern, suppression of natural urge
especially of hunger, bowel and urine and
emotions, Excessive physical strain like
swimming, climbing, walking, running,
sports which involve straining of joints like
in badminton, football etc., all such
occupation which involves excessive
movement of joints, resulting in joint
injuries.

12. Referral Criteria: Refer to Level 2
 1. Cases that are not responding to above
management and develop complications or severe
painful condition.
 2. Need further investigations.

13. Clinical diagnosis:
 The diagnosis is made on the basis of criteria
mentioned in Level-1 for fresh cases. The
case referred from Level-1 or

14. Clinical diagnosis:
 The diagnosis is made on the basis of criteria
mentioned in Level-1 for fresh cases. The case
referred from Level-1 or

15.  fresh case must be evaluated thoroughly for any complication.
 Investigations:
 • Haemogram
 • Serum uric acid
 • Serum calcium
 • RA Factor
 • S. alkaline phosphatase
 • X-Ray of affected joint
 • CRP
 Treatment:.

16. Medicines at level 2 for Sandhivata
Drug Dose form dose time duration Anupana
Mahayograj
guggulu
vti 1-2 vati
500 to 1 gm
After meal
/twice a days
15 days to 1
monhs Rasnadi
Kwatha,
Triphala
Kwatha
Kaishora
Guggulu6
vati 500-1 gm
Twice a days
after meals
15 days to 1
months Dashamula
Kwatha,
Luke warm
water
Vatavidhva
msa Rasa7
powder 125-250 mg Twice a days 15 days to 1
month
Water/hone
y
Narsimha
Churna8
churna 1.5 gm Twice a days 15 days to 1
month
water

17. Dashamo
ol-
arishta
decotion 15-30ml Twice a
days
/after
meals
15 days to
1 months
nil
Ashwagand
h- arista
15-30ml Twice a
days /after
meals
15 days to 1
months
nil
Amrita
Bhallataka
Avaleha 5-10 gm Once daily
1 monyhs milk

18. Local management:
 • Upanaha with leaves of Eranda, Nirgundi, Arka, Chincha etc.
on affected joints.
 • Lepa with Dashanga Lepa, Lepaguti, Gandhabiroja Lepa etc.
 • Janubasti / Greevabasti / Katibasti: Mahanarayana Taila9,
Masha Taila, Prabhanjana Vimardana Taila,10 Vishagarbha
Taila,11 Bala Taila12 etc
 • Abhyanga / Sthanika Mridu Snehana: Medicated oil such as
Mahanarayana Taila,13 Masha Taila, Kshirbala Taila,
Ashwagandha Balalakshadi Taila
 • Swedana (medicated fomentation):
 1. Ekanga (local fomentation) or Sarvanga Sweda (whole
body fomentation) with decoction of Nirgundi,
Dashamula, Eranda, Balamula, etc
 Patra Pinda Sweda: local fomentation by Pottali made
from leaves of Nirgundi, Eranda etc.

19. Pathya-apathya (diet and life style):
 Same as Level 1
 Referral Criteria: The cases those are not
responding to above mentioned therapy and
suffering from advanced stages of disease
like severe effusion, contractures,
osteoporosis or deformities or Patients with
some other uncontrolled conditions like
obesity, hypothyroidism, diabetes mellitus
and hypertension etc.

20. LEVEL 3: AYURVEDA HOSPITALS AT INSTITUTIONAL
LEVEL OR DISTRICT HOSPITAL/ INTEGRATED AYURVEDIC
HOSPITALS
 Clinical Diagnosis: Same as level 1 for a fresh case reporting directly.
 Investigations:
 1. Investigations mentioned in level 2 may be repeated if necessary.
 2. BMD
 Treatment: In addition to the treatment prescribed in level-1 and 2,
following procedures can be done.
 1. Basti Karma: Tiktaksheera Basti, Yapana Basti &Yoga Basti
 2. Agni karma (cauterization): Agni Karma on the affected joints
 3. Virechana: obese patients may be given Virechana
 4. Siravedha
 Pathya-Apathya (Diet and life style):- Same
 as level 1