Rajah Ayurvedic Hospital

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RHEUMATOID ARTHRITIS

A46 year-old moderately built house wife got admitted to our centre with the following complaints:

·         Multi joint pain, mainly on right shoulder, both knees, both elbows, both ankles, lower back, left jaw, both wrists and small joints of the hands and feet associated with swelling and morning stiffness for last 10 months

·         Anemia for last 10 months

·         Hypothyroidism for last 18 years

·         Irregular cycles and prolonged bleeding during menstruation

·         Mental stress due to various reasons

History of present illness:

Multi joint pain and swelling started about 10 months back. The onset was gradual and it was mainly on the knees, ankles, lower back, right shoulder, elbows, wrists, small joints of fingers and toes and the left jaw. She used to get swelling and rise of temperature over the joints. From that time onwards she used to get low hemoglobin levels too.

She consulted the doctor and he diagnosed her condition as sero- positive rheumatoid arthritis and anemia.

Due to the swelling her hands were deformed and slightly deviated medially. Her walking pattern was also different with forward bending.

At the time of her admission to our centre she was taking Methotrixate 3 times in a week for last 3 months to control the pain and swelling. She has been suffering from hypothyroidism since last 18 years and taking Thyroxine 1mgper day.

Her menstruation  irregular for last 3 months. Once it starts it continues for 3-6 weeks. No medication for that.

Mentally stressed and recently noticed loss of memory and concentration.

Findings on examination:

·         Deviation of left hand medially with swelling

·         Forward bent gait due to pain

·         Swelling and heat on the joints

·         Pale and dry eyes

·         Lab test results

·          Hb-8mg/dl

·         ESR-58mm/hr

·         RA factor-positive

After  the detailed consultation & dosha analysis,she was diagnosed with Pitha vatha dominant vatha raktham

Treatments given

Internal medicines:

1.       Chithrakadi kashayam with Nimbamruthadi eranda thailam

2.       Indukantham Kashayam with Suvarna mukthadi gulika

3.       Balarishtam and Nimbamruthasavam with Yoga raja gulgulu gulika

4.       Sapthasaram kashayam and Pushyanuga choornam

5.       Asokarishtam and Pravala bhasmam

6.       Mandoora vatakam with lemon juice

7.       Asthisrunghala choornam with honey

Physical therapies:

1.       Sarvanga Dhanyamla dhara

2.       Podikizhi with Kulathadi choornam

3.       Lepanam with kottam chukkadi and Jatamayadi choornam

4.       Elakizhi

5.       Pizhichil with Pinda thailam

6.       Ksheeravasthi

7.       Navarakizhi

8.       Sirodhara with panchagandha ksheeram

Along with this suitable diet, breathing exercises and meditation were also given.

Condition on discharge:

·         Her general condition has improved with better energy level.

·         Pain on the joints are considerably reduced

·         Swelling also completely gone

·         No mare morning stiffness

·         She had one menstruation during the stay here; it was on time and normal too.

·         Blood tests show

1.       Hb-10mg/dl

2.       ESR-30mm/hr

3.       RA factor-positive

Further recommendations:

o   Advised her to continue Indukantham kashayam, Mandoora vatakam and yoga raja gulgulu for 3 more months

o   Follow the specific diet

o   To continue the regular meditation

o   To continue the daily breathing exercises.