A Clinical and Conceptual Review of Sandhivata (Osteoarthritis) in Ayurveda with Special Emphasis on Management Approaches

Abstract

Background

Sandhivata (Osteoarthritis) is a degenerative joint disease that mirrors osteoarthritis in modern medicine, presenting with Sandhishoola (joint pain), Shotha (swelling), and Hanti Akunchan Prasarayoh (stiffness in movement). With its rising prevalence, particularly in the elderly, Ayurvedic management offers a holistic and sustainable alternative rooted in centuries-old clinical wisdom.

Objective

This study aimed to assess the clinical efficacy of classical Ayurvedic management of Sandhivata using internal formulations and external therapies, and to correlate outcomes with traditional descriptions.

Materials and Methods

A prospective clinical study was conducted in the Department of Kayachikitsa, College of Ayurved & Research Centre, Nigdi, Pune ,India from January 2019 to December  2019 . A total of 120 patients diagnosed with Sandhivata were treated using Rasnasaptaka Kashaya, Yogaraja Guggulu, and Maharasnadi Kwatha as internal medicines. External treatments included Abhyanga with Mahanarayana Taila followed by Nadi Swedana, and where indicated, Basti Chikitsa with Dashamoola Niruha Basti and Anuvasana Basti with Mahanarayana Taila. Clinical evaluation focused on pain reduction, joint mobility, swelling, and overall quality of life.

Results

Marked improvement was observed in Sandhishoola, Sandhishotha, and joint stiffness, particularly in early to moderate cases. Most patients reported enhanced mobility and reduced pain scores, with minimal adverse effects, validating the safety and efficacy of the Ayurvedic protocol.

Conclusion

The study supports that a comprehensive Ayurvedic approach using time-tested formulations and therapies significantly alleviates symptoms of Sandhivata. Integration of classical principles with standardized clinical methods can enhance the role of Ayurveda in managing chronic degenerative joint disorders.