Prasad, a 47-year-old individual working in the military, has been experiencing knee joint swelling for the past two weeks. The swelling occurred suddenly after a three-hour continuous bike journey, accompanied by an increase in temperature in the knee joint. It is significant that he used to engage in daily running sessions covering a distance of 4-5 kilometers. Seeking medical attention, he consulted an allopathic physician, who performed aspiration but the joint fluid filled up again after two days.Prasad’s dietary habits include regular consumption of non-vegetarian food. His laboratory reports indicate a uric acid level of 6.3, an ESR reading of 68, a negative RA status, as well as a high CRP level of 44.473. He experiences symptoms such as pain, a rise in body temperature, with no visible reddish discoloration. Additionally, there is a family history of degenerative changes, especially noted in his father. On a closer examination of Prasad’s overall health; it was found that he tends to suffer from constipation and a reduced appetite. Following his admission to the medical facility, he developed stiffness and pain on the left side of his jaw and neck, adding to his list of discomforts. After 10 days of IP treatment from Sree Subhramania Ayurvedic Nursing Home under the guidance of Dr Sanand,patient got a significant improvement in his presenting complaints and could lead a healthy life.
MRI scan of right knee
- Moderate effusion with synovial thickening and minimal peri synovial inflammatory changes likely inflammatory synovitis.
- Cartilage thinning in tibio-femoral and medial patello-femoral joints early degenerative arthritis.
- III-defined minimal subchondral marrow oedema are seen in medial condyle of femur and proximal tibia.Partial tear of ACL.
- Grade I signal changes seen in body and posterior horn of medial meniscus.
- Grade II signal changes seen in anterior horn and root of lateral meniscus.
- Popliteus tendinosis with associated tenosynovitis.
- Intermuscular and intramuscular oedema in the posterior aspect of knee joint.
- Subcutaneous oedema surrounding the knee joint.
Internal medicine
08/08/2024
- Nirgundyadi kashaya -60ml BD with hingu choornam
- Chandamarutham-1 pkt BD with ginger juice &sugar
- Hinguvachadi choornam- 1 tsp BD with hot water
09/08/2024
- Swarnapathradi choornam-1 tsp BD with hot water
12/8/2024
- Amrithottaram -60 ml BD
- Shuntyadi choornam -1 tsp BD hot water
14/08/2024
- Vatari rasam-25ml BD
- Kaishora guggulu- 1-0-1
External treatment
- Dhanyamladhara
- Thudumbala thepp 2 days
- Choornakizhi with rasnaaswagandhadi choorna
- Choornavasti-4 days
- Laghana -2 days
(Note* –
- Here are some of the medications prescribed to address the patient’s accompanying symptoms.
- This is a specialized plan for a person, please do not try it at home without the supervision of an Ayurvedic Doctor)
Improvement chart
| Sl.no | Symptoms before treatment | Percentage of reduction of symptoms after 5 days of treatment | Percentage of reduction Symptoms after 10 days of treatment |
| 1. | Right Knee joint swelling | 15% | 90% |
| 2. | Temperature rise in Right knee joint | 50% | 100% |
| 3. | Pain on touch(medial side tenderness) | 40% | 90% |
| 4. | Stiffness and pain in right jaw | 100% | 100% |
| 5. | Stiffness and pain in right jaw | 100% | 100% |
Importance of langhana as a treatment
The process that induces lightness in the body is known as langhana. The properties of substances that perform langhana include being light (laghu), hot (ushna), fast-penetrating (tikshana), cleansing (vishada), micro (sukshma), rough (khara), and movable (sara).
Effect of langhana:
During langhana, when one completely fasts or follows a light diet, food is not present for digestion. Thus kindled agni or digestive fire processes the ama(toxins) and leads to an increase in appetite known as agnideepana and amapachana respectively. Among the three doshas, the vitiated Kapha dosha is responsible for blockages in the body channels due to its heavy, channel clogging and sticky properties which resemble those of ama. According to traditional texts, langhana helps to enhance digestive power through amapachana and removes stagnation and blocks in tissues and channels, thus reversing pathological processes and strengthening the digestive system. It also reduces pain and inflammation.
Lepa mode of action
Application of medicinal lepa in the affected part and keep for specific time period. Ingredients of lepa may change based on different disease. After being applied externally, the lepa could have been absorbed into the body through sweat ducts and hair follicles.
Choorna pinda sweda
Churna Pinda is a type of Ruksha Sweda(sweating procedure performed with dry powder) that consists of Dry(Ruksha),hot(Ushna) etc. properties. Swedana Karma involves applying heat to increase vasodilation, decrease viscosity, change nerve conduction, increase metabolic rate, improving collagen tissue extensibility, reducing joint stiffness, relieving pain and muscle spasm, and reducing inflammation and body heaviness. The Ushna Guna(hot potency) of Swedana stimulates the sympathetic nervous system and vasodilation, increasing the circulation of the body.A one degree rise in body temperature induces sweating at a rate ten times higher than the basal heat production. The skin and specific deep tissues contain temperature receptors. Churna Pinda Sweda utilizes the vasodilation and sweating induction mechanisms due to its drug properties.
Choorna vasthi mode of action
Vasti impacts the entire body through rectal administration, removing vitiated Doshas, especially Vata Dosha and to some extent, Pitta and Kapha doshas. It helps in pacifying vitiated Vata Dosha through its Vatanulomana effect.
Vasti Dravya’s large volume may cause the colon to retain water or may encourage peristalsis. The liver is passed by the rectal veins before they enter the systemic circulation, draining the bottom part of the rectum. First-pass metabolism in the liver affects drug bioavailability. Improved absorption and bioavailability could result from increased vascularity and by lower first-pass metabolism.
