My sister, aged 60, was recently diagnosed with arthrosis. For several years, she had been suffering from severe pain in her lower back, radiating to one of her legs. The pain comes and goes, but has been gradually building, up to the point where a visit to the doctor became inevitable. She was diagnosed with arthrosis of the lower spine. The pain in her leg is caused by the fact that sometimes, the nerve that extends into the leg will get caught between two bones in a joint, resulting in a lot of pain in both the lower back and the leg.
Since arthrosis appears to be quite a common disease, I was wondering what it is exactly, and how it can be treated. And in particular, how it is treated in Ayurveda.
Difference between arthritis and arthrosis
Let’s first make it clear what we are talking about here. Arthrosis and arthritis are two very similar words, that often get confounded. Arthritis is a general term which describes several conditions that cause inflammation in the joints. Examples include osteoarthritis (OA), rheumatoid arthritis (RA), and gout.
Osteoarthritis (OA) is another name for Arthrosis. It’s the most common type of arthritis, and it is caused by normal wear and tear on joints and cartilage.
Cartilage is the slippery tissue that covers the ends of your bones and helps your joints move. Over time, your cartilage can deteriorate and may even disappear completely. This results in bone-to-bone contact in your joints, causing pain, stiffness, and sometimes swelling.
Arthrosis can affect any joint in your body. However, it’s most likely to affect the joints of your hands, neck, knees, hips and lower spine. Your risk of developing it increases with age. Which is probably why I’m hearing more and more about it, having reached a certain age myself now.
Most common symptoms of arthrosis
- joint pain
- joint stiffness
- tenderness around affected joints
- reduced flexibility in affected joints
- bone-to-bone grating or rubbing
- bone spurs, or small bits of extra bone growth that may develop around affected joints
Causes of arthrosis, according to Western medicine
Age: the older you are, the bigger your chances of developing arthrosis.
Gender: women are more prone to developing arthrosis than men.
Weight: being overweight puts extra strain on your joints, raising your chances of developing arthrosis.
Occupation: work that regularly puts strain on certain joints raises the chances of developing arthrosis in those joints.
Genes: if many members of your family suffer from arthrosis, you’re more likely to develop the disease too.
Western medicine treatment
Western treatment focusses on pain relief and control of inflammation.
- Pain medication: for example paracetamol or Ibuprofen, though neither should be used long-term on a daily basis.
- Regular and appropriate physical activity to strengthen the muscles that stabilise the joints in order to maintain or regain a certain range of motion.
- Food supplements like glucosamin, chondroitin sulphate or hyaluronic acid are often recommended.
- An occupational therapist can help develop strategies to adjust the work environment or habits to help manage the condition.
- Orthotics: for example braces, splints, or shoe inserts that help relieve stress and pressure on damaged joints.
- As a last resort: a surgical joint replacement or joint fusion.
Cause of arthrosis, according to Ayurveda
Ayurveda sees arthrosis, as any disease, as an imbalance of the dosha’s. The idea is that Ama (= toxins formed in the body) moves through the body, mostly in the blood, by the energy of Vata. When Vata becomes unbalanced, all movement in the body is impaired, and toxins can accumulate in the tissues as a sticky layer.
The toxins themselves are formed mainly by poor digestion, which is managed by Pitta. This dosha governs transformation. When Pitta is out of balance, digestion is impaired and food is not completely decomposed. This results in food rotting in the intestine, releasing toxins. Together with useful nutrients, these toxins are distributed through the body by the blood stream, causing impaired metabolism, suffocation of cells, and tissue damage.
Over time, Ama accumulates in the joints, eventually affecting the third dosha: Kapha. Kapha controls the fluids in the body. Its “liquid” nature is close to that of Ama – wet, greasy, heavy, cold, and when Kapha is strengthened, instead of nourishing and supporting the joints, it can become mixed with Ama.
As with any disease, the entire organism has to be brought back to balance. All three dosha’s can be involved and it takes an Ayurvedic professional to determine the state of each dosha, how it impacts the disease, and how it can best be brought back to balance.
However, there are several things you can do yourself to improve your situation:
1) Herbal treatment for arthrosis
There are 7 often used Ayurvedic herbal treatments for arthrosis:
The Ayurvedic herb Boswellia serrata, also called Indian frankincense, alleviates joint pain and inflammation. Boswellia blocks an enzyme (5-lipoxygenase) which plays a major role in the formation of chemicals called leukotrienes, which stimulate and perpetuate inflammation. Researchers have found that people with osteoarthritis who took Boswellia along with Ashwagandha, turmeric, and zinc reported less joint pain and increased mobility and strength.
The active ingredient in turmeric, curcumin, has been shown to inhibit key inflammation-producing enzymes (lipo-oxygenase, cyclo-oxygenase, and phospholipase A2), thus disrupting the inflammatory cascade at three different stages. Interestingly, some data suggest that it may protect the stomach against non-steroidal anti-inflammatories (NSAIDs).
Ashwagandha (Withania somnifera), has known anti-inflammatory effects. In a study published in 2007, the extract of this herb was found to suppress the production of pro-inflammatory molecules (TNF-alpha and two interleukin subtypes). In another study, the anti-inflammatory effect of Ashwagandha was comparable to taking the steroid hydrocortisone.
Ginger (Zinziber officinale) works as an anti-inflammatory by interfering with an enzyme (cyclooxygenase) that produces inflammatory chemicals in the body. There is some data showing that ginger has a moderate beneficial effect on arthrosis of the knee.
The Ayurvedic herb triphala has been used in India for thousands of years to treat arthrosis. Triphala is a formulary that consists of three herbs (amalaki, haritaki, and bibhitaki). Preliminary studies show that the herbs in triphala have anti-inflammatory effects.
Guggulu (Commiphora guggul) has been shown to be a potent inhibitor of the enzyme NFKB, which regulates the body’s inflammatory response. There are several studies that show decreased inflammation and joint swelling after administration of extracts of guggulu resin.
Shatavari (Asparagus racemosus) is an Ayurvedic herb that is considered to have a soothing, cooling, and lubricating influence on the body. Studies have found that it has an inhibitory effect on chemicals that create inflammation in the body, such as TNF-alpha, and IL-1B.
Body, mind and spirit are inextricably connected. So it’s not enough to just treat the body, it’s a big help to treat the mind as well. One way to do this is by practicing mindfulness meditation.
A study conducted in 1982 showing the beneficial effect of meditation on pain reduction was carried out by Dr. Jon Kabat-Zinn with a group of patients suffering from chronic pain. After completing a ten-week program of mindfulness meditation, 65 percent of the participants showed a significant reduction in pain levels. Since then, many other studies have confirmed these findings.
Researchers have found that through the regular practice of meditation, we can actually change how our mind perceives pain. It will not reduce the pain, but it can reduce the suffering.
Another study (Randolph, 1999) found that meditation in conjunction with conventional medical treatment enhances the effectiveness of Western medical treatment. In this study, patients were taught hatha yoga and meditation in two-hour classes. A year later, patients undergoing the pain and stress management program in addition to the medical treatment reported that their feelings of pain decreased by 79 percent.
3) Yoga for arthrosis
The regular practice of yoga increases strength, flexibility, and balance, all of which are important for health in general and even more so for those coping with arthrosis. When practiced regularly, gentle yoga movements not only strengthen the muscles that support the joints but also improve the flexibility of the muscles, which is more effective than just strengthening alone.
Yoga’s focus on balance and alignment helps improve biomechanical imbalances that create stress on the joints. As researchers have found, the damage to cartilage often occurs because of the unbalanced positions that the body is put in while sitting, walking, and moving. Misalignments of bones, dysfunctional movement patterns, lack of body awareness, and poor posture can all contribute to wear and tear of the cartilage. Yoga can retrain our body to move in ways that decrease stress on our joints.
4) Eat according to your constitution
If you regularly eat foods that your body has difficulty digesting, Ama will accumulate, leading to imbalance and thus disease. And if you already are ill, changing your diet, adapting your nutrition to your constitution, can positively impact your health.
Would you like to know which foods are good for you and which ones you should avoid? Take our dosha-test and download your personal list of food recommendations to get started right away.