A clinical study to evaluate the effect of Nithya Virechana on range of movements of joints in Amavata w.s.r. to Rheumatoid Arthritis

Deeksha Nayaka HV; Manjunath Kanthi; Niranjan Rao

doi:10.21760/jaims.10.4.4

E-ISSN:2456-3110

Research Article

Rheumatoid Arthritis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 4 APRIL

Publisher

www.maharshicharaka.in

A clinical study to evaluate the effect of Nithya Virechana on range of movements of joints in Amavata w.s.r. to Rheumatoid Arthritis

Deeksha Nayaka HV^1*, Kanthi M², Rao N³

DOI:10.21760/jaims.10.4.4

^1* Deeksha Nayaka HV, Post Graduate Scholar, Dept of Panchakarma, SDM College of Ayurveda College Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

² Manjunath Kanthi, Assistant Professor, Dept of Panchakarma, SDM College of Ayurveda College Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

³ Niranjan Rao, Vice Principal and HOD, Dept of Panchakarma, SDM College of Ayurveda College Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

Background: Amavata (Rheumatoid Arthritis) is a chronic, progressive inflammatory condition that primarily affects the joints, leading to pain, stiffness, swelling, and restricted mobility. It is characterized by the presence of Ama (undigested toxins) and vitiated Vata Dosha, which together contribute to pathological changes similar to Rheumatoid Arthritis (RA) in modern medicine.

Objective: This study aims to evaluate the effect of Nitya Virechana, assess inflammatory markers (ESR, CRP, ASO, RA factor), and measure the range of joint movements in individuals diagnosed with Amavata/Rheumatoid Arthritis.

Methodology: Nitya Virechana, a subtype of Virechana Karma, is described in classical Ayurvedic texts as a therapeutic intervention that facilitates the elimination of morbid Doshas via the Adhomarga. This procedure is not only beneficial in Pitta Nirharana but also effectively eliminates accumulated Ama, a key pathological factor in Amavata. Classical references suggest Nitya Virechana as an integral component in Amavata management. The present clinical study evaluates the efficacy of Nitya Virechana using Gandharvahastadi Eranda Taila in managing Amavata.

Results: Statistically significant improvement was observed across all parameters, with a p-value < 0.001, indicating positive therapeutic outcomes.

Conclusion: Gandharvahastadi Eranda Taila demonstrated significant efficacy in reducing CRP, RA factor, ASO, along with symptomatic relief and improved joint mobility in Rheumatoid Arthritis. The effectiveness of the treatment has been validated through statistical analysis of key clinical parameters.

Keywords: Amavata, Rheumatoid Arthritis, Nitya Virechana, Gandharvahastadi Eranda Taila

Corresponding Author	How to Cite this Article	To Browse
Deeksha Nayaka HV, Post Graduate Scholar, Dept of Panchakarma, SDM College of Ayurveda College Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India. Email:	Deeksha Nayaka HV, Kanthi M, Rao N, A clinical study to evaluate the effect of Nithya Virechana on range of movements of joints in Amavata w.s.r. to Rheumatoid Arthritis. J Ayu Int Med Sci. 2025;10(4):14-21. Available From https://jaims.in/jaims/article/view/4547/

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2025-03-09	2025-03-25	2025-04-05	2025-04-15	2025-04-25
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
None	Nil	Yes	11.54

© 2025 by Deeksha Nayaka HV, Kanthi M, Rao N and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(4)14

Download PDF Back To Article Introduction Objective of the study Materials and Methods Results Discussion Conclusion References

Deeksha NHV et al. Effect of Nithya Virechana on range of movements of joints in Amavata

Introduction

Amavata is considered as a both Santharpana and Amaja Vyadhi mentioned by Madhava Nidana which involves Ama along with Tridoshas.^[1] The Nidana being mainly Viruddha Ahara and Vihara, which leads to Utpatti of Ama along with Vata Prakopa gets SthanaSamshreya in Kaphasthana resulting in Amavata. The Lakshana’s of Amavata are Angamardha, Aruchi, Trushna, Gourava, Sandhishotha, Sandhishoola, Shoonatanga can be correlated with signs and symptoms of Rheumatoid arthritis.

Rheumatoid Arthritis affects approximately 0.024-1% of the adult population worldwide. Global prevalence rate of Rheumatoid Arthritis with genetic associations in India is 0.7%. It occurs more commonly in females than males, with a 2-3:1 ratio. Annual incidence of Rheumatoid Arthritis is approximately 40 cases per 10,000 and the prevalence rate is of 0.5-1% peaking in age group of 35-60 years. Effective curative management of Rheumatoid Arthritis helps to increase the productivity of individual mostly of the middle age.

Virechana is considered as the best Shodhana to balance the vitiated Dosha. Eranda Taila is mentioned as one of the Snigdha Virechaka Dravya in all Brihatrayees.^[3,4] By considering it as best in conditions like Amavata. It has properties like Snigdha, Tikshna, Sukshma Guna, Madhura Vipaka and Ushna Virya. It does both Snigdha and Pachana Karma, Sroto Shodhana that helps to tackle Amavata. Amavata is one among the Shoola Pradhana Vyadhi, mentioned as an independent disease by Acharya Madhavakara. In Madhava Nidana, Acharya has explained regarding the Nidana, Lakshanas.

Acharya Chakradatta,^[5] Vangasena,^[6] Bhaishajya Ratnakara,^[7] mentioned about Langhana, Deepana, Virechana, Katu Tikta Dravya Prayoga in management of Amavata. Acharya Charaka mentioned Eranda as best Agrya for Virechana^[2] in Vata Shleshmahara. Acharya Bhavaprakasha and Bhaisheyja Ratnakara^[7] mentions Prayoga of Eranda Taila in Amavata. Rheumatoid Arthritis is a chronic inflammatory disorder of autoimmune origin that may affect many tissues and organs but principally attacks the joints producing non suppurative, proliferative and inflammatory synovitis.

First recognized description of Rheumatoid arthritis in modern medicine was in 1800 by the French physician Dr. Augustine Jacob Landre Beauvais.^[8]

Objective of the study

To evaluate the effect of Nitya Virechana, to assess the inflammatory markers - ESR, CRP, ASO and RA and assess the range of movements in Amavata/ Rheumatoid Arthritis.

Materials and Methods

Ethical Committee Approval No. SDMCAU/ACA-49/ECH 33/2022-23

Design of the study:

An open label single group clinical study

Table 1: Showing the intervention of the study.

Intervention
Drug name	Gandharvahastadi Erandam
Dose	25 ml /day
Route of administration	Oral
Time of Administration	Morning around 9: 30 am
Anupana	Ushna Jala
Duration of the study	7 days

Source of Data

Patient source

Patients diagnosed with Amavata were selected from the OPD and IPD of Sri Dharmasthala Manjunatheshwara Ayurveda Hospital, Kuthpady, Udupi.

Method of collection of data

It was a non-randomized open-label clinical study with a pre- and post-test design to assess the efficacy of Virechana Karma and the range of movements in joints with Gandharvahastadi Eranda Taila in the management of Amavata. A detailed case proforma has been prepared on the disease Amavata or RA.

Diagnostic Criteria

ACR Revised criteria

Morning stiffness in and around joints for at least 1hour.
Soft tissue joint swelling observed by physician at least 3 joint groups (R or L: MCP, PIP, wrist, elbow, knee, ankle, MTP).

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Arthritis of hand joints (MCP, PIP or wrist).
Symmetrical swelling of one joint area in (2) above.
Rheumatoid nodule.
Positive Serum Rheumatoid factor.
Radiograph changes on wrist/hands: erosions or juxta-articular osteoporosis.

For classification purposes, a patient was said to have rheumatoid arthritis if he/she satisfied at least four of these seven criteria. Criteria 1 through 4 must have been present for at least 6 weeks.

Inclusion criteria

1. Patients fulfilling diagnostic criteria of Amavata/RheumatoidArthritis.
2. Patients aged between 35-60 years
3. Patients who are fit for Nithya Virechana Karma.

Exclusion criteria

1. Patients with systemic illness like Diabetes Mellitus, Hypertension which will hamper treatment
2. Pregnancy and Lactating women.
3. All autoimmune disorders other than Rheumatoid Arthritis.

Assessment Criteria

The signs and symptoms of Amavata/ Rheumatoid Arthritis and Inflammatory markers ESR, CRP, ASO and RA will be assessed before and after treatment.

Subjective Parameters

1. Number of Virechana Vegas

2. Amavata Lakshanas like Angamardha, Gourava, Alasya, Apaka, Shoonatanga, Aruchi.

Objective Parameters

The signs and symptoms and range of movements in wrist, elbow, knee, ankle, MTP, MCP, PIP of Rheumatoid Arthritis will be assessed before treatment and after treatment .

On zero^th day before treatment and on 7^th day, after treatment the range of movements will be assessed.

Rheumatoid Arthritis patients - 2010 ACR revised criteria. To assess the inflammatory markers - ESR, CRP, ASO and RA.

Intervention

1. The patients who fit for above said criteria is selected for Nitya Virechana for 7 days.
2. The patient will be administered Gandharvahastadi Earanda Taila in empty stomach, in a dose of 25ml with Ushna Jala as Anupana around 9 am.
3. After the administration, the patient will be observed for number of Vegas, assessment of Jeerna and Ajeerna Lakshanas of Virechana Dravya, Once the Samyak Viriktha Lakshana is achieved, then the patient is asked to take Laghu Aahara.

Duration of study

Total duration of the study: 7 days
Investigations included in the study is as follows, the inflammatory markers - ESR, CRP, ASO and RA

Results

1. Visual Analog Scale

Table 1: Statistical analysis of VAS

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P value
4.400	2.700	1.7	38.6%	BT	1.102	0.201	4.000	4.695	<0.001
4.400	2.700	1.7	38.6%	AT	0.877	0.160	2.000	4.695	<0.001

The results for the parameter of VAS showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test - Z value (4.695). Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in pain in multiple joints of the body.

2. Chronic Pain Grade Scale

The results for the parameter of the Chronic Pain Grade Scale showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test - Z value (4.899).

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Deeksha NHV et al. Effect of Nithya Virechana on range of movements of joints in Amavata

Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in pain in multiple joints of the body.

Table 2: Statistical analysis of Chronic Pain Grade Scale

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P value
2.467	1.667	0.8	32.4%	BT	0.629	0.115	2.000	4.899	<0.001
2.467	1.667	0.8	32.4%	AT	0.884	0.161	1.000	4.899	<0.001

3. Rheumatoid Arthritis

Table 3: Statistical analysis of RA

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	T value	P value
33.920	32.460	1.46	4.30%	BT	31.663	5.781	23.300	4.683	<0.001
33.920	32.460	1.46	4.30%	AT	31.505	5.752	23.500	4.683	<0.001

The results for the hematological parameter of the RA factor showed a highly significant interpretation (p < 0.001) with the Paired t-test – t value (4.683). Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in the RA factor.

4. Anti streptolysin-o titre

Table 4: Statistical analysis of ASO

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	‘t’ value	P value
193.653	186.197	7.456	3.8%	BT	211.315	38.581	94.600	2.206	0.035
193.653	186.197	7.456	3.8%	AT	211.444	38.604	90.000	2.206	0.035

The results for the hematological parameter of Anti-Streptolysin-O titre showed significant interpretation (p = 0.035) with the Paired t-test - t value (2.206). Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in Anti-Streptolysin-O titre.

5. C reactive proteins

Table 5: Statistical analysis of C reactive proteins

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	‘t’ value	P value
14.697	13.353	1.344	9.1%	BT	20.692	3.778	5.750	5.348	<0.001
14.697	13.353	1.344	9.1%	AT	19.859	3.626	4.750	5.348	<0.001

The results for the hematological parameter of C-reactive proteins showed a highly significant interpretation (p < 0.001) with the Paired t-test - t value (5.348). Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in C-reactive proteins.

6. Erythrocyte Sedimentation rate

Table 6: Statistical analysis of ESR

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	‘t’ value	P value
51.833	47.367	4.466	8.6 %	BT	35.306	6.446	48.000	435.000	<0.001
51.833	47.367	4.466	8.6 %	AT	33.793	6.170	43.500	435.000	<0.001

The results for the hematological parameter of Erythrocyte sedimentation rate showed a highly significant interpretation (p < 0.001) with the Paired t-test – t value (435.000). Nithya Virechana with Gandharvahastadi Taila showed a significant reduction in the Erythrocyte sedimentation rate.

7. ACR criteria

An RA score of 6 or above is considered a definite Rheumatoid Arthritis subject. The mean showed a significant reduction from definite RA to non-definite RA by the end of the course of treatment and follow-up.

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Table 7: Statistical analysis of ACR Criteria

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P value
7.100	5.100	2	28.1%	BT	1.605	0.293	7.500	4.853	< 0.001
7.100	5.100	2	28.1%	AT	1.517	0.277	5.000	4.853	< 0.001

8. Range of movement

Table 8: Statistical analysis of range of movement

ROM of	Mean			Wilcoxon signed rank test
ROM of	BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P value
Lumbar Spine	1.300	0.467	0.833	64%	BT	0.466	0.0851	1.000	5.000	<0.001
Lumbar Spine	1.300	0.467	0.833	64%	AT	0.490	0.0895	0.000	5.000	<0.001
Cervical spine	1.200	0.367	0.833	69.4%	BT	0.407	0.0743	1.000	5.000	<0.001
Cervical spine	1.200	0.367	0.833	69.4%	AT	0.490	0.0895	0.000	5.000	<0.001
Shoulder joint	1.200	0.300	0.9	75%	BT	0.0743	0.152	1.000	5.196	< 0.001
Shoulder joint	1.200	0.300	0.9	75%	AT	0.466	0.0851	0.000	5.196	< 0.001
Hip joint	1.233	0.400	0.833	67.5%	BT	0.430	0.0785	1.000	5.000	<0.001
Hip joint	1.233	0.400	0.833	67.5%	AT	0.498	0.0910	0.000	5.000	<0.001
Knee joint	1.400	0.600	0.8	57.1%	BT	0.498	0.0910	1.000	4.899	<0.001
Knee joint	1.400	0.600	0.8	57.1%	AT	0.621	0.113	1.000	4.899	<0.001
Elbow joint	1.200	0.267	0.933	77.7%	BT	0.407	0.0743	1.000	5.292	<0.001
Elbow joint	1.200	0.267	0.933	77.7%	AT	0.450	0.0821	0.000	5.292	<0.001
Ankle joint	1.233	0.467	0.766	62.1%	BT	0.430	0.0785	1.000	4.796	<0.001
Ankle joint	1.233	0.467	0.766	62.1%	AT	0.571	0.104	0.000	4.796	<0.001
Wrist joint	1.167	0.167	1	85.6%	BT	0.379	0.0692	1.000	5.477	<0.001
Wrist joint	1.167	0.167	1	85.6%	AT	0.379	0.0692	0.000	5.477	<0.001
MCP Joints	1.200	0.300	0.9	75%	BT	0.407	0.0743	1.000	5.196	<0.001
MCP Joints	1.200	0.300	0.9	75%	AT	0.466	0.0851	0.000	5.196	<0.001
MTP joints	1.200	0.300	0.9	75%	BT	0.407	0.0743	1.000	5.196	<0.001
MTP joints	1.200	0.300	0.9	75%	AT	0.466	0.0851	0.000	5.196	<0.001

The results for the parameter of the range of movement of the lumbar spine (low back) showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.000). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the lumbar spine. The results for the parameter of the range of movement of the cervical spine (neck) showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.000). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the cervical spine.

The results for parameter of range of movement of the shoulder joint showed a highly significant interpretation (p < 0.001) with Wilcoxon signed-rank test – Z value (5.196). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of shoulder joint. The results for parameter of range of movement of hip joint showed a highly significant interpretation (p < 0.001) with Wilcoxon signed-rank test – Z value (5.000).

Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the hip joint. The results for the parameter of the range of movement of the knee joint showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (4.899). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the knee joint.

The results for the parameter of the range of movement of the elbow joint showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.292). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the elbow joint.

The results for the parameter of the range of movement of the ankle joint showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (4.796). Nithya Virechana with Gandharvahastadi Taila showed a highly significant improvement in the range of movement of the ankle joint.

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The results for the parameter of the range of movement of the wrist joint showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.477). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the wrist joint.

The results for the parameter of the range of movement of the metacarpophalangeal joints (first digit) showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.196). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the metacarpophalangeal joints.

The results for the parameter of the range of movement of the metatarsophalangeal joints showed a highly significant interpretation (p < 0.001) with the Wilcoxon signed-rank test – Z value (5.196). Nithya Virechana with Gandharvahastadi Taila showed a significant improvement in the range of movement of the metatarsophalangeal joints.

9. Angamardha

Table 9: Statistical analysis of Angamardha

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P Value
1.000	0.367	0.633	63.3%	BT	0.000	0.000	1.000	4.359	<0.001
1.000	0.367	0.633	63.3%	AT	0.490	0.0895	0.000	4.359	<0.001

The mean score of Angamarda before the treatment was 1.000, which reduced to 0.367 after the treatment, with a difference in means of 0.633. This difference was found to be statistically significant with a P value of < 0.001.

10. Gaurava

Table 10: Statistical analysis of Gaurava

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P Value
1.000	0.367	0.633	63.3%	BT	0.000	0.000	1.000	4.359	<0.001
1.000	0.367	0.633	63.3%	AT	0.490	0.0895	0.000	4.359	<0.001

The mean score of Gaurava before the treatment was 1.000, which reduced to 0.367 after the treatment, with a difference in means of 0.633. This difference was found to be statistically significant with a P value of < 0.001.

11. Alasya

Table 11: Statistical analysis of Alasya

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P Value
1.000	0.367	0.633	63.3%	BT	0.000	0.000	1.000	4.359	<0.001
1.000	0.367	0.633	63.3%	AT	0.490	0.0895	0.000	4.359	<0.001

The mean score of Alasya before the treatment was 1.000, which reduced to 0.367 after the treatment, with a difference in means of 0.633. This difference was found to be statistically significant with a P value of < 0.001.

12. Shoonatanga

Table 12: Statistical analysis of Shoonatanga

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		EM	Median	Z value	P Value
1.000	0.100	0.9	90 %	BT	0.000	0.000	1.000	3.000	0.004
1.000	0.100	0.9	90 %	AT	0.316	0.1000	0.000	3.000	0.004

The mean score of Shoonatanga before the treatment was 1.000, which reduced to 0.100 after the treatment, with a difference in means of 0.9. This difference was found to be statistically significant with a P value of 0.004.

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13. Apaka

Table 13: Statistical analysis of Apaka

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P Value
1.000	0.000	1	100%	BT	0.00	0.000	1.000	3.742	<0.001
1.000	0.000	1	100%	AT	0.000	0.000	0.000	3.742	<0.001

The mean score of Apaka before the treatment was 1.00, which reduced to 0.00 after the treatment, with a difference in means of 1. This difference was found to be statistically significant with a P value of < 0.001.

14. Aruchi

Table 14: Statistical analysis of Aruchi

Mean			Wilcoxon signed rank test
BT	AT	BT-AT	% of improvement	SD		SEM	Median	Z value	P Value
1.000	0.000	1	100%	BT	0.00	0.000	1.000	3.742	<0.001
1.000	0.000	1	100%	AT	0.000	0.000	0.000	3.742	<0.001

The mean score of Aruchi before the treatment was 1.00, which reduced to 0.00 after the treatment, with a difference in means of 1. This difference was found to be statistically significant with a P value of < 0.001.

Discussion

Virechana is considered an essential therapeutic procedure in Ayurveda that promotes the elimination of toxins (Ama) and balances the Doshas. In this study, the use of Nithya Virechana, a daily form of Virechana, showed promising results in the management of Amavata. Eranda Taila, the key ingredient in this procedure, is known for its effectiveness in treating diseases associated with joint inflammation, especially those related to vitiated Vata Dosha. The therapeutic benefits of this treatment were observed in the reduction of joint pain, stiffness, and swelling, which are common symptoms of Amavata.

Amavata, as described in Ayurveda, is a condition characterized by the accumulation of Ama (toxins) in the joints, which causes pain, swelling, and stiffness. These symptoms resemble those of rheumatoid arthritis, a chronic inflammatory disorder. The pathogenesis of Amavata involves interplay of aggravated Vata Dosha and the formation of Ama, which settles in the joints, leading to inflammation and joint dysfunction. This understanding aligns with modern clinical findings of RA, where the body’s immune system attacks its joints, causing systemic inflammation and discomfort. The study’s findings, including reduction in inflammatory markers such as C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR), further support the Ayurvedic concept of Amavata as an inflammatory disease.

Eranda Taila, with its potent properties of being Snigdha (unctuous), Tikshna (sharp), and Ushna (hot), is particularly effective in addressing Vata-related disorders. The use of Gandharvahastadi Eranda Taila in Nithya Virechana therapy was observed to reduce the inflammatory markers and alleviate the symptoms associated with Amavata. The anti-inflammatory properties of the oil, in combination with its detoxifying effects, helped in reducing joint swelling, tenderness, and stiffness. This aligns with the Ayurvedic view that such therapies can pacify aggravated Doshas and provide relief from inflammatory conditions.

The study methodology, which included a combination of subjective and objective markers such as Range of Movement (ROM), RA score, and inflammatory markers, proved to be an effective approach for assessing the clinical outcomes of Nithya Virechana. Significant improvements were noted in joint mobility across various joints, including the lumbar spine, cervical spine, wrist joint, and knee joint, confirming the treatment’s efficacy in improving flexibility and reducing pain. Additionally, the decrease in the RA score and inflammatory markers (CRP, ESR) demonstrated a reduction in systemic inflammation, highlighting the systemic benefits of the treatment.

The study shows that Nithya Virechana with Gandharvahastadi Eranda Taila is an effective therapeutic approach for managing Amavata. It significantly improved joint mobility, reduced pain, and decreased inflammatory markers,

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aligning with both Ayurvedic principles and modern clinical findings. The reduction in subjective symptoms like Angamarda, Gaurava, and Alasya further underscores the treatment's effectiveness in managing both the local and systemic manifestations of Amavata. Further studies with larger sample sizes and longer follow-up periods are needed to confirm the long-term benefits and to establish Nithya Virechana as a reliable treatment option for chronic inflammatory diseases like Amavata.

Conclusion

Nitya Virechana Karma with Gandharvahastadi Eranda Taila effectively alleviated the symptoms of Amavata by balancing Vata and Kapha Doshas. The therapy demonstrated significant reduction in pain, stiffness, swelling, and redness, while promoting Samshodhana and restoring Dosha equilibrium, thus enhancing overall health and systemic inflammation.

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J Ayu Int Med Sci 2025;10(4)21

Research Article

Rheumatoid Arthritis

Journal of Ayurveda and Integrated Medical Sciences

A clinical study to evaluate the effect of Nithya Virechana on range of movements of joints in Amavata w.s.r. to Rheumatoid Arthritis

Deeksha Nayaka HV1*, Kanthi M2, Rao N3

Introduction

Objective of the study

Materials and Methods

Results

Discussion

Conclusion

References

Deeksha Nayaka HV^1*, Kanthi M², Rao N³