E-ISSN:2456-3110

Case Report

Sandhivat

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Ayurvedic management of Sandhivat - A Case Study

Dawar J1*, Jain R2, Sing D3
DOI:10.21760/jaims.10.5.37

1* Jitendra Dawar, Post Graduate Scholar, Dept of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

2 Rajesh Jain, Lecturer, Dept of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

3 Devjinder Sing, Post Graduate Scholar, Dept of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

Knee arthritis is the analogy of Vatavyadhi termed as Sandhivata in Ayurveda possessing similar symptoms like pain, limited range of motion, crepitus with bony enlargement. Vata is vitiated by Rooksha Aahar (Dry food material) and Ativyaama (Excessive exercise). It mostly affects the body's weight-bearing joints, particularly the knee, hip, and lumbar spine Sandhigata Vata is the most frequent type of articular condition, and it makes daily activities like walking, dressing, and bathing difficult for the person. Shula, Sotha, Vata Poornadriti Sparsha and difficulties flexion and extension of the Sandhi are the most common symptoms of the condition. The allopathic treatment provides the symptomatic relief but the underlined pathology remains untreated due to absence of effective therapy and also giving rise to many side effects, toxic effects and adverse reactions.

Keywords: Osteoarthritis, Sandhivat, Joint Degeneration, Cartilage Wear, Synovial Fluid Reduction, Inflammation, Joint Pain, Stiffness, Ayurvedic Treatment

Corresponding Author How to Cite this Article To Browse
Jitendra Dawar, Post Graduate Scholar, Dept of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.
Email: 		Dawar J, Jain R, Sing D, Ayurvedic management of Sandhivat - A Case Study. J Ayu Int Med Sci. 2025;10(5):246-249.
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https://jaims.in/jaims/article/view/4713/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-09 2025-04-26 2025-05-06 2025-05-16 2025-05-26
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© 2025 by Dawar J, Jain R, Sing D 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].

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Jitendra D et al. Ayurvedic management of Sandhivat

Introduction

In India, 15% of the population has arthritis. Even though better nutrition and cleanliness have extended life expectancy, the prevalence of arthritis has grown.[1] In India, the prevalence of osteoarthritis, one of the most prevalent Osteoarthritic conditions, ranges from 22% to 39%. Women are more likely than men to have OA.[2] The age range that this condition primarily affects is 40. By the age of 40, almost everyone has some kind of pathologic alteration in their weight-bearing joints.[3] Sandhivata is a Vatavyadhi affecting people in the Vridhavastha.[4] Because vitiated Vata is reflected in Dhatu Kshaya and Lakshanas, which are characteristics of the ailment, Dravyas, which have the qualities of Brimhana, Shoolahara, Stambhahara, and Balya, are part of the diet and treatment. The Vedic literature does not specifically describe Sandhivata as a sickness. A mention of Ashwinikumaras' expertise in treating joint disorders may be found in the Rigveda.[5] With the exception of Sharangadhara Samhita, Samhita Granthas have detailed illness of the Sandhivata with Lakshana and Chikitsa under Vatavyadhi. Current science has conducted a great deal of study and provides a thorough description of the condition, but as of yet, medicine has not found a cure for OA, which has led to an increase in the use of alternative remedies.

Case Report

History of present illnesses

A 55-year-old female patient was asymptomatic nine months prior, but over time, she developed symptoms like minor swelling in the right knee joint since three months, stiffness in both knee joints since five months, and pain in both knee joints and trouble walking since 7-8 months. Which are briefly mentioned in Table 2. She experienced recurring constipation problems, which are type 1 in consistency [Table 3]. Even after taking an analgesic, there was no improvement in the symptoms, which were only growing worse over time. The patient did not have a history of diabetes mellitus or hypertension. In order to receive Ayurvedic treatment, she went to the outpatient department of the Pt. Khushilal Sharma Government Ayurvedic College and Hospital in Bhopal, Madhya Pradesh, India, specifically the OPD of the Arthritis Clinic (Aamvat).

Examination of patient including vitals examination, Ashtavidha Pariksha (eight systemic examination) & specific locomotor system examination is mentioned in Tables 4, 5 & 6, respectively, & after obtaining written inform consent, treatment was started on inpatient department level.

Table 1: Demographic detail

Age55
SexFemale
AddressKolar
OccupationHouse wife
OPD no. / IPD no.20240044351
Marital statusMarried
Socioeconomic statusMiddle class

Table 2: Chief Complaints

SNChief complainDuration
1.Pain in both knee joint (right >left)6 Month
2.Difficulty while walking6 Month
3.Stiffness in both knee joints for less than 20 min5 Month
4.Mild swelling in right knee joints3 Month
5Lower back pain4 Month

Pain assessment by SOCRATES

  • Site - Both knee joint, lower back
  • Onset - Chronic
  • Character - Dull pain
  • Radiation - Absent
  • Associated Symptoms - Constipation
  • Time - 6 month
  • Exacerbation - Pain increased with physical activity
  • Severity - Moderate

Table 3: Associated Complain

SNAssociated ComplainDuration
1.ConstipationOn/Off

Past History - No history of trauma or fall was reported.

Medication History - Patient had not taken any previous treatment.

Personal History

Food Habits: Excessive intake of spicy food

Sleep: Disturbed due to pain

Addiction: No any addiction of alcohol and tobacco.

Family History: No significant family history was reported.


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Jitendra D et al. Ayurvedic management of Sandhivat

Table 4: Ashtavidha Pariksha

NadiVata, Pitta
MalaSama Mala
MutraSamyak
JivhaNirama
ShabdaPrakrut
SparshaSheetushana
DrukaPrakruta
AakrutiMadhyam

General Examination

Table 5: Vital Examination

Blood pressure130/90 mmHg
Respiratory Rate17/Min
Pulse75/Min
Temp.98.4°F
PainKnee joint, lower back

Table 6: Other general examinations

SNOtherFindings
1.PallorAbsent
2.IcterusAbsent
3.ClubbingAbsent
4.CyanosisAbsent
5.OedemaAbsent
6.Lymph nodeAbsent

Examination for Locomotor System (systemic examination)

Inspections

  • Difficulty and pain in both knee joints while walking for long duration
  • Mild Swelling over right knee joint
  • Knee flexion deformity on right knee (genu varum deformity)
  • Heberden node absent
  • Reflexes are intact
  • No any scar
  • No varicosities are seen
  • No any structural deformity in left knee joint

Palpation

  • Crepitus present in both knee joints
  • Affected flexion and extension of right knee joint

Range of movement (ROM)

Right knee joint

Flexion at right knee joint, 60° Extension of right knee joint 0°

Left knee joint

Flexion at Left knee joint, 70° Extension of right knee joint 0°

Tenderness

Right knee - Present
Left knee - Absent
Warmness - absent on both knee joint
Anterior drawer - Absent
Posterior drawer - Absent

Investigation (X - Ray B/L knee joint AP view)

jaims_4713_01.JPG

Finding of knee joint x-ray

  • Medially tibiofemoral epicondylar space reduced
  • Sub chondral sclerosis seen in both knee joints

Treatment: The following oral medicines were given

Table 7: Sanshamana Aushadha

SNMedicineDoseDurationAnupana
1.Ashwagandha Churna
Godanti Bhasma
Pippali Churna		3 gm bd
500 mg
500 mgjaims_4713_03.JPG1×2 Matra
1 hour after meal		2 monthsMaharasnadi Kwatha
2.Maharasnadi Kwatha20 ml 1 hour after meal2 months
3.Nucart OA2 bd 1 hour after meal2 monthsMaharasnadi Kwatha
4.Rasnadi Guggulu250 mg bd 1 hour after meal2 monthLuke warm water
5.Physiotherapy6 days

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Jitendra D et al. Ayurvedic management of Sandhivat

Table 8: Numerical rating scale (grading system of pain)

SNSymptomsBTAT
1Both knee joint pain72
2.Lower back pain60
3.Difficulty in while walking93
4.Stiffness81

jaims_4713_02.JPG

Discussion

Ashwagandha Churna - Ashwagandha, known scientifically as Withania somnifera, is a traditional herb used in Ayurvedic medicine. In the context of Sandhivata, which is the Ayurvedic term for joint disorders or arthritis, Ashwagandha is often used for its anti-inflammatory and pain-relieving properties.

Godanti Bhasma - Given that it is a good source of calcium, it should be utilized in cases of malnutrition and osteoporosis linked to Sandhivata.

Rasnadi Guggulu - Rasana has painkiller property.[6]

Tablet Nucart OA - This tablet is a nutritional supplement which is used to provide nutrition to the cartilages in conditions such as osteoarthritis. Its content extract of Boswellia serrata, and Chingali Satva acts as active ingredients which improves joint mobility and prevents cartilage deterioration.[7]

Conclusion

Early diagnosis and treatment using Shaman medicines and physiotherapy can effectively cure Sandhivata.

References

1. Satyalakshmi K. Clinical naturopathy yoga: A manual for physicians and students. 1st ed. Pune: National Institute of Naturopathy, Ministry of AYUSH, Bapu Bhavan; 2017. Chapter 34, p. 385 [Crossref][PubMed][Google Scholar]

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