Tuesday, October 2, 2018

Ayu Cafe Live chat - Sandhivata

Views shared by several Ayurveda professionals and non-Ayurveda people in discussion group:
All views shared here are only for knowledge. This information doesn’t have any scientific validation. Various doctors and non-medicos have shared their views and experiences in this discussion. Please do not try any of the suggestions described here, without prior consult from your regular, qualified doctor. Dr. Prerak Shah and no other person is responsible for any unwanted effects, side effects or contra-indications in your health. Thank you.
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Topic for discussion: Sandhivat
Ayulink:This is very comon complain we are facing in our practice. Usually we try to give shaman chikitsa to our patients. some times we also try to give diet advise.
4929: abhihata janya is one of cause
Vd. Ekta D. Patel: In which type of Sandhivata Agnikarma is best?  Degnrative or abhigataj
Ayulink:I mostly go for panchkarma. abhyang, svedana and basti are my favourite
71473: Abhighataja......

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Ayulink: I consider OA is more related with snadhivata! and for the diagnosis I also take help of x-ray / MRI
71473: In degenerative sandhivat we HV u to use dhatukshayajanya chikitsa
Dr. Shekhar Gole: Chikitsa should be aushadhi aahar and vihar so diet and exercise should also be advised with medicines
14929: In degenerative tikta kshree basti is useful
Dr. Pulkit Baxi: Sometime we found it  b coz of malnutrition too.
Ayulink:asthi dhatu kshaya?
Dr. Pulkit Baxi: I think if we use SANDHI THERE MUST B INVOLVEMENT OF -- JOINT
14929: not only asthi..snanyu also got invoved
Ayulink:Major question is: Sandhivata = degenrative disorders?
14929: no
Ayulink: Involvement of sandhi and asthi dhatu gat vata is different condition
71473: No. It may leads to degenative changes
14929: In inital stage there wont be degeneration..
Ayulink:sandhi vata = vata in sandhi...may be sandhi is disturbed or not. may be symptoms are there or not. May be degenration is there or not
Dr. Pulkit Baxi: Not agree sir. Some time only bones . We can see osteophytes
Ayulink:may be sandhi is paiful or not
Vd Ashish Kumar: सन्धि मर्म स्थान है।इसमे हमे रक्त,सन्धि,श्लेशक कफ,अस्थि,मांस की विकृति को देखना चाहिये
Ayulink:snayu gat vat is again different condition
Vd Ashish Kumar: मेद विकृति = स्नायु विकृति. मेद की उपधातु है स्नायु
Ayulink:sandhi vata is commonly refer as OA of knee joint. Can someone describe classical symptoms of sandhivata? according to text book?
Dr. Pulkit Baxi: I always try to give calcium supplements like Hadjod- shallaki etc along with abhyang swedan
Vd Ashish Kumar: 90% सन्धिवात परतंत्र निदान सेवन से होता है,जैसे कफ वर्धक आहार से स्थूलता और अवरोधजन्य सन्धिवात
Vd Rameshwar Dhanaji: vaatpurna druti sparsha shoth sandhigate anile prasaran akunchan pravrutish savedana
Ayulink:over exercsion, improper use of sandhi, excessive use of sandhi, improper postures, aahar - vihar are major cause
Vd Ashish Kumar: ज्यादातर वैद्य सीधे सीधे लक्षण के आधार पर केल्शियम के आयुर्वेद सप्लीमेंट्स उपयोग करते है वो ज्यादातर मामलों में रिजल्ट नही देते
14929: can we consider spondylolysis as sandivata
Vd Ashish Kumar: हेतु विपरीत चिकित्सा ही श्रेष्ठ है।
Vd Rameshwar Dhanaji: we should not forget kaphakshay in sandhigat vaat.
Dr. Shekhar Gole: Calcium absorption is also important
Ayulink:Spondylolysis is defined as a defect or stress fracture in the pars interarticularis of the vertebral arch.
Dr. Supratim Bir: And kafa nashak approach do work in great extent, specifically Agnikarma
Vd Ashish Kumar: कफ क्षय और वात प्रकोप के रोगी कृश होते है उसमे सीधे सीधे तैल स्नेहन अभ्यंग और स्निग्ध स्वेद लाभकारी है
Ayulink:can be considered under sandhivata
Dr. Madhura Phadtare: Differential diagnosis are-aamvaat,sandhigatvaat, vat rakta,kapha ksheen ,mans ksheen ,asthiksheen ,        avruta vaat-santarpanotha , kshayvaat vrudhi-apatarpnoth
Vd Rameshwar Dhanaji: avrutta vaat is also capable of doing kaphkshay
Vd Ashish Kumar: बस्ति सर्वश्रेष्ठ
14929: vatapoorna druthi sparsha shoto sandigate anile | prasarana akunchanauyo pravruthischa vedanam (charaka vatavyadi chik ). shushruta says shola shoopha.
Dr. Madhura Phadtare: Differential diagnosis are-aamvaat,sandhigatvaat, vat rakta,kapha ksheen ,mans ksheen ,asthiksheen ,        avruta vaat-santarpanotha , kshayvaat vrudhi-apatarpnoth
Ayulink:Can we consider Spondylolisthesis under sandhivata? Spondylolisthesis is the slippage or displacement of one vertebra compared to another.
71473: 2 types.....nirupsthambit Nd upasthambit.....according to type treatment will change
Neelamben Chudasma: For Sandhivat what oil we use for basti ?
Ayulink:asymptomatically we can use Maha narayan oil, Nirgundi oil, bala oil  etc.. for basti
Vd. Ahmed Savani: Janu Basti gives good results & improvement & VALUKA SWEDA thrice a day in Amavata induced Sandhivata!! My Question is Clinically (by examination) how to differentiate between the Sandhivata & Amavata
Vd. Kalpesh Makvana: Pichu is also good option in oa
Ayulink:That depends on your individual thinking. Yes, I would also consider VATA = Nervous system
Vd Rameshwar Dhanaji: hetu sevan is key in diagnosing the conditions.
Dr. Nilesh Patel: Mahanarayan taila, Kshirabala taila, Narayan taila, Nirgundi taila, Bala taila etc
Ayulink:pichu with which oil?
14929: In case of amavata shoota with stanika ushmata will be there..but in sandivata no ushmata
Vd. Kalpesh Makvana: I m using Murvenna oil pichu
14929: In amavata agravets with oil appl in sandivata it decreas
Dr. Nayan Gajera: If any arthritic pain not subside by vat chikitsa,then think about rakt
Dr. Pulkit Baxi: So. Instead of treating local symptoms should we try  to do something for nervous SYSTEM too ???
14929: In chornic case by seeing the pt leg we can diagnos the sandivata
Ayulink: Clinical symptoms: aamavata having inflammation, sandivata no aamavata in major joints (mostly), sandhivata in minor aamavata pain is constant, sandhivata no constant aamavat pain like scorpio bite, sandhivata not such strong
Neelamben Chudasma: How about exercise and yoga work for that?
Vd. Ahmed Savani: In degenerative case, we prescribe Trikatu, Arjuna, Ashwagandha, Punarnava, Godanti (in case of intense pain) Any Guggulu (MP: Yogaraja Guggulu, EBH, Agni Chikitsa. What's your thought process behind this?
Ayulink:EBH = erand brashta haritaki
Vd Ashish Kumar: आम वात= कोटमचुकादि, वात रक्त= क्षीरबला, सन्धिवात क्षय जन्य = धानवतर, शूल युक्त = महानारायण सब तैल निराम अवस्था में जानु बस्ति या पिचु उपयोग करें।
Vd. Ahmed Savani: Does in Sandhivata (especially Knee J.) Does Crepitation should always be present ❓❓
Dr. Nayan Gajera: No..
Ayulink:Not necessary....depending on the stage of degenration.
Vd. Ahmed Savani: Degeneration is progressive process not all of sudden!
Dr. Pulkit Baxi: Yes.
Ayulink:Lets start with treatment aspect. we have 30 min left in this session. Many friends are silent...let us give them opportunity to write something
Vd. Ahmed Savani: Sandhivata is usually BL.Ri8 Like OA?
Dr.Satish Panda: Mild sanshodhan give you a Long standing result
Vd. Ahmed Savani: Sandhivata before the age of 40 is uncommon, Always stressed on occupation, lifestyle! It's more of Amavata rather than Sandhivata (in my opinion)
Vd. Kalpesh Makvana: Ksheerbala aavrti cap also giving good results in sandivat
Dr. Shekhar Gole: Lakshadi Guggul , Yograj Guggul, Dashmoolarisht, Mahanarayan Tel
Vd Ashish Kumar: सभी आमवात जीर्ण अवस्था मे सन्धिवात बन जाते है या उन्हें सन्धिवात की चिकित्सा करनी चाहिए,आप पाचन के बाद।
Dr.Satish Panda: For savere pain use nirgundi
Vd Ashish Kumar: आप= आम
Dr. Shekhar Gole: If swelling is there give Punarnava Guggul
Dr. Nayan Gajera: For any type of pain Dashmool tail + dhanvantar tail.matra basti give good results
Dr. Yogin Patel: Can we do panchkarm in rainy season in oa ? Or abhyang of oil in rainy season? I think It will increase pain & swelling
Vd Ashish Kumar: वर्षा ऋतु में तो बस्ति करना ही है।
Dr. Shekhar Gole: Yes
Vd. Ahmed Savani: What could be the  reasons behind the Ushnata in AV & no Ushnata in SandhiVata (SV)?? Pls explain. Agreed
Dr. Shekhar Gole: Ans was by mistake
Vd. Shrinidhi: Well we need to also keep in mind gata vata concept and go with pancha tikta grita 10 ml bid with . lakshadi guggulu with maha rasnadi khada will give satisfactory result along with local application of  kottamchukkadi taila or maha narayana taila will be benificial
Vd. Sachin Kadlag: If Dhatookshaya is origin than Snehana   is first line of treatment . while Swedana  is first line of treatment i f Aavarana is origin
14929: In case degenaration ..wr asthi kyasa will be there nd vata vruddhi.. so thikta rasa is agni deepaka nd pachak but vata vruddhi kara.. so by  adding ksheera wch is balya so it reduces vata prakopa due to tikta rasa dravya .. in case of degeneration process there wil be ashi gata dhatu agni mandya so.. tikata rada basti is adviced
Vd. Sachin Kadlag: Anuvaasan  basti is useful in dhatookshaya while  mainly Niruha in Aavarana .
Vd. Ahmed Savani: Above of all in Amavata, Pain is more & along with the stiffness @ the time in morning from wake up, get bit relief after performing some action. While in SandhiVata, Pain is constant & increased while doing any activity like walking etc!!
14929: avarna mimics like amavata..
Vd. Sachin Kadlag: yes
Vd Ashish Kumar: अवरोधजन्य या सन्तर्पण का भी बताएं
Ayulink:most common hoe remedy is use of fenugreek, ginger, castor etc. Ginger is good for sandhivata
Vd Ashish Kumar: कैसे उपयोग करना है।
Ayulink: Similarly Fenugreek tea made from fenugreek seeds  are good
14929: i usly prescribe Rasana sapktata or maha rasnadi kashays with yogaraja or trayodasghanha
Ayulink: ginger powder form with diet or with water
14929: with agnitundi
Vd. Sachin Kadlag: When rakta is involved sthaanik rakta mokshan is sometomes useful
Ayulink:Prepared medicines are lot available with ginger and other vata shaman herbs
Dr. Shekhar Gole: Ginger garlic paste along with castor oil for local application is also useful
14929: lashuna kshrera paka readucez pain
Ayulink: Rasna, ahswagandha, bala, guduchi, guggulu, nirgundi, shallaki all are herbs whichw e sue frquently
Vd. Sachin Kadlag: Ginger juice externally  in Aavarana janya sandhivaata or Saama condition useful to relieve upastambha and avarodhajanya shotha
Ayulink: yogaraj guggulu, sinhanad guggulu, rasnadi guggulu, tryodasang guggulu, shallaki all are guggulu preparations are most commonly practiced by vaidyas. pind sveda is also good for local treatment.
14929: along with horse gram can we use with ginger padte
Vd. Ahmed Savani: In decoction form i.e Kwatha or Phanta (personal experience) along with Jeeru (Cumin)
Vd. Manhar Prajapati: We are using agnikarm at pain point it works good
Dr. amit Jain M. P: Sinhanad gugul
Dr. Pulkit Baxi: So finaly we come to DIPAN PACHAN.  FROM WHERE ACTUALLY WE SHOULD START? Without dipan pachan no role of calcium supplements etc
Ayulink: Agnikarma is now in days becoming popular treatment
Vd. Ahmed Savani: This is really good, have to try on someone. Isn't for transient relief?
Vd. Manhar Prajapati: Will try
Vd. Ahmed Savani: Agreed, Agni Chikitsa is must!
14929: daily pichu can be used
Ayulink:we dont have actually scientific data avaibale for agnikarma. Thousands of practitioners are doing agnikarma, but very rare published paper on it
Vd. Ahmed Savani: That doesn't resolve the pathology, isn't?
Ayulink: and too with long term follow up records. How about kwath? and asava and arishta? anybody using it for sandhivata?
Dr. Shekhar Gole: Is agnikarma only pain management ?
Vd. Manhar Prajapati: It's syptomatic releif sometimes it cure also?
Vd. Ahmed Savani: But does that give prolonged relief in the complaints, I doubt 
Vd. Manhar Prajapati: Daily 10-15 pt we are use
Vd. Ahmed Savani: Dashmula- aristha & Kwatha, as it vatahara & shulahara both! Rasnadi Kwatha. Any Data you possess ?
Vd. Manhar Prajapati: First think daily we see knee pain pt is it really sandhivat according defination ?
29104: Panchtikhta ksheer basti is best in degenerative changes.. Osteo changes
Dr. Samir Suneri: Oil application of kapoor and menthe And after that some heat application like Linda swed is very usefull
Dr. Pulkit Baxi: So this would b my prescription If sever pain use -  Agnikarm Otherwise Dipan pachan AUSHDHI FIRST, Calcium supplements, ABHYANG SWEDAN , MAHARASNA KADHA. ANY GUGGLU  PREPARATION.IF SEVER DEGENARATION  THEN GOLD PREPARATION
Vd. Manhar Prajapati: What kind of dose u prefer?
29104: 450ml - 500 ideal dose
Dr. Subroto kumar Das: Aamvata starts from small joints like finger joints/ phalanges and then it may spread to other joints. It later cause deformity is joint as seen as Swan neck deformity in R.A. hands. Sandhivata on the other hand happens in weight bearing joints like hip, knee etc. Mostly sandhivat is unilateral in appearance.
Dr. Pulkit Baxi: Including BASTI
Vd. Sachin Kadlag: Guduchi ksherr basti 250 ml is given in my clinic
Dr. Supratim Bir: Obviously it resolves Pathology, it's a wonderful therapy. Need several sitting with medicinal assistance. It mainly works with instant aampachan
USA C. Monsanto: According to my research and cross-referenced with hundreds of field observations, I have explored Charaka's explanation of pragyaparadhana. I've discovered that there is a more fundamental level from where we can look at the disturbance of tri dosha, which is the level where prana, tejas and ojas get disturbed by what Charaka describes as the psychophysical actions that accompany the imagination of an immediate danger. According to observation, fear-control disturbs prana and therefore vata; sadness-anger disturbs tejas and therefore pitta and rejection-disassociation disturbs kapha. Areas that are affected in these subtle actions are fear-control - sthapani-basti; sadness-anger - nila/manya-nabhi; rejection-disassociation - adipati-hridaya-guda (including legs and feet). The way that fear-control expresses through tension and tightness. Sadness-anger expresses as heat, burning, swelling and inflammation. The way that rejection expresses is through pressure, heaviness and absence. The combination expreses as numbness, ache and pain, which is an composite expression of feeling powerless, frustrated and helpless.
In older age there is more fear and sense of loss of control and feelings of helplessness and powerlessness. Hence, more tension and pain. This tension and fear are negative vata, or prana, contracting or keeping sadness (heat) from expressing, producing burning. And when we suppress or reject this discomfort inside the body, pain arises. Pain is tight, burning and pressure or fear, sadness and rejection - negative vata, pitta and kapha. This will manifest in the areas where sthana is weakest and that relate to old physical and or psychological trauma. Each main marma-chakra relates to certain theme. For instance hridaya relates to opening one's heart to others or connecting with others. Arms extend from this Chakra, reaching out to others. When older people experience difficulties connecting on a human level and reaching out is difficult, and feel fear and or powerlessness, they develop pain and tension in the arms and hands, tension and pressure and or pain in the chest area. A precursor of osteoarthritis, heart problems and high BP. One can observe these signals long before the onset of osteoarthritis itself and guide patients, or clients to become aware of and resolve their emotional blocks. This is how we can approach from the point of view of Sattvavajaya chikitsa.
14929: use kshya janya kb taila shuddha bala taila maha narayana we can u use.
71473: Bala guduchyadi kashayam, Yograj guggul, Guggultiktak kwath tablet, Ksheerbala tail capsule, Along with panchakarma.....basti chikitsa.....yoga basti or matra basti....
29104: If there is swelling... Upnaham swednam Or dashmoola ksheerdhara goes well also.
Dr. Afzal mohammad qureshi: Nirgundi and sallaki maybe same drug
Vd. Ahmed Savani: Any paper supporting this fact? Pls do share Bcoz What I come across, patients feel better, complaints get relieved ...but the pathology remain as it is in MRI or any imaging studies...from the database of Global Agnikarma Centre, what I remember!!
Dr. Supratim Bir: In such way Helps to resolve avaran janna Vata prakop.
14929: usely dhahavantara taila usely i prescribe
71473: Dhanwantar tail, Mahanarayan tail, Dashmool  tail, Sahachar tail, Bala tail
Vd. Ahmed Savani: In some patients I tried using Dhanvantari Taila in Patra Pinda Swedana (Nirgundi)
Dr. Afzal mohammad qureshi: In sab telon ko milakar
Dr. Subroto kumar Das: They are different. Vitex nigundo and boswellia serrata. Refer D.G. Texts.
Vd.manisha Kanchare: I prefer shdangodak full day for aampachan
Dr. Supratim Bir: AK do cure almost every pain instantly. But in avaran janna Vata prakop the sustainability can be observed. In IVDP Agnikarma and niruha vasti both procedure cure the pain but physical change can't be observed in MRI. That indicates the modern Pathology is not the last word.
Vd. Shrinidhi: Prasarini taila in few pt gives good results also when given orally in 2 ml dose but no consistent result
14929: useful in dhatuksha with reduced degree of  movemnt  janaya
Vd. Hardik bhatt: Lashun kshir pak is good for aamavata . And all vat vyadhi disorders
Compiled by - Dr. Dhruti Kagrana

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