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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
Ayulink:yes
14929: not only asthi..snanyu also got invoved
Dr. Pulkit Baxi: But in OA WE CAN SAY ASTHI DHATU
KSHAY OR ASTHI DHATU GAT VAT
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
Dr. Pulkit Baxi: YES. BUT NOT ALWAYS. I SHOW SO MANY YOUNG PERSONS ALSO SUFFERED
FROM LACK OF CALCIUM ND SO PAIN IN JOINT ND WEAKNESS OF BONES
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 ?
Dr. Pulkit Baxi: I think where ever pain we should
consider VAT ND SO NERVOUS SYSTEM TOO.
AS PAINKILLER OF ALLOPATHY DIRECTLY WORK ON NERVOUS SYSTEM ND RELIEVE PAIN. IN AAYURVEDA ARE WE CONSIDERING NERVOUS SYSTEM
INVOLVMENT???
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
Dr. Pulkit Baxi: GINGER TAB. AVAILABLE IN HIMALAYA
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
Compiled by - Dr. Dhruti Kagrana
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