Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma

Amavata is a disease in which vitiation of Vata Dosha and accumulation of Ama take place in joint(s), and it simulates rheumatoid arthritis (RA) at modern parlance. Shamana (conservative) and Shodhana (biological purification of the body) treatments are advised in Ayurveda whereas anti-inflammatory, analgesics, steroids, and disease-modifying antirheumatic drugs are required for its management as per modern medicine, which are not free from side effects. A female was suffering from multiple joints pain with swelling, severe morning stiffness, restricted movements, malaise, and Mandagni (poor appetite) for the past 1½ year, which was classified as Amavata/RA (having 7/10 score as per the RA classification criteria, 2010). After Deepana-Pachana and Snehapana, Virechanakarma was done by the administration of Trivrita Avaleha and castor oil. The assessment was made on the basis of relief in signs and symptoms and serological findings of RA factor, C-reactive protein (CRP), immunoglobulin E (IgE), and erythrocyte sedimentation rate. After Virechanakarma, RA factor reduced from 94.0 IU/ml to 50.0 IU/ml, CRP reduced from 22.7 mg/L to 1.8 mg/L, and IgE was reduced from 680 kU/L to 53.7 kU/L, with remarkable reduction in joints pain and swelling. Further, by avoiding specific Nidanas, i.e., known allergens for food, drugs, and inhalants, the patient has relief in almost all signs and symptoms for the past 1 year of follow-up with least medications. This single case report highlights that Amavata/RA can be managed with appropriate diet regimen, Virechanakarma and can be managed effectively with minimum requirement of medicines.