Introduction
Osteoarthritis (OA) is a degenerative disease of joints that impacts hundreds of millions of individuals worldwide and is a leading cause of long-term pain and physical disability.1 It is most commonly reported in the hip, knee, hand, foot, and spinal joints.2 The knee joint is most frequently affected, characterised by irreversible degeneration of articular cartilage involving femoral, tibial, and patellar surfaces.3 Clinical features include joint pain, soreness, restricted mobility, crepitus, intermittent effusion, and varying degrees of local inflammation. In India, knee OA prevalence has been reported at 28.7%.4
Clinical manifestations and disease burden
- Joint discomfort and persistent soreness
- Mobility restriction with progressive functional limitation
- Crepitus and intermittent effusion
- Local inflammatory changes of variable intensity
- High prevalence burden, particularly in knee OA cases
The primary treatment goals in OA include pain relief and preservation of physical function. However, conventional management offers only symptomatic control through analgesics, with no definitive preventive or curative pharmacological option. Non-steroidal anti-inflammatory drugs (NSAIDs) remain the most commonly used agents, though primarily for symptomatic relief.
Ayurvedic correlation and pathophysiological understanding
- OA is correlated with Sandhigata Vata, where Vata is vitiated in joints
- Sandhi refers to joints and Vata governs structural and functional equilibrium
- Progressive degeneration occurs due to Vata vitiation with advancing age.5
- Represents a chronic degenerative spectrum linked with physiological imbalance and ageing
Ayurvedic therapeutic approaches
Ayurveda describes multiple formulations and therapeutic strategies for Janugata Sandhivata, including:
- Yograj Guggulu
- Ashwagandha Churna
- Narayana Taila
These formulations have been reported as beneficial in managing joint degeneration and associated symptoms.
Therapeutic actions of key formulations
Yograj Guggulu:
- Widely used in arthritis and myalgia
- Exhibits analgesic (vedanasthapana) and anti-inflammatory (shothahara) actions
- Supports dosha equilibrium (vata, pitta, kapha)
- Enhances metabolism (agni) and physical strength (bala) through deepana, pachana, and rasayana properties
- Improves general functional status in age-related metabolic decline
Ashwagandha (Withania somnifera):
- Exhibits vatahara, shothahara, vedanasthapana, and rasayana effects
- Provides bone and muscle nourishment through brumhana (dhatu pushtikara) action
- Supports structural integrity and functional restoration in degenerative conditions6
conclusion
OA represents a major degenerative joint disorder with increasing prevalence and limited curative options in conventional medicine. The condition closely aligns with Sandhigata Vata in Ayurveda, where progressive Vata vitiation leads to joint degeneration. Ayurvedic formulations such as Yograj Guggulu and Ashwagandha offer multi-dimensional therapeutic actions including analgesia, anti-inflammatory effects, metabolic enhancement, and tissue nourishment. These approaches provide a structured alternative framework for symptomatic management and functional improvement in OA, particularly knee involvement.7
References:
1. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039-1049. doi:10.1002/art.1780290816. https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0004-3591&date=1986&volume=29&issue=8&spage=1039
2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646-656. https://pmc.ncbi.nlm.nih.gov/articles/PMC2572542/
3. Nasser Y, Jennane R, Chetouani A, Lespessailles E, Hassouni ME. Discriminative Regularized Auto-Encoder for Early Detection of Knee OsteoArthritis: Data from the Osteoarthritis Initiative. IEEE Trans Med Imaging. 2020;39(9):2976-2984. doi:10.1109/TMI.2020.2985861. https://ieeexplore.ieee.org/document/9057550
4. Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop. 2016;50(5):518-522. doi:10.4103/0019-5413.189608. https://pmc.ncbi.nlm.nih.gov/articles/PMC5017174/
5. Mangal A, Shubhasree MN, Devi P, et al. Clinical evaluation of Vatari guggulu, Maharasnadi kwatha and Narayan taila in the management of osteoarthritis knee. J Ayurveda Integr Med. 2017;8(3):200-204. doi:10.1016/j.jaim.2017.02.001. https://pmc.ncbi.nlm.nih.gov/articles/PMC5607387/
6. Witt CM, Michalsen A, Roll S, et al. Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee--study protocol for a randomized controlled trial. Trials. 2013;14:149. Published 2013 May 23. doi:10.1186/1745-6215-14-149. https://pmc.ncbi.nlm.nih.gov/articles/PMC3664613/
7. Kachare K, Makhija D, Sharma A, et al. Evaluation of Yograj Guggulu, Ashwagandha Churna and Narayana Taila in management of Osteoarthritis Knee: A study in tribal dominant community. J Ayurveda Integr Med. 2025;16(2):101077. doi:10.1016/j.jaim.2024.101077. https://pmc.ncbi.nlm.nih.gov/articles/PMC12023793/#cebib0010