Introduction
Arthritis represents a major global health challenge, affecting more than 350 million people worldwide and significantly impacting quality of life, work productivity, and healthcare expenditure. Globally, musculoskeletal disorders are among the leading contributors to disability-adjusted life years (DALYs), particularly in the aging population.
The term polyarthritis refers to inflammation involving five or more joints and encompasses a broad spectrum of disorders, including autoimmune, degenerative, and metabolic arthropathies. These conditions vary considerably in their pathophysiology but share common manifestations such as pain, inflammation, stiffness, and progressive joint dysfunction. 1,2
Clinical spectrum of polyarthritis
Polyarthritis includes several distinct clinical entities, each characterized by unique disease mechanisms.
Major conditions include:
- Rheumatoid arthritis (RA)
- Psoriatic arthritis (PsA)
- Systemic lupus erythematosus (SLE)
- Ankylosing spondylitis (AS)
- Osteoarthritis (OA)
- Polyarticular gout
RA is a chronic systemic autoimmune disorder characterized by synovial hyperplasia, pannus formation, and progressive joint erosion. PsA is associated with psoriasis and commonly presents with enthesitis, dactylitis, and joint damage. SLE frequently manifests as non-erosive polyarthritis accompanied by multi-organ involvement, while AS primarily affects the axial skeleton and sacroiliac joints. Osteoarthritis is characterized by cartilage degeneration, subchondral bone remodeling, and low-grade synovial inflammation, whereas chronic gout may progress to involve multiple joints due to monosodium urate crystal deposition.3
Limitations of conventional management
Current treatment strategies include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biological agents.
Although these therapies have improved disease outcomes, long-term use may be associated with:
- Gastrointestinal ulceration
- Hepatotoxicity
- Renal dysfunction
- Immunosuppression
- Increased susceptibility to infections
Furthermore, sustained remission is not achieved in all patients, highlighting the need for safe and accessible long-term management strategies.
Ayurvedic perspective on joint disorders
Ayurvedic medicine conceptualizes joint disorders under various classifications based on doshic imbalance and clinical features. Arthritic conditions may be understood under categories such as:
- Amavata
- Vatarakta
- Sandhivata
- Kuṣṭha-janya Sandhigata Vāta
These classifications provide a framework for understanding disease progression and therapeutic planning based on the predominant pathological factors involved.
Therapeutic relevance of Ayurvedic herbs
Several Ayurvedic herbs have demonstrated activity against inflammatory pathways involved in chronic arthropathies.
- Shallaki (Boswellia serrata):
- Shallaki has been shown to inhibit COX-2 activity, suppress 5-lipoxygenase pathways, and reduce leukotriene production, contributing to pain relief and cartilage protection.
- Guggulu (Commiphora mukul):
- Guggulu contains guggulsterones, which are recognized for their anti-inflammatory, antioxidant, and lipid-lowering properties.
- Ashwagandha (Withania somnifera):
- Ashwagandha exhibits immunomodulatory, anti-stress, and cortisol-lowering effects, making it relevant in autoimmune and chronic inflammatory conditions.
- Guduchi (Tinospora cordifolia):
- Guduchi is known for its TNF-α suppressing, macrophage-modulating, and antioxidant activities, supporting its role in inflammatory disorders.
Conclusion
Polyarthritis encompasses a diverse group of autoimmune, degenerative, and metabolic joint disorders that contribute substantially to global disability. While conventional therapies remain central to disease management, their long-term limitations have increased interest in integrative approaches. Ayurvedic concepts such as Amavata, Vatarakta, and Sandhivata, along with medicinal herbs including Shallaki, Guggulu, Ashwagandha, and Guduchi, offer important therapeutic perspectives for the long-term management of chronic arthropathies.4,5
References:
1. Eakin GS, Amodeo KL, Kahlon RS. Arthritis and its Public Health Burden. Dela J Public Health. 2017;3(1):36-44. Published 2017 Mar 22. doi:10.32481/djph.2017.03.006. https://pmc.ncbi.nlm.nih.gov/articles/PMC8352468/
2. Safiri S, Kolahi AA, Cross M, et al. Prevalence, Deaths, and Disability-Adjusted Life Years Due to Musculoskeletal Disorders for 195 Countries and Territories 1990-2017. Arthritis Rheumatol. 2021;73(4):702-714. doi:10.1002/art.41571. https://pubmed.ncbi.nlm.nih.gov/33150702/
3. Chia JE, Ang SP, Iglesias J, Krittanawong C, Mukherjee D. Clinical Characteristics and Outcomes of Acute Ischemic Stroke in Patients With Systemic Lupus Erythematosus. A Nationwide Cohort Study. Int J Rheum Dis. 2025;28(6):e70307. doi:10.1111/1756-185X.70307. https://pmc.ncbi.nlm.nih.gov/articles/PMC12169068/
4. Martillo MA, Nazzal L, Crittenden DB. The crystallization of monosodium urate. Curr Rheumatol Rep. 2014;16(2):400. doi:10.1007/s11926-013-0400-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC3975080/
5. Javed D, Verma R, Anwar S, Pandey R. Polyarthritis spectrum disorders managed by ayurvedic formulation arthocon: A clinical case series. Bioinformation. 2025;21(7):1901-1905. Published 2025 Jul 31. doi:10.6026/973206300211901. https://pmc.ncbi.nlm.nih.gov/articles/PMC12569900/#s6