Osteoarthritis
Osteoarthritis is the most common form of arthritis. The cartilage that cushions the joint slowly wears, causing pain, stiffness and reduced movement, most often in the knees, hips, hands and spine. In Ayurveda it is called Sandhigata Vata: aggravated Vata drying and weakening the joint. If knee pain is your main concern, see Knee Pain, which also covers causes other than osteoarthritis. Ayurvedic care may suit people with knee, hip, hand or spine osteoarthritis who want to ease symptoms alongside their usual medical care.
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- Pain that is worse with activity and eases with rest
- Stiffness after sitting or in the morning, usually lasting less than 30 minutes
- Grating or crackling (crepitus) in the joint
- Bony enlargement and reduced range of movement
Assessment & Treatment
- Consultation, joint examination and review of X-rays.
- Internal medicines, which may include classical formulations.
- Local therapies: Janu Basti (a warm medicated oil pool held over the knee) for knees, Patra Pinda Sweda (warm herbal bundles pressed on the joint), and Abhyanga (oil massage) with Swedana (sweat therapy, often using steam).
- Where suitable, a joint-care Panchakarma programme (a course of cleansing and nourishing treatments) with Basti.
- Strengthening exercise, weight and diet advice.
Precautions & When to See a Doctor
See a doctor for a joint that is hot, red and swollen, sudden severe pain, a locking or giving-way knee, or pain at night that does not settle. Seek urgent care for a swollen joint with fever, as this can mean an infection in the joint. Seek emergency care for numbness around the groin or buttocks, loss of bladder or bowel control, or new leg weakness, as these can signal a serious spinal problem. See a doctor promptly if you cannot put weight on a joint. Herbal medicines can interact with blood thinners and other medicines, so tell us everything you take. Do not stop prescribed medicines, such as painkillers or anti-inflammatories, without speaking to your doctor. Ayurvedic care here is complementary to your medical care, not a replacement for it. Tell us before starting herbs if you have liver disease, or if you are pregnant or breastfeeding. Keep active: regular exercise is a core part of osteoarthritis care.
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How Ayurveda Understands It
Because osteoarthritis is seen as Vata-driven degeneration, treatment focuses on nourishing and lubricating the joint: warm oil therapies, sweating therapies, Basti (a medicated enema) and Vata-balancing herbs, combined with diet, weight management and appropriate exercise.
What the Evidence Shows
Some Ayurvedic treatments for osteoarthritis have been tested in randomised trials, but the findings are mixed and need confirmation:
- A randomised trial found that a combined Ayurvedic treatment programme reduced knee osteoarthritis symptoms more than conventional care [1]. The authors call for further studies to confirm the effect.
- In a six-month randomised trial, standardised Ayurvedic formulations were equivalent to glucosamine and celecoxib for knee pain and function [2]. The same trial saw an unexpected rise in a liver enzyme (SGPT), which the authors say needs further safety assessment.
- A late-stage (phase 3) randomised trial in people with mild-to-moderate osteoarthritis found a herbal formulation not meaningfully less effective than diclofenac [3]. The authors call for larger, longer comparisons.
- In a randomised, placebo-controlled crossover trial (eight weeks on each treatment), Boswellia serrata extract reduced knee pain and improved knee movement and walking distance, but imaging showed no change in the joint [4]. Minor stomach side effects were reported.
- A 32-week placebo-controlled trial showed potential benefit of the formulation RA-11 [5].
However, a systematic review found no robust evidence for Ayurvedic massage, steam or enema on their own [6], and a diagnostic study found that Ayurvedic doctors agreed closely on the main diagnosis but agreed less well on constitutional details such as prakriti and agni [7]. Herbal results apply to the specific products studied.
Prepared by the AyurSoul Healthcare team from the published research listed below. Medical review by Dr. Hemlata Soni, BAMS is in progress. This page is for education and does not replace individual medical advice. Medical disclaimer.
Frequently Asked Questions
Is osteoarthritis just "old age"?
Age is one factor, along with weight, injury, genetics and joint load. Symptoms can often be eased at any age, for example with exercise and weight management.
Will I need surgery?
Many people manage well without it. If surgery is considered, that decision should be made with your orthopaedic surgeon.
Can I exercise with osteoarthritis?
Yes. The right exercise is strongly recommended. We will advise you on suitable exercise.
Clinical Research
7 studies: 1 systematic review / meta-analysis, 6 randomised trials.
Show the 7 studies
Numbers in the text refer to this list. Each study is labelled by type: systematic reviews and randomised trials are stronger evidence than pilot studies or single case reports.
- Kessler CS, Dhiman KS, Kumar A, et al.. Effectiveness of an Ayurveda treatment approach in knee osteoarthritis – a randomized controlled trial. Osteoarthritis and cartilage, 2018. Randomised controlled trial PubMed
- Chopra A, Saluja M, Tillu G, et al.. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford, England), 2013. Randomised controlled trial PubMed
- Modak MD, Barde MP. Efficacy of an Ayurvedic Formulation for Mild-to-moderate Osteoarthritis: A Phase 3, Randomized Controlled Study. Alternative therapies in health and medicine, 2017. Randomised controlled trial PubMed
- Kimmatkar N, Thawani V, Hingorani L, et al.. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial. Phytomedicine : international journal of phytotherapy and phytopharmacology, 2003. Randomised controlled trial PubMed
- Chopra A, Lavin P, Patwardhan B, et al.. A 32-week randomized, placebo-controlled clinical evaluation of RA-11, an Ayurvedic drug, on osteoarthritis of the knees. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2004. Randomised controlled trial PubMed
- Kessler CS, Pinders L, Michalsen A, et al.. Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis. Rheumatology international, 2015. Systematic review / meta-analysis PubMed
- Kessler CS, Morandi A, Kumar A, et al.. Reliability of Ayurvedic Diagnosis for Knee Osteoarthritis Patients: A Nested Diagnostic Study Within a Randomized Controlled Trial. Journal of alternative and complementary medicine (New York, N.Y.), 2019. Randomised controlled trial PubMed