Expert Article: Joint Care In Monsoon Season; Medicinal And Non-Medicinal Measures To Manage Joint Pain

There are six seasons observed in India, viz. Shishir - late winter, Vasant - spring, Grishma - summer, Varsha - monsoon, Sharad - autumn and Hemant - early winter. The first three seasons are referred to as Aadan Kala or northern solstice. The last three are referred to as Visarga Kala, i.e., southern solstice. The Monsoon season, or Varsha Ritu, is the first season in the southern solstice.

The atmosphere during the Varsha Ritu leads to changes in body humour and the body's strength, i.e., host defence and immunity at its low and digestive strength at its low. Certain diseases may increase due to changes in the internal atmosphere due to changes in the external atmosphere. Visha (poison - microbial toxins or toxins) and Ama (an intermediate or accumulated waste product of metabolism) increases in the body, which may lead to different ailments.

Patients suffering from the disease of the respiratory tract, alimentary tract, joint and muscle diseases, cold and cough, infective and paraxial diseases, infective liver diseases like jaundice, malaria etc., may find difficulty during this period the morbidity rate increases during this period.

During the monsoon, a patient suffering from different types of arthritis often observes increased symptoms and worsening of the medical condition. Read on to know the dos and don'ts to reduce the problem and symptoms of arthritis and proper joint care.

Effect Of Atmospheric Changes And Increase In Morbidity

It is to clarify that disease is the change of the body's internal environment that may be produced by an external agent or interaction of external agent and internal atmosphere and changes in internal body atmosphere. As per the concept of Robert Koch,' the disease is caused by the small organisms, i.e., pathogen or microbes. This concept is not wrong, but the mere presence of the pathogen is not a disease; moreover, the human being remains the reservoir or source of infection; thus, ancient Ayurveda scholars opined disease to be broad as Doshaja (caused by changes in equilibrium of Doshas) and Agantuja. There is the interaction of physical, chemical, and biological stresses on different tissues in the body. When it fails, it leads to malformation, i.e., disease.

As per Ashtanga Hridya, the body humour gets vitiated during the rainy season; Vata vitiates prominently in the season, but all the three humours, i.e. Vata, Pitta and Kapha, get vitiated during this season. Moreover, the physical changes in the environment increase moisture, cloudy weather, and lack of proper sunlight produce amlatva. This favours the growth of different fungi, putrefying and fermenting microbes. All these factors change the body's internal atmosphere and tissue homeostasis. This leads to microbial dysfunction that may lead to different ailments.

Concept Of Ama And Joint Disease

Ama may be a new term for the majority but is not a new term for Ayurveda. Ama is an intermediate product of metabolism, inflammatory molecules, etc., collectively known as Ama. Ama is produced due to three reasons, viz. absolute or relatively reduced functions of Agni (enzyme and/or hormones), accumulation of waste materials that are supposed to be liberated out or production of intermediate products that don't get metabolised (synthesis or formation of different types of cytokines). When these cytokines get realised, it leads to an inflammatory reaction. This includes leaking capillaries, white cells, and a few red cells getting into interstitial space; macrophages and neutrophils are usually high in the area. This leads to increased warmth, swelling, restricted functions, etc. manifests.

Different physical stressors can affect body tissues, and this produces Ama. Ancient Indian medical scholars opine that cloud formation, morning hours, night, and cold, increase these intermediate products of metabolism and cytokines that lead to restricted movements, stiffness in joints, swelling, and pain in joints.

It has been observed that patients suffering from rheumatic problems, i.e., RA, arthritis, SLE (lupus disease), scleroderma, myalgia, etc., increase in symptoms or problems during monsoon season and winter season. This is because the environmental factors affect the internal atmosphere and lead to increased symptoms and disease.

Non-medicinal Measures To Manage Joint Disease In Monsoon

As narrated above, the joint problem increases during the monsoon and winter, which can be managed by certain lifestyle and diet measures that help reduce the problem and ensure the quality of life during the rainy season.

Addition of condiments - Some can be used in regular food, especially vegetables and Dals and dry additives to control the disease.

Methi (Fenugreek) - Methi is a commonly used condiment in Indian households. As per Ayurveda, it is bitter and has the qualities of controlling Vata Dosha, increasing gastric digestion and metabolism. Therefore, it is used in diseases originating from Vata. It is rich in water-soluble Vitamin B group and Vitamin C and A. In addition, it contains essential minerals like zinc, iron etc. The important active ingredients in Methi were trigonelline, lysine and l-tryptophan, making it the best choice to control different diseases.

It may be used for controlling cholesterol (and correcting dyslipidaemia); experimental studies on mice have shown a positive effect on cholesterol gall stones and reduces blood sugar. It is also used in managing arthritis for controlling pain and inflammation. It can be used as a dry powder with Jira (cumin seeds) and Ajwain (thymol seed) in equal quantities or ten seeds soaked in water and drinking eating seeds.

Ginger - Dry and fresh ginger are both commonly used condiments in Indian houses; ginger is liver protective, and dry ginger also possesses anti-inflammatory and pain-relieving action. Ginger is mostly safe, but excessive use in very high doses may lead to acid peptic syndrome in a few cases (allergic response). Dry ginger can be used with an equal quantity of turmeric (not more than two gms) after meals to relieve joint pain and inflammation.

Ginger can also be used as ginger water or ginger decoction. This can be prepared with approximately 1 tsp (5 gms) of ginger in water. 80 ml, boiling it to half and then taking lukewarm. It can also be taken with castor oil.

Turmeric - This herb is the source of curcumin. The extracted curcumin is used for medical management of rheumatic disease, muscular disease, metabolic syndrome, arthritis, anxiety etc. this alkaloid is present in turmeric, a common condiment used in Indian homes that can be used with ginger as described for better effects.

Hing (asafoetida) - Asafoetida is best known for its carminative action. In the household, this is used in abdominal pain internally and externally. In ancient Ayurveda classics, asafoetida is also used for managing cardiac emergencies. Yadavaji Trikamaji Acharya narrated the use of Hingukapur Vati in cardiac disease and emergency (shared in his clinical experiences). It is a good source of antioxidants and possesses anti-inflammatory and pain-relieving action. This can be used as condiments in different vegetables or dal.

Food And Diet Management

Diet planning is important during the rainy season. Physical activity is often compensated, and energy needs are slightly reduced during the season. Moreover, there is the possibility of increased free radical formation (Ama formation). Therefore, food suitable for individual and digestive strength may be used. There is a need to reduce calorie intake by approx. 20% by reducing glucose with a proper protein intake and a modest amount of lipids.

Fasting: This is commonly practised during the rainy season in India; traditionally, the fasting festival happens to be observed during the four months of rain, starting from Ashadha month to Kartak month (July to October). Fasting one mealtime a week may help to detox the body easily. Detoxing the body naturally reduces the problem and ensures a better quality of life.

Exercise and daily routines - moderate physical exertion, light yogic exercise, Pranayam, Asana, Surya Namaskar, stretching exercise help to ensure better mobility, reduces stiffness, reduce pain, and improve mobility and thus improve quality of life. The selection of exercise for an individual can be made by examining the patient and his problem; this is individualised non-pharmacological medical management.

Bowel regulation - regularity bowel reduces symptoms in most patients; with clear bowels, there is psychological relief to patient's symptoms. Bowel or faecal matter is composed chiefly of undigested food residue but has a minute portion of metabolic waste products. This means that if the bowels are proper, the metabolic toxins are excreted, ensuring betterment in disease. Bowel regulation doesn't mean using purgatives, as excessive use of purgatives may also lead to problems, so proper bowel regulation can be planned after the patient examination.

Medicinal Measures To Manage Joint Disease In Monsoon

There are different medicines that Ayurveda physicians can prescribe as per the need of the patient and disease. the commonly used Ayurveda medicines include - Trikatu, Trifala, Dashmula, Panchamula, Gugglu products, Chandraprabha, Erandamula, Rasana, Rasanasaptak, chitrakadi, eranda, etc.

Statutory instructions: The article is presented to increase the awareness about Ayurveda on the traditional knowledge of Ayurveda from old Ayurveda texts and applicable as per interpreting the ancient Ayurveda text. Readers can read and get informed about Ayurveda, for more details and consultations, do contact an Ayurveda physician or Ayurveda Hospital.