Ayurveda is an traditional Indian practice involving a natural, holistic approach to treating medical conditions.

Some Ayurvedic practitioners use Ayurveda to treat rheumatoid arthritis (RA), which they call "amavata." Ayurvedic treatment can include supplements, dietary changes, and exercise. This article will review Ayurvedic treatment for RA, including the basic principles and whether research supports its use.

General principles

The term "Ayurveda" is a combination of two Sanskrit terms "ayu" (life) and "veda" (knowledge). Practitioners work to balance the three energy forces, or "doshas," of life: "vata," "pitta," and "kapha."

Ayurvedic treatments for RA depend on which diagnostic guidelines the practitioner uses. For example, those who practice from the guidelines "Madhava Nidana" believe that imbalances in the gut and inflammatory compounds cause RA. On the other hand, practitioners from the "Ashtanga Hridaya" school of thought believe that RA is the result of poor dietary and lifestyle habits that cause inflammation in the body. Both approaches use herbs, supplements, dietary changes, and exercise to help relieve RA symptoms.

Herbs and supplements

Ayurvedic practice often involves the use of herbs and supplements as treatment. Some of the herbs that Ayurvedic practitioners often use to treat RA include:

• Boswellia serrata (Indian frankincense)
• Garlic
• Ginger
• Ricinus communis (castor oil)
• Ashwagandha

Some Ayurvedic medicine formulations also contain "bhasma," which are specially prepared forms of metals, such as silver, copper, and iron. An Ayurvedic practitioner may also prepare special oils that contain herbs. People can massage these oils into areas where they experience symptoms.

The US Food and Drug Administration (FDA) does not regulate Ayurvedic supplements in the same way as prescription medications. As a result, less information is available about how supplements work, how they may interact with other prescription medications, and if they are safe.

For this reason, it is vital that people only purchase Ayurvedic supplements from a reputable practitioner and tell their doctor if they are using Ayurvedic treatments. They should also ask their Ayurvedic practitioner exactly what is in each preparation to ensure that it does not contain compounds that a person is allergic to or that may interact with other medical treatments.

Diet

Ayurvedic practitioners believe the following dietary habits may cause or worsen the symptoms of RA:

• Drinking alcohol
• Eating spicy foods
• Taking in excess salt
• Consuming too many sour, sweet, or sugary foods
• Eating uncooked foods
• Eating foods that cause acid reflux

As a result, an Ayurvedic practitioner will recommend avoiding these foods. Some Ayurvedic practitioners also recommend soups that contain barley and rice, as these are thought to add a sense of lightness to the body. Sometimes, a practitioner may recommend a castor oil fast. This is when a person consumes castor oil, a natural laxative, to encourage intestinal purification. Over several days, a person will reintroduce foods and ultimately progress to a healthful routine diet.

Exercise and lifestyle

Ayurvedic practitioners believe that positive lifestyle habits can support RA treatment. They believe that a sedentary lifestyle leads to the formation of "ama," which causes inflammation and disease. Practicing yoga, an essential part of Ayurvedic medicine, can help a person with RA to be more active and also reduce stiffness and pain. Ayurvedic practitioners may recommend the following tips for people with RA:

• Using hot water, not cold, to bathe in and drink
• Avoiding exposure to cold breezes
• Avoiding late-night or late-afternoon naps
• Practicing yoga to relieve mental stress
• Using massage therapy with herbal oils to reduce pain and stiffness

While Ayurvedic practitioners do believe that physical activity can help relieve some conditions, they recommend that people with RA avoid excess walking.

What does the research say?

Little extensive and modern research exists on Ayurvedic treatments specifically for RA. Researchers report difficulties designing clinical trials to test Ayurvedic interventions, compared with modern medicine or placebos. Many studies are small, making it difficult for researchers to know if the results would apply to larger populations.

For example, a 2011 study published in the International Journal of Ayurveda Research studied Ayurvedic treatments in 290 people with RA over 7 years. At the study's conclusion, the author found that even participants with severe RA reported improvements, including reductions in swelling and pain. However, the study did not use a control group, so the conclusions are difficult to confirm.

Other, smaller case studies support the use of Ayurveda in treating individuals with RA. A 2015 case report on Ayurvedic treatment in a 45-year-old female supported the use of Ayurveda for reducing RA symptoms. The treatment included massage, supplements, a castor oil fast, avoiding spicy foods, and eating "light" foods.

Some aspects of Ayurvedic treatment have more support in contemporary research. For example, many Ayurvedic practitioners recommend yoga to help relieve RA symptoms. A 2018 study on 75 adults with RA found that yoga improved fitness, flexibility, mood, and overall health-related quality of life.

Summary

Unfortunately, little high-quality research exists to support the use of Ayurvedic treatments for RA. However, with a doctor's supervision, many of the dietary and exercise-related changes may be beneficial. Also, any reduction in inflammation is likely beneficial. Since RA can damage joints without effective treatment, working with a rheumatology doctor along with an Ayurvedic practitioner is important.

Currently, there is no licensing program for Ayurvedic practitioners in the United States, nor is there an official training or certification process. This is different from Ayurvedic training in India, which has many regulations. Anyone considering Ayurvedic treatment should speak to their regular doctor and be sure to ask about an Ayurvedic practitioner's training and safety practices.