Arthritis is the most common-communicable able disease in the present era. ‘Arthros’ means’ Joints’ and Arthritis means “inflammation of joints”. The disease burden of arthritis is in the rise in recent times. Arthritis appears in various types and we are commonly heard about Osteoarthritis, Rheumatoid arthritis, and Gouty arthritis or simply Gout. All of these have the common symptom of edematous reddish painful joints which restricts the movement of the part. Gout is an arthritic condition that is characterized by a sudden unexpected attack. Gout can happen to anyone and presents with excruciating pain, redness, and edema. The affected joint will have severe tenderness too.
The prevalence of gout is increasing in India as well as World. An unhealthy life style and diet patterns precipitate gouty arthritis. Most of the patients skip treatment because of the subsidence of pain some hours after the attack.
It commonly attacks the big toe of the foot. Gout is characterized by intense pain and discomfort. The most distinguishing feature of gouty arthritis is the time of the attack. It can be a midnight attack without any prior warning. Not only the big toe but also the ankles, elbows, and fingers also are the victim of gout attacks. The unexpected attacks can recur many times too. The detailed story of gout can be read under the following headings.
Causes of Gout
Gout is the result of impaired uric acid excretion mechanism in the body. Kidneys fail to excrete uric acid which is produced by the breakdown of excess ‘purines’ obtained through foods and drinks in the body. The impaired excretion leads to the accumulation of uric acid as crystals in the body. The usual sites of accumulation are the base of joints, especially in the foot. Over intake of meat and seafood leads to the increased level of purines in the body. Beer consumption and the increased intake of fruit sugar or fructose, overweight and obesity, diabetes, cardiac disease, renal diseases, etc. can result in increased uric acid production in the body. Gout is said to have a genetic occurrence also. Familial inheritance is observed commonly. Gout can also occur as a result of traumas and surgery. Normally gout has more affinity to men and the incidence rates in men are higher than in females. Females are having lower uric acid levels as compared to men. 30-50 years of age are the peak period of gout occurrence in men. Post-menopausal women tend to have more incidence of gout as menopause itself causes a surge in uric acid levels in the blood. Some malignant cancers also increase uric acid levels. Lead poisoning, hypothyroidism and skin diseases like psoriasis also contribute to uric acid accumulation in the body. The use of certain antibiotics is said to have the property of increasing uric acid in the body.
Symptoms of Gout
- Severe arthralgia in the first 12 hours of the attack.
- Lasting discomfort of joints for weeks.
- Swelled joints with reddish skin, warmth and tenderness.
- Restricted movements of the affected joint.
- Stiffness of the joint.
- In chronic cases, the uric acid crystal deposits cause small lumps around the joint. These are called as ‘tophi’.
Investigations: X-rays, Ultrasound, Blood tests.
Chronic gout: it causes damage to bones and cartilage. Damage to kidneys and resultant problems like kidney stones can arise. Chronic untreated gout tends to worsen the situation by affecting more joints. The presence of gouty tophi can make the joint appear deformed.
Ayurvedic Treatment for Gout
Gout can be correlated to the Vataraktha condition. The symptoms of Vataraktha coincide with that of gout.
Mostly internal medications are followed. In modern medicine use of non-steroidal anti-inflammatory drugs and analgesics are commonly used. Like in every arthritic condition, the power of natural medicine to cure gout is commendable. Ayurveda offers a comprehensive and effective treatment to tackle the menace of gout.
The Ayurvedic approach is based on the principles of prevention and Cure. The foremost approach is the prevention of the incidence of gout and the prevention of the recurrence of gout.
The preventive aspect is founded on the disciplined way of life. It includes proper diet, lifestyle and exercises. As diet is one of the founding causes for the occurrence of gout, proper choice of diet is very much important. Ayurveda clearly mentions foods that are to be used and to be avoided for perfect joint health. High fiber and low protein food are recommended.
- Foods that vitiate Vata and Pitha dosha are to be avoided. They include meat, alcohol, dry foods, and excess intake of Madhura, Amla, and Lavana foods (sweet, sour, and salt).
- As joints are the seat of Kapha dosha special care should be taken not to take excess kapha vardhaka foods. Increased use of Madhura rasa causes vitiation of kapha dosha too.
- The foods should not be having high protein content and the use of tobacco is prohibited.
- The use of dairy products should be reduced.
- Drink more water every day.
- Seasonal fruits can be taken.
- Vegetable foods are mostly advocated for healthy joints.
- Even though meat is prohibited soup of goat meat can be taken as it is highly nourishing and strengthens the joints.
- Use of curd, yogurt to be reduced or avoided.
- Timely intake of food needed.
- Rice and other cereals, and skimmed milk can be taken.
- Avoid excess use of black gram.
- Intake of pulses should be reduced.
For perfect joint health, mild exercises are to be done daily.
Abhyanga or oil massages everyday needed. Abhyanga can be with Dhanwantharam taila, Sahacharadi taila, or simply sesame oil. The practice of Yoga and meditation also helps in retaining good joint health.
On the treatment side, Gout can be treated along the lines of Vataraktha or rheumatoid arthritis.
The objective must be to reduce inflammation and pain initially. For that purpose, Ksheera dhara using the decoction of Dasamoola can be used.
Decoctions that reduce inflammation like Punarnavadi Kashaya can be taken or fermented medicines like Amritharishta or Punarnavasava.
External applications or Lepanas with medicines like ‘Ellum Nishadi Choorna’ can be done to reduce edema.
Virechana or purgation using Gandharva Eranda thaila with milk can be done to eliminate the doshas.
KsheeraVasthi or enema using milk and other medicines is highly effective in treating gout.
Kashayas like Rasnerandadi, Maharasnadi, Sahacharadi, etc. is advised. The use of Pindathaila is advocated for external application after the subsidence of inflammation.
After the subsidence of pain and inflammation care should be given to avoid deformities. Rasayana medicines can be given to aid the body to eliminate excess uric acid and to retain the anti-oxidant wealth. Guduchi or Tinospora cordifolia is an excellent medicinal drug in treating gout.
The medicine formulations containing Guduchi are Guduchyadi kwatha, guduchi satwa etc. Guggulu or ‘Commiphora wightii’ is a powerful medicine to treat arthritic conditions.
Guggulu-containing tablets like Kaishora guggulu, Yogaraja guggulu and Vyoshadiguggulu are effective choices in the treatment. Applying kizhi or potali sweda using the leaves of Arka plant or Calotropis gigantea, with ghee and rock salt is effective to reduce pain and inflammation.
Proper rest is essential during the treatment. Care should be taken to avoid dehydration, as it can lead to further accumulation of uric acid in the body.
Do not walk on rugged surfaces using bare feet and try to clean the affected part every day.
21 Natural remedies for Gout
- Use of Ginger juice with slight amount of jaggery helps in reducing the inflammation.
- Application of cold water in the affected part helps in reduction of pain and inflammation.
- Use of green gram as soup along with ghee.
- Dasamoola Ksheera dhara helps in alleviating pain.
- Use of citrus fruits which contain Vitamin C.
- Use of Punarnava or Boerhavia diffusa in food, which is a powerful natural diuretic.
- Use of coffee found to effects in reducing uric acid levels.
- Use of cherries found to be effective in reducing uric acid levels.
- Use of banana helps in reduction of uric acid levels.
- Blood purifying foods are advocated like dry grapes and dates.
- Use fenugreek seeds kept overnight soaked in water to reduce inflammation and pain.
- Daily intake of two garlic pods helps to eliminate uric acids.
- Antioxidant rich foods like Indian gooseberry, coriander seeds etc are to be taken to stabilize uric acid levels in the body.
- Turmeric used along with milk daily helps in long term prevention of gout.
- Daily use of the decoction of Kokilakshaka – (Asteracantha longifolia) helps in preventing gout in long term.
- Pouring slightly heated Dhanyamla over the affected part helps to reduce pain and swelling.
- Hot and cold compress applications to increase blood circulation and helps to reduce pain.
- Soaking the affected part in warm water containing Epsom salt helps to reduce pain and tenderness.
- Use of aswagandha or Withania somnifera powder can help in curing gout as it is having strong anti-inflammatory properties.
- Application of Pichu, an Ayurvedic treatment in which medicine is soaked in cotton and put over the affected part can be done.
- Use Triphala powder daily for overall health of bones and joints.
The prevention and cure of gout is actually in our hands itself. A dedicated and disciplined life is the keystone for preventing every disease.