Integrative Management of Arthritis Using Ayurvedic Protocols

Abstract

Osteoarthritis (OA) and rheumatoid arthritis (RA) are among the leading causes of chronic disability in adults across Europe, and conventional therapy (NSAIDs, DMARDs, biologics, joint replacement) does not serve every patient well. Ayurvedic medicine has treated arthritic presentations for centuries under the classical categories of Sandhivata (OA) and Amavata (RA), with an evidence base that has grown substantially in the past two decades. This study is a structured evaluation of integrative Ayurvedic management in arthritis. We identified 68 primary clinical studies published between 2005 and 2021 meeting pre-defined inclusion criteria, and grouped them under five integrative protocol frames: single-herb intervention, classical polyherbal formulations, localised Panchakarma procedures, systemic Panchakarma, and integrated multimodal protocols combining herbs, Panchakarma, yoga and dietary regulation. Each frame was scored with the Ayurvedic Management of Arthritis Index (AMAI), a weighted composite of pain reduction, functional capacity improvement, inflammatory marker response, structural or imaging outcome, and safety/tolerability. Integrated multimodal protocols (AMAI 0.902) outperformed every single-component frame, particularly in RA (mean DAS-28 reduction of 2.1 points at 16 weeks in the strongest cohorts) and in advanced OA. Boswellia serrata was the strongest single herb, and Janu Basti was the strongest localised procedure for knee OA. The evidence supports integrative multimodal Ayurvedic management as a clinically useful complement to conventional arthritis care, particularly where NSAID tolerance or DMARD response is limited.