A RANDOMIZED CONTROLLED CLINICAL TRIAL TO EVALUATE THE EFFECT OF VEDANASTHAPANA MAHAKASHAYA PARISHEKA ON PAIN PARAMETER IN AMAVATA W.S.R. TO RHEUMATOID ARTHRITIS

Amavata is a classical Amaja Vyadhi characterised by the concomitant vitiation of Ama and Vata Dosha, which, if untreated, progressively involves deeper dhatu and impairs joint function. The primary etiological factors include Viruddha Ahara and improper lifestyle, leading to the formation of Ama. This Ama, in combination with aggravated Vata, localises in the joints, producing hallmark clinical features such as Sandhi Shoola, Stabdhata, and Sandhi Shopha. Ayurvedic texts emphasise therapeutic interventions including Langhana, Swedana, Deepana, and the application of Katutikta Dravya. Ruksha Swedana, in particular, is advocated for Amavata, addressing both Ama and Vata vitiation. From a modern biomedical perspective, Amavata is often correlated with rheumatoid arthritis (RA), a chronic autoimmune inflammatory disorder characterised by symmetric polyarthritis, systemic manifestations, and progressive joint deformities. As RA is incurable, effective pain management remains essential to improve functional capacity and quality of life, particularly in middle-aged individuals. Swedana is one of the principal treatment modalities advocated in the management of Amavata. Vedanasthapana Mahakashaya possesses analgesic and anti-inflammatory properties and may provide effective symptomatic relief when administered as Parisheka Sweda. Aim: To evaluate and compare the efficacy of Vedanasthapana Mahakashaya Parisheka and Twak Patra Parisheka on pain parameters in patients suffering from Amavata w.s.r. to Rheumatoid Arthritis. Materials and Methods: A randomized open-label comparative clinical trial was conducted on 30 patients diagnosed with Amavata fulfilling diagnostic criteria. Patients were randomly allocated into two groups of 15 each. Group A received Twak Patra Parisheka and Group B received Vedanasthapana Mahakashaya Parisheka for 30 minutes daily for seven consecutive days. Results: Both interventions produced statistically significant improvements in pain and associated symptoms. Vedanasthapana Mahakashaya Parisheka demonstrated superior improvement in VAS, VRS, NRS, and painDETECT scores compared to Twak Patra Parisheka. Conclusion: Vedanasthapana Mahakashaya Parisheka was found to be more effective than Twak Patra Parisheka in reducing pain and improving clinical manifestations of Amavata.