MANAGEMENT OF STHOULYA ASSOCIATED WITH JANU SANDHIGATA VATA: A CASE REPORT

Background: Sthoulya (obesity), a Santarpanajanya Vyadhi described in Ayurveda, is characterized by excessive accumulation of Meda Dhatu and Kapha Dosha, leading to impaired physical function and increased susceptibility to various metabolic and musculoskeletal disorders. Obesity is a well-recognized risk factor for knee osteoarthritis due to increased mechanical loading and chronic low-grade inflammation. In Ayurveda, this clinical presentation closely resembles Janu Sandhigata Vata, a degenerative disorder affecting the knee joint. Ayurveda advocates a holistic management approach comprising Shodhana, Shamana, Panchakarma procedures, dietary regulation, and lifestyle modifications to address both the underlying pathology and associated symptoms. Case Presentation: A 58-year-old female presented with progressive weight gain for five years, resulting in difficulty performing routine daily activities, along with bilateral knee pain for three years. She was a known case of type 2 diabetes mellitus and hypertension. Clinical examination and Ayurvedic assessment established the diagnosis of Sthoulya associated with Janu Sandhigata Vata. The patient underwent a comprehensive Ayurvedic treatment protocol comprising Sarvanga Udwartana, Sarvanga Parisheka, Janu Lepa, Janu Basti, Matra Basti, Snehapana, Virechana, internal Ayurvedic medications, dietary modifications, Yoga, and Pranayama. Results: Following completion of treatment, the patient exhibited significant clinical improvement. Body weight decreased from 103.3 kg to 97 kg, with a corresponding reduction in BMI from 38.9 kg/m² to 36.5 kg/m². Waist circumference decreased from 143 cm to 118 cm, and the waist-to-hip ratio improved from 1.02 to 0.84. Pain intensity assessed using the Visual Analog Scale (VAS) improved from 5 to 1 in the right knee and 4 to 0 in the left knee. Functional mobility, walking ability, and performance of activities of daily living also improved substantially, without any reported adverse events. Conclusion: This case demonstrates that a comprehensive Ayurvedic treatment protocol integrating Panchakarma, external therapies, internal medications, dietary regulation, Yoga, and lifestyle modifications can effectively reduce body weight, alleviate knee pain, and enhance functional capacity in patients with Sthoulya associated with Janu Sandhigata Vata. Further well-designed clinical studies are warranted to validate these findings and establish evidence-based treatment protocols.