SWASTHA ARANA

 Sandhigatavata is mentioned under Vatavyadhi in Ayurveda. Charaka has placed it under Nanatmaja Vyadhi. Vagbhata has considered Vatavyadhia as “Maharoga”. This emphasized the fact that the vatavyadhi are critical in the treatment. Charaka has described the disease Sandhigatavata under Vatavyadhi Chikitsa chapter (Ch.Ch.28/37). Sushruta has also categorized Sandhigatavata under Vatavyadhi chapter. He has given its symptoms and the line of treatment. (Su/Ni/1/27)

In Allopathic science the similar condition of joint is explained as cervical spondylosis.

Cervical spondylosis is a degenerative joint disorder with the symptoms of Pain, Restricted and Painful Movements of the neck Joints and later Joint Instability. It is a slow progressive disorder and occurs usually after the age of 40 years. Thus due to these similarities, Grivasandhigatavata and cervical spondylosis can be taken as similar disease condition.

Classification of Sandhigatava

No reference is available of classification of Sandhigatavata. Sandhigatavata mainly occurs due to Prakopa of Vata and so it can be classified in three types as below.

1.   Dhatukshyajanya
2. Vataprakopaka Nidana Sevanajanya
3.  Avaranjanya

Sandhigatavata can be classified according to its Nidana – Nija and Agantuja

•     Nija Sandhigatavata
•     Agantuja Sandhigatavata.      

Symptoms of Grivasandhigatavata (Cervical Spondylosis)           

The cardinal symptoms of grivasandhigatavata are as follows.

1. Sandhi Shula : joint pain.
2. Sandhi Shotha : joint swelling.
3. Hanti Sandhi Gatah: inability to flexion and extension or inability of movements.
4. Akunchan Prasaranayoh Vedana: pain during the movements.

 Treatment

Sandhigatavata is a disease of vata, Mainly it occurs due to Dhatukshya or Avarana, Hence, general treatment of Vatavyadhi can be adopted, i.e., Snehana, Svedana, Mridu Samshodhana, Vasti and drugs which pacify vata, diet and behavior may also be applicable in Grivasandhigatavata. Sushruta (Su. Ch.4/8) and Vagbhata (A.S.Ch.23/13, A.H.Ch.21/19 & 22) have described Snehana, Upanaha, Agnikarma, Bandhana, Mardana and Svedana for the treatment of Sandhigatavata.

 Snehana  (Oil application):

Snehana therapy is administered to a persons in two different ways as follows.

1. External application in the form of Abhyang
2. Internal application as Snehapana

Both external and internal Snehana are effective in Sandhigatavata.

Upanaha  (poultice):

Upanaha is one of the four types of Sveda explained by Sushruta. Svedana is the procedure which relieves Stiffness, Heaviness, Cold and which induces sweat.

Agni karma  (cauterization):

Agnikarma on the affected joints relieves pain. To perform Agnikarma on Sandhi, Ksuadra, Guda and Sneha are to be used.

Bandhana  (Bandage):

 Bandhana is bandaging tightly leaves of Vatashamaka drugs on affected Sandhi. This bandaging does not leave any scope for Vata to inflate the Sandhi. In Sandhigatavata, Swelling appears like a bag inflated with air. Bandhana causes abatement in this Shotha.

 Unmardana  (Massage):

This is the type of massage in which pressure is exerted on diseased Sandhi. It relieves Sotha and enhances blood circulation.

Vasti  (Medicated enema):

Since Sandhigatavata is a Vatavyadhi, Vasti is the best treatment for it.