Sandhivata vs Amavata
Sandhivata (osteoarthritis) is Vata-driven cartilage degeneration — pain on movement, stiffness after rest, crepitus. Amavata (rheumatoid arthritis) is fundamentally different: Ama (undigested metabolic toxin) circulates and lodges in joints with Vata, causing the bilateral, symmetric, inflammatory pattern of RA. Mistreating one as the other is common and counterproductive.
Sandhivata (OA) protocol
Internal Vata-pacifying medications + external Janu Basti, Kati Basti (medicated oil pooled over the joint for 30 minutes). Abhyanga with Mahanarayan or Dhanwantaram Taila daily. Patra Pinda Sweda (medicated leaf bolus fomentation) gives strong relief in flare-ups. Avoid local steroid injection if at all possible — it accelerates underlying Vata vitiation.
Amavata (RA) protocol
Treatment begins with Ama-pachana (digestion of Ama) using Chitrakadi Vati, Trikatu, dry ginger. Only after Ama is digested do we apply external therapies — sudation, oils. Premature oleation in Amavata worsens the condition; this is the single most common clinical mistake.