Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints of hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

An autoimmune disorder, rheumatoid arthritis occurs when our immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis sometimes can affect other organs of the body such as the skin, eyes, lungs and blood vessels.

Although rheumatoid arthritis can occur at any age, it usually begins after age 40. The disorder is much more common in women.

While in ayurveda Amavata is the most crippling of the joint disease. It occurs throughout world in the all climate and all ethical groups. Ama associated with aggravated vat play dominant role. The clinical features of Amavata such as pain, swelling, stiffness, fever, general debility are most identical mentioned in classical texts. In classics treatment mentioned in Amavata is Dipan, Pachan, Shodhan, Shaman, Asthapan basti, Vaitaran basti. Among them Vaitaran basti is very effective in Bahudosh and Leendosh avastha. It used in new and old Amavata as well because it brings Doshas from Shakha to Kostha and remove it from Gudmarg and gives relief.

Presently available modern medication for Rheumatoid arthritis and medication for pain (NSAID) is causing many side and toxic effect and requires long term medication which suppresses immunity and produces other diseases.

Hence there is a need to find such a therapy which gives better relief without any side or toxic effect and also natural, cost effective and easily available .hence the ayurvedic treatment required for this autoimmune desease.so this study was selected

Introduction

Amavata is first mentioned as separate disease by madhav nidan,where it is stated that mandagni plays key role in the menefestation of the disease. Acharya madhav described most characterstics features of the disease, severe pain similar to a scorpion bite. Asthi and sandhi are chief sites of presentation of cardinal symptoms, such as sandhi shool,sandhi grah,sandhi sotha etc.this symptoms are resembles the cardinal symptoms of rhumatoid arthritis i.e. pain, swelling, stiffness, fever, general debility etc. Amavat chikitsa described by chakradatta is dipan,tiktakatu ras, kshar basti, vaitaran basti, saindhavadi anuvasan and many yogas. while in modern science Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that primarily affects joints. It may result in deformed and painful joints, which can lead to loss of function. The disease may also have signs and symptoms in organs other than joints.

The cause of RA is not completely understood. The process involves an inflammatory response of the capsule around the joints (synovium) secondary to swelling (turgescence) of synovial cells, excess synovial fluid, and the development of fibrous tissue (pannus) in the synovium. It also affects the underlying bone(focal erosions) and cartilage(thinning and destruction).

Sign and symptoms of Amavata

Cardinal symptoms of Amavata are

1. (Vriscik damsha vata vedana)Morning pain severe in nature
2. (Sanchari Vedana)shifting pain
3. (Stambha) stiffness of joints
4. (Jwara) Increase temperature
5. (Karmahani) loss of movements
6. (Sandhi Vikruti) joint deformity.
7. (Kshudhamandya) Loss of appetite

Signs and Symptoms of Amavata according to doshik dominance

• Vitiated Vata produces colicky pain, body ache, abdominal distension, giddiness, stiffness of back and waist, constriction and spasm of blood vessels.

Vitiated Pitta produces fever, diarrhea, thirst, giddiness and delirium.
Vitiated Kapha produces vomiting, anorexia, indigestion, fevers with cold, lassitude and heaviness in body