The human species is unique in its existence for various reasons. The biggest among them is our erect posture, which allows us to stand and walk. In the process though, our knees take the hit, as they bear the entire body weight. The joint is a complex yet robust structure, comprising bones, muscles, tendons, menisci and ligaments, all working together to provide support.
In Ayurveda, a joint is represented by the word sandhi, which means something that connects two things by etymology. Among them, janu sandhi (knee joint) is the most important. All sandhis are considered seats of kapha dosha, which is responsible for smooth movement of joints. Due to reasons like ageing and repeated stress, kapha decreases and vata increases, resulting in degenerative changes. The knee joint can be affected by various conditions like osteoarthritis and injuries like meniscal tears. The former is part of the natural ageing process and, thus, a common cause of knee pain among the elderly. This condition is called sandhigata vatam. Factors like increased body weight, long walks on an uneven surface, climbing stairs etc. can aggravate the condition.
The pain can also be symptomatic of existing systemic diseases like rheumatoid arthritis and lupus, which Ayurveda categorises under conditions like vataraktha and aamavata. In addition, conditions such as meniscal tears and ligament damage due to sports-related incidents, falls or accidents can disrupt normal knee function. This is called marma abhighata, indicating injury to vital points.
Strengthening the Muscles A fully functional knee relies on the strength of the thigh and calf muscles. Any stiffness, inflammation, or injuries to these muscles can affect the joint movement. Therefore, any ayurvedic treatment for pain or swelling doesn’t focus solely on the knee but the entire unit. The first step is to identify whether the pain or swelling is due to a local cause or a systemic issue.
If it is a local cause, then treatments involve applying medicated powders like nagarathy lepa choornam, jadamayathy lepa choornam, karutha vattu lepam and marma gutika with suitable media to provide anti-inflammatory and analgesic effects. Procedures like janudhara (pouring medicated oil, milk, decoction over the knee) and januvasthy (retaining specific oils over the joint for a specific time at a specific temperature) are also used to address knee issues.
The Role of Panchakarma Panchakarma techniques like snehapanam (intake of medicated ghee), virechanam (therapeutic purgation), ksheeravasthy, yapana vasthy and ardhamatrik vasthy (various types of enemas), are crucial in managing knee issues that don’t respond to internal medication and local procedures. Apart from this, many sudation practices like patrapotal swedam (leave bolus made to apply heat in the body), choorna panda swedam (medicated powders made as bolus to deliver heat to painful parts) and shastika panda swedam (cooked special rice in milk to strengthen the muscle) etc. are employed.
Abhyanga for Lubrication Regularly applying medicated oils can maintain knee joint lubrication and help reduce swelling. Commonly used among them are murivenna, chinchathy tailam, kottamchukkathy tailam and sahacharathy tailam, each prescribed based on the specific clinical assessment.
Marma Manipulations Ayurveda identifies 107 vital energy points called marma in the body. Trained practitioners use specific techniques to reduce pain in these points, especially in the janu sandhi marma.
The author is a Professor at the Department of Panchakarma, Ashtamgam Ayurveda Medical College, Kerala
