Abstract

AYURVEDIC MANAGEMENT OF ANKYLOSING SPONDYLITIS WITH SACROILIITIS: A CASE REPORT

Akshaya S.*, Suvendu Rout

Abstract

Ankylosing spondylitis, a type of arthritis, is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints, potentially leading to stiffness and fusion of the vertebrae. In India, the prevalence of Ankylosing Spondylitis is estimated to be around 0.7 to 1.0 per 1,000 population, with a higher prevalence in men than women.[5] This case presents a 30-year-old male from Chennai, working as a borewell supervisor, who sought treatment for chronic low back pain lasting six months, worsened after stopping gym workouts. He had a history of back stiffness for 3–4 years and significant weight loss of 25 kg over 1.5 years. MRI revealed bilateral sacroiliitis and mild lumbar disc bulges at L3-L4, L4- L5, and L5-S1. His clinical diagnosis included ankylosing spondylitis with moderate disease activity, as indicated by a BASDAI score of 4.6, BASFI Score of 5.9 and a Visual Analog Scale (VAS) score of 8. The patient underwent a comprehensive physical examination to assess spinal mobility and sacroiliac joint involvement, including Schober’s test, chest expansion, and provocation tests. MRI findings confirmed bilateral sacroiliitis, and further tests indicated ankylosing spondylitis. The patient’s pain intensity was high at admission, as reflected in the VAS score. The patient received a combination of internal and external Ayurvedic therapies aimed at balancing the vata dosha and improving spinal mobility. External treatments included Snehanam, Taila Dhara, Swedanam, and Vasthi, along with mild Virechanam everyday. Internally, ayurvedic medications focusing on Deepana, pachana, vatanulomanam, aamaharam were prescribed. Following treatment, the patient’s BASDAI score dropped from 4.6 to 2.2, BASFI Score from 5.9 to 4.5 and the VAS score decreased from 8 to 3. The Ayurvedic approach, centered around Vatavyadhi line of management, provided significant relief for the patient. The combination of external therapies and internal medications helped reduce pain and stiffness, enhancing the patient’s mobility and quality of life. The overall therapeutic approach demonstrated the potential of Ayurveda in managing chronic inflammatory conditions like ankylosing spondylitis.

Keywords: Ankylosing Spondylitis , katishoolam/ kati graham, vatavyadhi.