Preprint / Version 1

Integrative approach combining Ayurveda, Counselling, Yoga and Meditation with standard of care in the management of Amavata (Ankylosing Spondylitis): A Case Report




Case report, Ayurveda, Ankylosing Spondylitis, Amavata, Integrative approach, Amapachana


Introduction: We report a diagnosed case of Ankylosing Spondylitis treated with an integrative approach by adding Ayurveda, Yoga and meditation techniques with standard of care. Considerable improvement of disease symptoms and disease markers as well as reduced dependence on allopathic medications were observed after the intervention.

Main complaints of the patient: A 59 year old male patient on standard of care treatment for Ankylosing Spondylitis reported for Ayurvedic treatment. Withdrawl of medications led to relapse of  stiffness, swelling and pain in neck, back, hip, knee joints, ankles, shoulders and all interphalangeal joints along with intermittent constipation and disturbed sleep due to pain.

Diagnosis: The patient was diagnosed by a Rheumatologist to be suffering from Ankylosing Spondylitis with a positive HLA B27 genetic marker specific for the disease. Symptoms of the patient matched closely to that of vÄÂtapradhÄÂna prakupita ÄÂmavÄÂta.

Interventions: Treatment for vÄÂtapradhÄÂna prakupita ÄÂmavÄÂta was administered in sequence - ÄÂmapÄÂcana (treatment to correct digestion and metabolic processes), sraṃsana (bio-cleansing therapy), snehana (treatment with oils) and bṛṃhaṇa (nutritive therapy) and included both internal medicines and external therapies along with diet, lifestyle adjustments, counselling, Yoga and meditation.

Outcomes: At the last follow up, CRP value reduced to 15.7 mg/L from the baseline value of 37.5 mg/L, and ESR from 103 mm/hr to 8 mm/hr indicating reduction of inflammation. The patient has been able to adjust the dose of NSAID and Immunosuppressant from once in twenty-four hours to once in eighty four hours and steroids to once in a week. The Ayurvedic treatment also helped in improvement of digestion and general well-being. Counselling, Yoga and meditation significantly reduced the stress of the patient and improved his sleep cycle.

Take Away Lesson: Integration of Ayurveda, Yoga, meditation and conuselling with standard of care has the potential to improve quality of life and reduce severity of disease as well as dependence on pain killers, immunosuppressants and steroids in patients suffering from chronic Ankylosing spondylitis.


Dakwar E, Reddy J, Vale FL, Uribe JS. (2008). A review of the pathogenesis of ankylosing spondylitis. Neurosurg Focus. doi: 10.3171/FOC/2008/24/1/E2

Braun J, Sieper J. (2000). Inception cohorts for spondyloarthropathies. Z Rheumatol. https://doi: 10.1007/s003930050215.

Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A. (2002). Ankylosing spondylitis: an overview,

Xu X, Shen B, Zhang A, Liu J, Da Z, Liu H, et al. (2016). Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis. Patient Prefer Adherence. https://doi: 10.2147/PPA.S86612.

Günther V, Mur E, Traweger C, Hawel R. (1994). Stress coping of patients with ankylosing spondylitis. J Psychosom Res. https://doi: 10.1016/0022-3999(94)90103-1.

Tripathi B, editor, Madhav Nidana of Madhavkar, Amavata Nidana: Chapter 25, Verse 8-10. Varanasi: Chaukhabha Sanskrit Sanshtan, 2006; 571

Paradakara SS, editor, Astangahrdayam of Vagbhata. Varanasi: Chaukhambha Surabharathi Prakashana ; 2007

Acharya JT, editor, Carakasamhita of Caraka, Sutra Sthana ; Apamarga tanduleeya : Chapter 2, Verse 18. Varanasi: Chaukhamba Orientalia, 2011; 26.

Shastri KSA, editor, Bhaisajyaratnavali, Varanasi: Chaukhambha Sanskrit Sansthan ; 2004.

Shastri PP, editor, Sharngadhara Samhita of Sharangadhara, Madhyama Khanda; Sandhana Kalpana: Chapter 10, Verse 78-92. New Delhi: Chaukhambha Publications, Reprint 2013; 239.

Prabhakara RG, editor, translator and commentator, Sahasrayogam, New Delhi: Chaukhamba Publications; 2019

Falkenbach A, Oberguggenberger R. (2003). Ayurveda in ankylosing spondylitis and low back pain. Annals of the Rheumatic Diseases. https://doi: 10.1136/ard.62.3.276.

Singh SK, Rajoria K. (2016). Ayurvedic approach for management of ankylosing spondylitis: A case report. Journal of Ayurveda and Integrative Medicine. https:// doi: 10.1016/j.jaim.2015.10.002.

Edavalath M. (2010). Ankylosing spondylitis. Journal of Ayurveda and Integrative Medicine, https://doi: 10.4103/0975-9476.72619.