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Vazhi azhal keel Vayu and Uthiravatha suronitham is a vatha disease mentioned in the Siddha text book of Yugi vaidhya chindhamani. The clinical features bear a resembalance to Rheumatoid arthritis of knee joint. For treating RA, Varmam therapy was used. It is one of the external therapies mentioned in Siddha literature. A 45-year old female from Vizag reported to the Chakrasiddh OPD on 27.09.2021 with chief complaints of pain and swelling in both knee joints since 10 yrs. She was given Siddha therapy. This therapy works on Varma points where the pranan, ie, vital energy of our body is concentrated. The total treatment is given for 30 days with 2 phases and gap in between. There was noticeable difference after the treatment. Clinically, it was confirmed by noting relief in her signs and symptoms taken on VAS scale for pain and pre and post assessment on the basis of laboratory investigations The pain was markedly reduced from 9/10 score to 4/10 after treatment. The range of movements of the knee joint was also improved.


Autoimmune diseases have deteriorative effects on physiological systems and results in faulty immune system. Rheumatoid arthritis, an autoimmune disorder occurs when individual's immune system mistakenly attacks own body's tissues. This disease affects the structure and function of musculoskeletal joints and gradually affects the complete body (Osborn, 2005). It is a chronic progressive disease with symptoms related to inflammation in the joints resulting in pain, swelling, deformity and immobility, especially in the fingers, wrists, knees and ankles. In some cases it may also cause severe pain in other joints like shoulders, lower back and elbows. The condition attacks the lining of joints known as the synovial membrane, especially in the upper and lower limbs. This causes painful swelling and restricted movement; eventually resulting in joint deformity (Lowe, 2006).

RA is widely prevalent worldwide with 1.8% population affected by this and is increasing with population growth. Though, RA is found in both sex but studies show it is more predominant among females with more severity at age >35 yrs (Roberts J; Burch TA. 1996). In present, lifestyle changes including bad food habits, physical inactivity, and wrong body posture, disturbed biological clock leads to the manifestation of these autoimmune diseases. Studies shows increase in stress levels and hormonal imbalance, there is malfunctioning of the circulatory system, producing symptomatic pain, discomfort and deformity of affected joints (Prekumar, 2004; O'Brien, nd). In its progressive stages, RA not only damages affected joints but other structures and organs too. Modern science and treatment have no cure of RA and aims on limiting joints damage, preventing loss of function and decreasing pain by use of steroids (Stein C.2005). The signs of R.A bear resemblance to two diseases - Vazhi azhal keel Vayu (a type of osteoarthritis), and Uthiravatha suronitham which are mentioned in Siddha literature (R Thiyagarajan,2019). Recent studies shows alternative therapies like Siddha vaidyam; which is an ancient and old therapy, has proved to be significantly affecting such systemic disorders due of its simple methodology: It treats by aligning body energies (mind, body and spirit) and by using different techniques like Pressure Manipulaiton Therapy (Varmam) & Physical Manipulation Therapy (Thokkanam), there is an improvement of overall circulation by encouraging blood and lymph flow to the affected area. This activates the body's internal healing mechanisms thus, resulting in cure, decrease in pain and an improved lifestyle. It is seen that Siddha therapy, when used in conjunction with Physiotherapy, Diet monitoring and yoga, can have a positive systemic effect in the management of the symptoms and progression of such autoimmune disorders.

Signs and Symptoms of R.A

Rheumatoid Arthritis is a chronic progressive disease involving the joints bilaterally especially in the fingers, wrists, knees and ankles. In some cases it may also cause severe pain in other joints like shoulders, lower back and elbows. 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.

The main symptoms includes: Swelling, warmness, tenderness & pain in the affected joints, Morning stiffness that may stay for long during day, Rheumatoid nodules or firm bumps of tissues felt on skin, Fever, Fatigue and tiredness, Weight loss, loss of appetite and lack of sleep.

Case Report

A 45-year-old female, a desk worker from Vizag presented to Chakrasiddh centre in September, 2021 with ten years history of R.A. with severe pain and swelling involving both her knees, lower back and feet. She complained of complete body stiffness especially in morning lasting for three to four hours. She was taking help of stick to walk due to severe pain in knees and inability to keep her back straight, a kind of spine postural disorder. From past few months, she noticed constant flare-up of symptoms with dull, achy pain in all joints especially in her right knee. The pain is continuous and gradually increases till evening with an intensity 9/10 on VAS scale (Table-1). The pain subsides only after taking rest and medications.

She complained of popping sounds from her knees on sitting and walking. Due to tenderness and inflammation, she could feel her knees warm and swollen. She was able to walk for 10 minutes with help of stick & very slow speed and could not climb stairs. She could notice that on lying straight on bed, her legs were not touching the ground. On changing position from sitting to standing or vise-versa, she felt lot of stiffness and took time to do the activity.

Occasionally, she use to have a low-grade fever and, from few weeks, was unable to attend her office due to her deteriorating condition. As, she was from middle class family and her medications were expensive, she wanted to get back to her work soon. She visited many doctors including Rheumatologist and was following their medications but as soon as she stops taking them, she could observe the flaring of her symptoms. To stop dependency on medications for her ailment, she was advised by her relative who saw the video of Chakrasiddh on you tube to visit centre to take treatment for the disease.

History of Past Medical Illness

The patient is non-diabetic and non-hypertensive. Family history of patient was significant with father having hypertension and mother arthritis from 40 years. On taking complete medical history of patient, it was known that she had high grade fever 11 years back which was controlled by medications but after 5 months she started getting pain in her wrists and ankles. Later on, pain and mild swelling started radiating to knee joints. 5 years back pain was so severe that she consulted an orthopaedic surgeon who took out x-ray and did laboratory investigation such as ESR, CRP, RA factor. Her RA value was 156 and he referred her to Rheumatologist who confirmed her having RA. She is on steroids from than but from last 2 years, pain and morning stiffness has aggravated even after having pain killers. She was also on special diet for RA but due to office timings, patient was irregular in her diet patterns.

When she came to the centre in Sept, 2021, her vitals were within normal limits on presentation. Her RA value had come down to 65 due to continuous use of steroids from last few years but her Blood reports were showing high ESR and positive CRP. On physical examination, there was swelling, tenderness, and warmth involving multiple joints but especially Bilateral knees. The joints were erythematous and tender to touch. Due to severe pain, she had limited range in the involved joints. Her walk was very slow and was dragging her feet while moving.There was a joint effusion in both knees with right knee more affected with it. Both feet were very tender around the metatarsal-phalangeal joints. The rest of the examination was routine. On the basis of sign and symptoms she was confirmed for Vazhi azhal keel Vayu and Uthiravatha suronitham-. RA (8/10 classification criteria of RA, ACR, 2010) (Table-2).

We present this case to show effect of Siddha therapy on autoimmune diseases like RA by reducing pain and improving the flexibility in deformed joints without use of medicines. This was confirmed by noting relief in her signs and symptoms taken on VAS scale for pain and pre and post assessment on the basis of laboratory investigations (Table-3). Clinically, pre and post x-rays also verified the success of treatment.

Treatment Protocol

The treatment was started on 27th Sept, 2021; it was planned for 30 days with 20 days in initial phase and rest 10-15 days after gap of 2 months. The treatment included all major joints with B/L knee joints to be attended daily and all other joints to be done alternate days. The patient was kept on strict RA diet. She was advised to have olive oil, lots of fresh fruits and veggies, beans but avoid cold and sour food items, potato and sugar as they are believed to increase inflammation in joints. Daily physio exercise and walking for 1/2 hr was initiated.

In initial week, patient had lots of pain as she had capped her steroids but could see difference in her stiffness. She could notice that she was able to walk slowly for 20 mins without any help while earlier she could not walk without stick. She could identify her stiffness reduction in both knees and lower back; was able to do the exercises which was not possible earlier. She was able to stand and sit with ease & could take 3- 4 stairs.

The chief healer did several Varma Points including Moto Varmam (center point of base of patella), Asaivuthirikannu Varmam (middle of medial and lateral border of patella) & Naaithalai Varmam (apex of patella). In 4th week, patient was overall 50% so it was decided to give her a break for 2 months. A special diet was advised during her break which included Alfa-alfa seeds, Epsom salt and cod liver oil intake with weekly thrice physiotherapy sessions.

After break, her treatment was again started on 7th Feb, 2022 with C/O pain in wrist and elbows. There was stiffness in her back while sleeping so her sleep was disturbed but in knees there was vast improvement with low intensity pain 5-6/10 on VAS. The treatment was given to her for 18 days in 2nd phase. On completion, the patient had mild to moderate stiffness in her lower back and now was visibly standing straight. She was able to stand for 1/2 hr and could walk for 30-40 mins in slow speed with bearable pain 4/10 on VAS scale. As, patient showed almost 70% improvements in her symptoms, x-rays were advised and explained to her (Figure-1). Her lab investigations verified the changes in RA value and her blood reports showed difference from her pre treatment report. Finally, the points were closed on 18th Feb, 2022.


R.A is a debilitating condition that is likely to interfere with your daily activities and functional abilities in the long-term. Siddha Vaidya, approach can offer relief from rheumatoid arthritis symptoms and improve your quality of life. This case study proved that Siddha treats by aligning body energies and activates the body's internal healing mechanisms by opening the channels thus resulting in cure. Siddha therapy along with diet and physiotherapy sessions played a vital role in this RA case in reducing pain, functional independence and quality of life which can be clearly seen in symptoms and lab investigations.