“Role of Ayurveda in the Management of Osteoporosis”- A Short Review

 

Dr. Dnyaneshwar Kantaram Jadhav ¹, Dr. Gauravkumar V. Shaha. ² Dr. Chaitalee Anil Walale (Shaha) ³ Dr. Sankalpa S. Bawiskar⁴

 

¹ MD Kaychikitsa, Associate Professor, Department of Swastawritta. Shri Dhanwantari Ayurvedic Medical College, Mathura, India

² MD Kaychikitsa, Ph.D. (Sch) Associate Professor, Department of Kaychikitsa. Poornayu Ayurved Chikitsalay Evam Anusandhana Vidyapeeth, Jabalpur MP, India

³ MS (Prasutitantra Evam Streeroga), Assistant Professor - Prasutitantra Evam Streeroga. Poornayu Ayurved Chikitsalay Evam Anusandhana Vidyapeeth, Jabalpur MP, India

⁴ MD Kaychikitsa Professor and HOD, Department of swastawritta. Shri Dhanwantari Ayurvedic MEDICAL COLLEGE, Mathura, India

 

1. INTRODUCTION

1.1. DEFINATION OF OSTEOPOROSIS

Osteoporosis is defined as a progressive systemic skeletal disease characterised by low bone mass and micro architectural deterioration of bone tissue with consequent increases in bone fragility and susceptibility to fracture. Wikipedia (2025)

 

2. CAUSES OF GENRALISED OSTEOPOROSIS Riggs and Melton (1992)

1)    Senility

·        Post immobilization

·        Post menopausal

·        Protein deficiency

·        Inadequate intake at old age

·        Illness malnutrition

·        Excess protein loss at 3^rd degree burns, CRF etc)

2)    Endocrinal

·        Cushing’s disease

·        Hyperthyroid state.

3)    Drug induced

·        Long term steroid therapy.

 

3. SIGNS AND SYMPTOMS OF OSTEOPOROSIS

·        Bone pain (Asthi toda)

·        Feeling of breaking of bone (Asthi bheda)

·        fracture (Anga Bheda)

·        Extreme fatigue (srama)

·        Joint pain (sandhi shool)

·        Periodontal disease (Danta bhanga)

·        Hair loss (kesh patan)

·        Forward bending of spine (vinamana)

·        Weakness (bala kshaya)

·        Brittle and soft bone (Asthi  saushirya)

·        Difficulty in walking (sandhi saushirya)

 

4. GENRAL EXAMINATION OF OSTEOPOROSIS

The findings are subtle and can be missed. A slight loss of height and increased kyphosis due to compression of the arterial part of the vertebral bodies is seen in most causes.

1)    Radiological feature

·        Radiological evidence of decreed bone mass is more reliable, but about 30 % of the bone mass must be loss before it becomes apparent of x-rays. The following feature may be noticed on x-rays:

·        Loss of vertical height of a vertebra due to collapse.

·        Cod fish appearance: the disc bulges into the adjacent vertebral bodies so that the disc becomes bi-convex

·        Ground glass appearance of the bone, conspicuous in bone like the pelvis.

·        Singh’s index: Singh et al. graded osteoporosis into 6 grades based on the trabecular pattern of femoral neck trabeculae.

·        Metacarpal index and vertebral index are other method of qualification of osteoporosis.

2)    Other investigations

·        Biochemistry: serum calcium, phosphate alkaline phosphates are within normal limits. The total plasma proteins and albumin may be low.

·        Densitometry: this is a method to quantify osteoporosis, where absorption of the photons emitted from the gamma emitting isotopes, by bone calcium is measured. Two types of densitometers are available- ultrasound based and x-ray based.

·        Bone biopsy: sometimes bone biopsy also needs to rule out osteoporosis.

 

5. OSTEOPOROSIS IN AYURVED

In Ayurved osteoporosis can consider as Asthi kshya. In Ayurvedic Samhita description of Asthi kshya comes under dhatu kshya. In sutrastan maharshi charak described eighteen types of kshaya Tripathi (2011). As per charak Samhita, we can consider Asthi kshay is an independent disease. Description of sign and symptoms as well as aetiology of this disease found in Samhita.

Ashraya – Ashrayi Bhava: Description of Ashraya-Asharayi bhava found in Ashtang Rudaya. This theory helps to understand ayurvedic description and pathology of osteoporosis. Asthi is stan of vata dosha. As vata is increases Asthi decreases and vice versa. This relationship of vata and Asthi dhatu called as Asharya Ashrayi Bhava. Generally, increases or decreases dosha will increases or decreases compounds Asharya i.e dhatu mala. But this rule is not applicable for vata dosha and Asthi dhatu. Garde (2010)

 

6. TREATMENT OF OSTEOPOROSIS IN AYURVED

The line of treatment will be correction of Asthi datwagni.to rule out vikruti of former dhatu, to provide nourishment to the Asthi .to start regeneration process in the Asthi .to start regeneration process in the Asthi.

All the philosophy of Asthi dhatu takes place in Asthi vaha srotus and Asthi dara kala. The Asthi dhara kala lies in the pakwashaya, which is similar to large intestine. All the conversion into Asthi dhatu of different nourishing factor takes place in this part, because this is the seat of Asthi dhatwagni. Thus, all nourishment begins in pakwashaya.

Thus, the treatment occurs in 2 main parts -1 shodhana and 2 shamana.

Behind all the above mentioned vikruti, which are to be corrected, there is vitiation of vata, the basic body human, which governs almost all the body physiology.

Therefore, for correction of vata, the very first step is Basti, which is the medicine for vata as shodhana chikitsa. Basti mean enema of various oil, decoction, honey etc which clines the pakwashaya, regularize the vata and thus improve all body metabolism. As stated above pakwashaya is also the root of Ashthidhara kala.

 

7. LIFESTYLE CHANGES

1)    Daily exercise: strengthens the bone.

2)    Stop smoking: smoker have lower bone density than nonsmoker.

3)    Get some sun: exposure of some skin to the sun needs to occur on most days of the week to allow enough vitamin D production.

4)    Drink alcohol in moderation: excessive alcohol consumption increases the risk of osteoporosis.

5)    Limit caffeinated drinks: excessive caffein can affect amount of calcium that our body absorbs.

Some of the formulations useful in Ashtikshya (oeteoporosis). Yograj Gugul, Trayodashang Gugul, Laxshadi Gugul, Abhadi Gugul, praval Bhasma, AjAsthi Bhasma, Kukundatwak Bhasma, Dashamularishta, Bhbhul twak choorna, Bhbularishta.

Panchkarma:

Snehana – Sarvanga Abhayanaga with til tail, Lakshadi tail, chandanbala tail.

Swadan: Sarwanaga swedan.

Basti: panchtikta ghrit ksheerbasti

 Vata shamana: Yograj guggul, Trayodashang guggul, Dashamularishta, Snehan, Swedan.

Asthi poshana:  Lakshadi guggul, abhadi guggul, panchtiktaksheer basti, snehan.

Rasayana: til tail anuwasana basti.

Thus, correction of pakwashaya status and modification of lifestyle helps in the improvement of bone physiology and prevent osteoporosis.

 

8. DISCUSION

In Ayurveda, Osteoporosis is not referred to by its modern name, but the condition is understood and described in terms of Dhatu Kshaya (the depletion of tissues) and Vata-Vyadhi (diseases caused by the disturbance of Vata dosha). Osteoporosis, which is characterized by the weakening of bones and increased susceptibility to fractures, aligns with these Ayurvedic principles, especially the imbalance of Vata dosha affecting the Asthi dhatu (bone tissue).

 

9. CONCLUSION

While Ayurveda does not specifically define osteoporosis as modern medicine does, the principles of Vata imbalance, Dhatu Kshaya, and the importance of proper nourishment and rejuvenation therapies provide a comprehensive approach to understanding and treating conditions that lead to bone weakening and fractures. Ayurvedic therapies, when combined with modern medical practices, can offer a holistic approach to managing and preventing osteoporosis.

 

CONFLICT OF INTERESTS

None. 

 

ACKNOWLEDGMENTS

None.

 

REFERENCES

Garde, G. K. (2010). Astang Ruday, Sutra Stan: Doshadividyaniya Adhya (Adhya 2, verses 26–27, p. 61). Proficient Publication House.  

Riggs, B. L., & Melton, L. J. III. (1992). The Prevention and Treatment of Osteoporosis. The New England Journal of Medicine, 327(9), 620–627. https://www.nejm.org/doi/abs/10.1056/NEJM199208273270908   

Tripathi, B. (2011). Charaka Samhita (Vol. I, Sutra Sthan 21/8, p. 324). Varanasi: Chaukhamba Bharti Academy.  

Wikipedia contributors. (2025, March 15). Osteoporosis. Retrieved March 15, 2025, from