Ayurvedic Management Of Janusandhigata Vata (Knee Osteoarthritis) By Jalaukavacharana And Adjuvant Ayurvedic Medication: A Case Report

Background:Knee osteoarthritis is a chronic degenerative joint disorder characterized by pain, stiffness, tenderness, swelling, crepitations, and restricted joint movements, leading to functional disability and reduced quality of life. In Ayurveda, the clinical features of Knee osteoarthritis resemble Janusandhigata Vata. Jalaukavacharana (leech therapy), a parasurgical procedure described in Ayurveda, is traditionally indicated for conditions associated with pain and inflammation. This case report evaluates the clinical outcome of Jalaukavacharana in a patient with bilateral knee osteoarthritis. Methods:A patient diagnosed with bilateral knee osteoarthritis presented with pain, tenderness, swelling, crepitations, stiffness, and pain during knee movements. Baseline assessment was performed using the Visual Analogue Scale (VAS) for pain and clinical parameters including tenderness, swelling, crepitations, stiffness, and pain on movement. The patient underwent a multimodal Ayurvedic treatment regimen including Panchakarma procedures, adjuvant Ayurvedic medication, and Jalaukavacharana. Two sittings of Jalaukavacharana were administered at a 15-day interval. Clinical evaluations were conducted before and after each sitting and at a follow-up visit on Day 30. Results:At baseline, the patient reported bilateral knee pain with a VAS score of 4, along with tenderness, mild swelling, crepitations, stiffness, and pain during knee movement. Following the first sitting, pain reduced to VAS 1 in both knees, with improvement in all associated clinical parameters. Swelling resolved completely in the left knee and reduced in the right knee. The clinical improvement was maintained until the second sitting. At the Day 30 follow-up, complete relief was observed in both knees. Pain reduced to VAS 0, and tenderness, swelling, crepitations, stiffness, and pain during knee movement were absent bilaterally. No adverse events were observed during the treatment or follow-up period. Conclusion:Jalaukavacharana was associated with progressive and sustained improvement in the clinical manifestations of bilateral knee osteoarthritis in this patient. The intervention resulted in complete resolution of pain and other assessed clinical parameters at the 30-day follow-up. These findings suggest that Jalaukavacharana along with adjuvant Ayurvedic drugs is a viable therapeutic option in the management of knee osteoarthritis; however, further controlled clinical studies are required to establish its efficacy and safety. Keywords: Jalaukavacharana; Leech Therapy; Knee Osteoarthritis; Janusandhigata Vata, Ayurved.