Evidence-Based Integrative Ayurvedic Management of Amavata (Rheumatoid Arthritis) Triggered by Post-COVID-19 Infection through a Novel Medicated Water Therapy – A Clinical Case Report

Abstract

Background: Post-COVID-19 autoimmune complications, particularly rheumatoid arthritis (RA), represent emerging clinical challenges. Amavata, the Ayurvedic correlate of RA, arises from Ama and vitiated Vata dosha. Conventional disease-modifying antirheumatic drugs (DMARDs) carry long-term risks, necessitating integrative therapeutic alternatives. Case Presentation: A 41-year-old female bank cashier presented with a 4.5-year history of bilateral symmetrical joint pain and swelling involving metacarpophalangeal (MCP), proximal interphalangeal (PIP), and ankle joints, developing six months after confirmed COVID-19 infection (April 2020). Symptoms included morning stiffness (30–60 minutes), chronic fatigue, disturbed sleep, and gastrointestinal complaints. Laboratory investigations confirmed seropositive RA: rheumatoid factor 45.2 IU/ml, erythrocyte sedimentation rate (ESR) 112 mm/hr, and C-reactive protein (CRP) 6.90 mg/L. Intervention: An 11-week integrative Ayurvedic protocol was implemented alongside ongoing DMARD therapy. Sequential Shamana Chikitsa comprised Amrutha Shadangam Kashayam, Hinguvastaka Churna, Indukanta Ghrita Snehapana, Trailokya Vijaya Vati, and Simhanada Guggulu. A novel two-phase Sausadham Jala (medicated water) therapy utilised Phase I Nagara Dhanyaka Siddha Jala followed by Phase II Laghu Panchamula Jala with Amalaki churna. Agnikarma, Sukshma Vyayama, and Pathya-Apathya guidelines were concurrently applied. Outcomes: Rheumatoid factor normalised (18.4 IU/ml), ESR reduced markedly (18 mm/hr), and CRP declined (5.2 mg/L). Symptom severity improved from Grade 3 to Grade 1 across joint pain, swelling, and stiffness. Digestive weakness, appetite loss, and constipation resolved completely. No adverse effects were recorded. Conclusion: This evidence-based integrative Ayurvedic approach with novel Sausadham Jala therapy demonstrates significant therapeutic efficacy in post-COVID-19. Amavata, addressing inflammatory processes and underlying metabolic dysfunction. Larger randomised controlled trials are warranted to validate these findings.