A New Dimension To The Ayurvedic Disease Sandhivata and Sandhi Bhagna WSR To Modern Disease Osteoarthritis

Osteoarthritis (OA) is the most prevalent degenerative joint disorder worldwide, characterised by progressive deterioration of articular cartilage, subchondral bone remodelling, synovial inflammation, and periarticular structural changes. Its global burden is escalating with ageing populations and rising obesity rates, making it a significant public health concern. In Ayurvedic medicine, the disease finds its classical counterpart primarily in Sandhivata, a Vataja Nanatmaja Vyadhi (disease causes exclusively due to Vata dosha) described in Brihatrayi texts, characterised by Shotha (joint swelling), Shoola (pain), Vatapurna Druti Sparsha (bag-of-wind feel on palpation), and restricted Prasarana-Akunchana (flexion-extension). Additionally, the complication Sandhi Bhagna (fracture), encompassing six forms of joint dislocation (Sandhimukta), provides a sophisticated Ayurvedic taxonomy of advanced OA sequelae. This literature review systematically explores the classical Ayurvedic conceptualisation of Sandhivata and Sandhi Bhagna in relation to the modern understanding of OA pathophysiology, epidemiology, differential diagnosis, and management. Drawing upon primary Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam) and contemporary peer-reviewed biomedical literature published over the past decade, the article critically analyses aetiological parallels (Dhatu Kshaya and cartilage degradation; Vata Prakopa and neurogenic inflammation), pathogenetic convergences (Shleshak Kapha depletion and synovial fluid loss; Asthi Shoshana and subchondral bone sclerosis), diagnostic correlations (threefold examination and clinical examination), and therapeutic applications of classical Ayurvedic interventions including Snehana (oileation), Swedana (fomentation), and Basti (enema). Research gaps in integrative clinical trial design, biomarker validation of Ayurvedic constructs, and standardisation of classical formulations for OA are identified. This review aims to provide a scholarly foundation for future integrative research and evidence-based Ayurvedic clinical practice in musculoskeletal disorders.