Integrative Management of Ankylosing Spondylitis: An Ayurvedic Case Study

Background: Dandaka Roga is an Ayurvedic clinical presentation associated with stiffness, pain, restricted movement and musculoskeletal functional impairment. The clinical features of inflammatory axial and peripheral arthropathies may overlap with this presentation, although an Ayurvedic clinical correlation is not an exact biomedical equivalent. Case Presentation: An 11-year-old male patient with documented enthesitis-related juvenile idiopathic arthritis (ER-JIA), HLA-B27 positive, axial and peripheral arthritis, right hip arthritis and enthesitis presented with knee pain/swelling and bilateral ankle swelling. Previous treatment included conventional rheumatological medicines. Early sacroiliitis had been reported on MRI, and the case was clinically correlated with Dandaka Roga. Intervention and Outcome: The patient received Mahatikta Ghrita Snehapana in an escalating dose of 10, 20, 30, 50, 70 and 100 mL over six days, followed by Virechana with Trivrit Avaleha. After Samsarjana Karma, a 16-day Kala Basti schedule was administered using Dashamula Niruha Basti (approx. 200 mL) and Dhanwantara Taila Anuvasana Basti (50 mL). Symptomatic improvement was reported in musculoskeletal pain, stiffness, joint discomfort and functional symptoms. Conclusion: This case documents the application of a sequential Panchakarma protocol in a child with ER-JIA clinically correlated with Dandaka Roga. The available record supports a description of symptomatic improvement only. Controlled studies are needed to evaluate safety and effectiveness.