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Seeking Advice on Treatment for Ankylosing Spondylitis and Associated Symptoms
Orthopedic Disorders
Question #46936
111 days ago
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Seeking Advice on Treatment for Ankylosing Spondylitis and Associated Symptoms - #46936

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I have ankylosing spondylitis, HLA-B27 antigen, bed sciatic pain that comes and go and is debilitating when comes to point cant walk and in wheelchair when flares. Also had a few head injuries which exasperate symptoms. The disorder also affects my eye nerves pain in form of iritis and bladder have many UTIs and just overall urinary issues I think related to nerves in that region being affected. I try many things over past 2-3 decades and no relief. I heard gold may help with arthritic pain in these joints and was wondering about a combination of healing metals such as • Vasant Kusumakar Ras? But also heard that Sameera Pannaga Rasa would help. Do you think it would be okay to take Vasant Kusumakar and Sameera Pannaga Rasa in combination? What do you recommend in general for this? Thank you much for advice

How long have you been experiencing symptoms related to ankylosing spondylitis?:

- More than 10 years

What triggers your flare-ups or worsens your symptoms?:

- Physical activity

How would you describe your current pain level during a flare-up?:

- Debilitating
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Doctors' responses

Hello, Your history of ankylosing spondylitis (HLA-B27 positive) for more than 10 years, with severe inflammatory low-back and sciatic pain causing wheelchair dependence during flares, along with iritis (eye nerve inflammation) and recurrent urinary/bladder issues, clearly indicates a long-standing systemic inflammatory autoimmune disorder with deep involvement of the spine, sacroiliac joints, nerves (Majja), eyes, and Apana Vata (pelvic–bladder region). Past head injuries further aggravate Vata, worsening neurological pain and flare severity.

In such chronic cases, conventional medicine often offers symptomatic control only. Ayurveda approaches this condition as Gambhira Vata–Pitta Pradhana Vata Vyadhi, affecting Asthi–Majja Dhatu, where treatment aims to control inflammation, pacify aggravated Vata, nourish nerves and joints, and prevent flare recurrence through stage-wise therapy. Regarding your question on gold and mineral medicines: 👉 Vasant Kusumakar Rasa and Sameera Pannaga Rasa should NOT be taken together. They are used sequentially, based on disease stage and flare activity, under strict supervision.

🔎 Recommended Investigations (If not done in the last 6 months) CBC, ESR, CRP – disease activity & inflammation Liver & Kidney Function Tests – safety before Rasoushadhis Serum Vitamin D, B12, Calcium Urine routine & culture – recurrent UTIs MRI spine / SI joints – disease progression (if available)

💊 Internal Medicines Phase 1 – 30 days 1.Simhanada Guggulu – 2 tablets twice daily after meals 2.Mahayogaraja Guggulu (without gold) – 1 tablet twice daily 3.Dashamoola–Guduchi Kashayam – 15 ml + 30 ml warm water, twice daily before food 4.Shallaki (Boswellia serrata) – 400–500 mg capsule, twice daily

Phase 2 – 45 days 1.Vasant Kusumakar Rasa – ½ tablet once daily after breakfast With cow’s milk OR honey + ghee (equal quantity) 2.Ashwagandha Ghana Vati – 1 tablet twice daily 3.Guduchi Satva – 500 mg twice daily 4.Gokshura Churna – ½ tsp twice daily with warm water (supports bladder & Apana Vata) ⚠️ Do not use Sameera Pannaga Rasa during this phase.

Phase 3 – Acute flare-up protocol (short-term only) (For severe pain & immobility) 1.Sameera Pannaga Rasa – ¼ tablet once daily, for 7–10 days only 2.Rasna Saptaka Kashayam – 15 ml + 30 ml warm water, twice daily 3.Castor oil – 5 ml with warm milk at bedtime (if digestion allows) 👉 Stop Sameera Pannaga as soon as the flare subsides.

🌿 External & Supportive Therapies 1.Abhyanga (daily oil massage) Mahanarayana Taila / Sahacharadi Taila 2.Swedana (sudation therapy) Nadi Sweda or Patra Pinda Sweda 3.Basti Therapy (most important for AS) Anuvasana Basti – Ksheerabala / Sahacharadi Taila Niruha Basti – Dashamoola-based Kati Basti – during lumbar & sciatic flares

🥗 Diet & Lifestyle Recommendations ❌ Avoid Cold exposure, cold water bathing Excess physical exertion during flares Red meat, fermented foods, alcohol Late nights, fasting Suppressing urine or bowel urges ✅ Include Warm, freshly prepared, unctuous food Rice, moong dal, vegetable soups Cow’s ghee – 1–2 tsp daily Turmeric with ghee (small quantity) Regular sleep–wake routine

🧘🏻‍♂️ Yoga & Breathing Practices (Only during remission, gently) Asanas Gentle spinal mobility Supported stretches Vajrasana after meals Pranayama Anulom Vilom – 10 minutes Bhramari – 7 rounds Nadi Shodhana – daily ❌ Avoid aggressive backbends or forceful physiotherapy.

🕉️ Follow-up & Duration Reduction in flare severity: 4–6 weeks Improved mobility between flares: 2–3 months Reduced flare frequency with consistent Basti & Rasayana therapy Eye and bladder symptoms stabilize with Apana Vata correction

✨Chronic ankylosing spondylitis with nerve, eye, and bladder involvement can be significantly controlled, but requires structured, phased Ayurvedic management. Gold-based medicines help only when introduced at the right stage, and Sameera Pannaga is reserved strictly for short-term flare control.

With kind regards, Dr. Sumi MS (Ayu)

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Hello, This requires a detailed examination by an ayurveda doctor in person so that line of treatment is accurate. Please visit a nearby ayurveda clinic which has panchakarma treatment facility. Panchakarma treatment swll be of great help to improve QoL along with internal ayurveda medications. Kind regards, Take care.

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Don’t worry take brihath vata chintamani ras 1tab bd, makaradwaja 1tab bd, DHANWANTARI tail+ murivenaa tail for kati vasti, anuloman ds 1tab bd, rasansapthaka kashyam 20ml bd enough U ll get results

Dr RC BAMS MS

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For your condition where spinal inflammation has been present for many years with severe flare episodes ,nerve pain ,eye involvement ,and urinary disturbances the choice of medicine must be extremely careful.

Vasant Kusumakar Ras is not a medicine meant for active disease states where pain inflammation ,stiffness ,nerve irritation and immune activity are ongoing ,It is meant for use only when the body is stable ,digestion is strong ,inflammation is under control ,and tissues are ready to receive nourishment . When taken during active ankylosing spondylitis ,it can increase heat in the system worsen joint pain intensify nerve irritation trigger eye pain and aggravate urinary symptoms

Sameera Pannaga Rasa is a very strong fast acting medicine Its nature is sharp penetrating and stimulating It is traditionally reserved for specific acute conditions and only for short duration In a body where nerves are already sensitive spinal cord and sciatic region are involved bladder function is unstable and head injury history exists this medicine can overstimulate the nervous system and worsen pain flares tremors anxiety urinary irritation and sleep disturbance.

Using these two medicines together increases the risk of systemic imbalance .This combination is not advised because both are heavy acting and demand a very stable internal environment which is not present in your current disease stage.

Gold containing medicines do not work like painkillers .They do not suppress inflammation immediately .Their role is restorative and strengthening after inflammation has settled .When used at the wrong time they can do more harm than benefit.

For a condition like yours the correct approach is to first reduce inflammatory activity calm nerve irritation ,improve bowel and bladder regulation ,support eye health ,and stabilize the spine .when flare frequency reduces ,pain intensity decreases and mobility improves should stronger restorative medicines even be considered.

Avoid physical overexertion during flare periods . Avoid cold exposure ,irregular sleep ,long fasting ,dry foods and anything that increases internal dryness ,or heat Maintain warmth regular routine, gentle movement only when pain allows and consistent rest during flares.

Strong medicines should always be introduced one at a time never combined and only after the body shows signs of readiness Otherwise repeated worsening cycles can occur.

Your condition requires patience consistency rather than forceful intervention .When handled in the correct sequence improvement may be slow but it is safer and more sustainable.

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Don’t take these medicines right now. It is better to consult personally and ayurvedic doctor.

Panchakarma therapies have significant role in your condition.

These abhyanga, dhara will improve your condition.

Till consultation you can start some internal medicine 1. Amrutottara kashaya 15 ml+ 45 ml lukewarm water at morning. 2. Rasnaerandadi kashaya 15 ml+ 45 ml lukewarm water at evening. 3. Vaiswanara choorna 1/2 tsp at lunch time after food. 4. Avipathy choornam 1/2 tsp at night weekly twice.

Take care, Dr. Shaniba

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Some regime you should follow

✔️Do’s:✔️ Eat freshly cooked food. Chew an inch of fresh ginger half an before meal. Eat only fruit vegetables. Limit dairy products (stop if possible)

🧘‍♀️Yoga🧘‍♀️ Virabhadrasana Trikonasana Vrukshasan Prasavkonasan Bhujangasan Balasan Shavana

First thing in the morning as you open your eyes you have to do this exercise on bed. Raise your left leg straight up as high as you can without bending your knees. Bring in back down upto 5 degree donot touch down hold it in the air. Repeat this atleast 5 times in the start and slowly slowly increase the count.

🧘‍♀️Pranayam🧘‍♀️ Anulom Vilom Bhastrika Kapalbhati

❌Dont’s:❌ Sitting directly under a fan or right in front of the A.C Oily, spicy, processed food. Packed food products. Sour and fermented items. Bakery items. Fried food products. Potatoes.

💊Medication💊

Tab. Ampachak Vati. 2 tabs twice a day before food. Tab. Sinhanad Guggul 2 tabs twice a day before food. Cap. Palsinuron 2 caps twice a day before food. Syp. Maharasnadi Kwath 3 tsp twice a day before food with warm water.

Tab. Shankhavati 2 tabs twice a day after food. Suck and eat like hajmola

Sunthi Siddh Castor Oil. 3 tsp at bed time with a cup of hot water.

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Hi Well suffering from a long time requires physical examination also but for now I would like to recommend you Shallaki plus -2-BD Yograj guggulu -2-BD Magavatavidhwansan rasa-2-BD Shankh bhasma-250 mg-BD

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Once try Spinal dhara at near panchkarma centre Take lubartone ( avn pharma ) 2 tds Take ashtisrukhla ghee 5 ml at empty stomach at morning

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1.Simhanada guggulu 2 tab twice daily with water after meals 2.Shallaki tablets 2 tab twice daily with water after meals 3.Rasna saptak kwath 20 ml with 20 ml water twice daily with water after meals 4.Ashwagandha capsules 1 cap twice daily with warm milk after meals

🧘 Lifestyle & Diet Support -Gentle yoga & physiotherapy: Focus on flexibility, avoid over‑exertion. -Heat therapy: Warm compresses for sciatic pain. -Diet: Anti‑inflammatory foods (leafy greens, turmeric, ginger, flaxseed, walnuts), avoid excess red meat and processed foods. -Eye care: Regular ophthalmology check‑ups for iritis. -Hydration: Adequate fluids to reduce UTI risk.

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ANKYLOSING SPONDYLITIS IS A CHRONIC INFLAMMATORY CONDITION AFFECTING THE SPINE LARGE JOINTS AND SOMETIMES OTHER SYSTEMS LIKE EYES AND BLADDER YOUR HISTORY OF SCIATIC PAIN IRITIS AND RECURRENT URINARY ISSUES INDICATES THAT THE INFLAMMATION IS WIDESPREAD AND CAN BE EXACERBATED BY PRIOR TRAUMA SUCH AS HEAD INJURIES OVER DECADES THE BODY CAN DEVELOP SENSITIZATION AND FLARE PATTERNS MAKING MANAGEMENT CHALLENGING

VASANT KUSUMAKAR RAS AND SAMEERA PANNAGA RASA ARE USED FOR JOINT PAIN INFLAMMATION AND NERVE INVOLVEMENT BUT THEY ARE HIGHLY POTENT BHASMAS AND NEED VERY CAREFUL USE ONE OF THE CONCERNS IS THAT TAKING MULTIPLE HEAVY METAL PREPARATIONS TOGETHER CAN STRESS THE DIGESTIVE AND EXCRETORY SYSTEMS AND CAN WORSEN INTERNAL TOXICITY OR GASTROINTESTINAL DISTURBANCE

VASANT KUSUMAKAR RAS IS TRADITIONALLY USED FOR CHRONIC JOINT PAIN ,DIABETIC NEUROPATHY AND NERVE RELATED ISSUES AND METALS ARE PROCESSED TO REDUCE TOXICITY .

SAMEERA PANNAGA RASA IS POWERFUL AND IS OFTEN USED FOR PAIN INFLAMMATION AND NERVE DISORDERS, COMBINING THEM WITHOUT PROFESSIONAL MONITORING IS NOT RECOMMENDED BECAUSE THE EFFECTS CAN BE ADDITIVE AND CAUSE GUT DISTURBANCE OR LIVER STRESS.

THE GENERAL RECOMMENDATION IS TO START WITH ONE PREPARATION AT A TIME UNDER CLOSE MONITORING OF LIVER KIDNEY AND BLOOD PARAMETERS AND ALSO TO ENSURE DIGESTIVE CAPACITY IS OPTIMAL WITH SUPPORTIVE DIET AND HERBS THEN BASED ON RESPONSE AND TOLERANCE A SECOND PREPARATION MAY BE INTRODUCED GRADUALLY

DAILY PHYSICAL THERAPY AND STRETCHING D FOR ANKYLOSING SPONDYLITIS TO MAINTAIN SPINAL FLEXIBILITY AND REDUCE STIFFNESS REGULAR BREATHING AND RELAXATION PRACTICES HELP NERVOUS SYSTEM CALMING AND REDUCE PAIN PERCEPTION DIGESTIVE AND LIVER SUPPORT HERBS AND DIETARY REGIMES HELP PROCESS THE METALS AND REDUCE SIDE EFFECTS

FOR BLADDER AND URINARY ISSUES SUPPORTIVE HERBS AND LIFESTYLE MEASURES ARE IMPORTANT AS NERVE INVOLVEMENT CAN CAUSE FREQUENT INFECTION AND FLOW ISSUES MAINTAINING HYDRATION REGULAR VOIDING AND MONITORING INFECTION EARLY PREVENTS COMPLICATIONS

HEALTH MONITORING WITH REGULAR BLOOD TESTS LIVER AND KIDNEY FUNCTION AND POSSIBLY URINE CULTURE IS IMPORTANT IF YOU USE BHASMAS CHRONICALLY

START WITH VASANT KUSUMAKAR RAS AFTER FOOD ONCE DAILY

SAMEERA PANNAGA RASA CAN BE INTRODUCED LATER IF NECESSARY BASED ON TOLERANCE AND RESPONSE IT IS NEVER RECOMMENDED TO TAKE BOTH TOGETHER

CONSISTENCY ,PATIENCE AND REGULAR FOLLOW UP ARE ESSENTIAL FOCUS ON , REGULAR EXERCISE PROPER SLEEP NUTRITION AND STRESS MANAGEMENT ALONG WITH CAUTIOUS USE OF HERBO METALLIC FORMULATIONS .THIS HOLISTIC APPROACH SUPPORTS PAIN RELIEF JOINT FUNCTION AND OVERALL WELLBEING

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Ankylosing spondylitis is auto immune and cannot be cured. You have to take ayurvedic medicine that can make your life comfortable and least side effects. Do abhyangam full body massage with sesame oil and expose to sunrays during sunrise and sunset time will help. Always do whatever exercises are possible to be done daily, like pranayam, stretching exercises, and sitting on chair yoga under expert’s guidance. Avoid sour fermented foods cold foods drinks icecream. Avoid exposure to cold climates and direct breeze. Start with Rasnasapthakam kashaya 10ml twice daily after food with water Sinhanad guggul 1-0-1 after food with water Mahavatvidhvansh vati 1-0-1 after food with water. Dashamoola ghanvati 1-0-1 after food with water. Apply dhanvantrum oil on affected area twice daily. Follow up after 1 month

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I’m sorry for your long struggle, AS can be relentless, especially with iritis, UTIs and urinary issues (likely from inflammation affecting nerves). Head injuries may exacerbate flares via stress/Vata. Gold-based Rasas like Vasant Kusumakar Ras have anecdotal benefits for arthritic pain, but studies show limited evidence for AS relief. Sameera Pannaga Rasa is more conceptual for inflammation. Combining them is safe but not ideal long-term , use one Rasa with herbals for better synergy.

Best Combination to start 1 Sameera Pannaga Rasa – 1 tablet morning with warm water (single Rasa – anti-inflammatory for flares & pain) 2 Yogaraja Guggulu – 2 tablets morning + night after food (reduces stiffness & sciatica). 3 Shallaki 600mg – 2 tablets morning + night after food (clears inflammation in joints & eyes). 4 Gokshuradi Guggulu – 2 tablets morning + night after food (supports urinary health & UTIs). 5 Dashmoolarishta – 20 ml + 40 ml warm water after lunch & dinner

Oil (Daily – Must) Warm Maharasnadi Taila – gentle full-body massage nightly followed by hot fomentation 10 min (relieves pain & stiffness

Recommended Panchakarma (Highly Effective – Do if Possible) 1 Matra Basti (daily small oil enema with Sahacharadi Taila 50ml) for 15–21 days (nourishes nerves, reduces flares & sciatica).

2 Abhyanga + Swedana (oil massage + steam) – 14–21 days At reputed ayurvedic Panchakarma center

Diet Give only: moong khichdi + ghee, pomegranate, coconut water. Avoid completely: spicy/sour, cold drinks, non-veg, excessive salt.

Lifestyle Gentle walk 20–30 min daily (slow pace). Anulom-Vilom 10 min daily (reduces stress from head injuries). Sleep 10 PM – 6 AM strictly. No heavy activity/straining.

Regards Dr Gursimran Jeet Singh MD Panchakarma

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