Hello Rajesh,
Thank you for clearly explaining your health background. At 25, with chronic back pain due to bilateral sacroiliitis, past osteopenia, and low Vitamin D (20.7 ng/mL), your condition reflects a Vata–Kapha imbalance with Asthi dhatu kshaya (bone tissue depletion) in Ayurveda. This needs a dual focus: controlling inflammation (sacroiliitis), rebuilding bone strength (osteopenia), and correcting Vitamin D deficiency.
🔎 Key Findings in Your Case * Sacroiliitis (inflammation of sacroiliac joints): Often linked with autoimmune causes (e.g., Ankylosing Spondylitis). * Osteopenia: Low bone density at a very young age → needs urgent correction to prevent osteoporosis. * Vitamin D deficiency: 20.7 ng/mL (below normal, should be 30–50 ng/mL). * Dust allergy: Suggests hypersensitive immune system.
1. Ayurvedic Internal Medicines (after doctor’s guidance) * Lakshadi guggulu – 2 tablets twice daily after meals (bone strengthening). * Ashwagandha churna – 3 g with warm milk daily (muscle & bone support). * Shallaki (Boswellia) – 1 capsule twice daily (reduces joint inflammation). * Guduchi (Giloy) – 1 tablet twice daily (immune modulation & anti-inflammatory).
2. External Therapies * Abhyanga (oil massage) with Mahanarayana taila or Dhanwantharam taila – daily before bath. * Nadi sweda (steam therapy) for stiffness relief.
🥗 Diet & Lifestyle
❌ Avoid * Cold, sour, fermented foods (curd at night, bakery items). * Smoking, excess tea/coffee, alcohol. * Prolonged sitting posture.
✅ Include * Warm milk with turmeric (strengthens bones, reduces inflammation). * Tila (sesame seeds), almonds, dates, figs (calcium rich). * Amla, curry leaves, drumstick leaves (Vitamin C & calcium for bone health). * Sun exposure: 20–30 min daily (morning sunlight best for Vitamin D). * Drink warm jeera–ajwain water for digestion & inflammation balance.
🧘🏻♂️ Yoga & Physiotherapy * Gentle physiotherapy for sacroiliac joint stability. * Yoga asanas: -Bhujangasana, Setu Bandhasana, Tadasana, Shalabhasana (for spine & bones). -Pranayama: Anulom Vilom, Bhramari – reduce inflammation & improve oxygenation. -Avoid high-impact exercises until bones regain strength.
📌 Follow-up Investigations
Vitamin D, Calcium, PTH every 6 months.
ESR, CRP, HLA-B27 if inflammation persists.
DEXA scan yearly.
✨ Rajesh, your main focus should be on Vitamin D correction + bone strengthening + inflammation control. An integrative plan of Vitamin D supplementation, bone-supportive Ayurvedic Rasayanas (Lakshadi guggulu, Ashwagandha), diet, yoga, and lifestyle correction can help you rebuild strength and prevent progression to osteoporosis or severe arthritis.
With kind regards, Dr. Sumi
HELLO RAJESH,
From your description , it sounds like you have chronic inflammatory sacrolitis (likely related to pondyloarthritis) along with osteopenia and vitamin D deficiency (20.7 ng/mL). These issues are interconnected: long term inflammation can weaken bones, and low vitamin D can worsen pain and bone strength
In ayurveda, your condition corresponds mainly to -Asthi kshaya - bone depletion -Vata Vyadhi- vata aggravation in bones and joints- especially in Trika sandhi (sacroiliac joints) -possibly ama accumulation (inflammatory toxins due to poor digestion/metabolism)
TREATMENT GOALS -reduce inflammation and pain -remove ama(toxins) to stop further damage -pacify aggravated vata -rebuild and nourish bone tissue (asthi dhatu) -restore strength, flexibility, and immunity
INTERNAL MEDICATIONS
1) SIMHANADA GUGGULU= 1 tab twice daily after meals with warm water for 3 months =removes ama, reduces joint inflammation, relieves stiffness
2) YOGARAJ GUGGULU= 1 tab twice daily after meals for 3 months =pacifies vata, strengthens joints, relieves chronic back pain
3)LAKSHADI GUGGULU= 1 tab twice daily with milk after meals for 3 monhs =promotes bone healing and bone tissue nourishment
4) DASHMOOLA KASHAYA= 20 ml + equal water twice daily before meals for 3 months =reduces inflammation and muscle stiffness
5) PRAVAL PISHTI + MUKTA SHUKTI BHASMA= 125 mg each twice daily with honey after meals for 2 months =natural calcium and vitamin D source, supports bone density
6) AMALAKI RASAYANA= 1 tsp daily in morning =rejuvinative- improves immunity and energy
HOME REMEDIES -warm mustard oil or mahanarayan taila massage on lower back daily before bath -drink warm water infused with dry ginger or cumin to aid digestion and reduce ama -take turmeric + black pepper + ghee daily- 1/4 tsp each to reduce inflammation -sesame seeds black or ragi porridge for bone calcium -soaked almonds 5 and 1 date every morning for strength -moringa leaf soup or drumstick vegetable-natural calcium and anti inflamamtory
DIET -warm, freshly prepare dfood -milk, ghee, almond, sesame seeds, ragi -soups, vegetable stews, moong dal khichdi -turemric, ginger, black pepper -fruits= papaya, dates, pomegranate -herbal teas= ginger tulsi cinnamon
AVOID -cold, dry, stale or frozen food -excess pulses - rajma, chana, raw salads -fried food, white sugar, bakery items -excess sour or spicy fod -cold drinks, carbonated beverages -coffee in excess
Eat only when hungry, avoid overeating, and drink warm water throughout the day
YOGA ASANAS -marjariasana= improve spine flexibility -bhujangasana= strengthens lower back -setu bandhasana= strengthens hips and sacrum -pawanmuktasana= relieves stiffness -tadasana= improves posture
Avoid forward bending, twisting, or jerky movements
PRANAYAM -Anulom vilom= balances vata -bhramari= calms nerves, reduces pain perception -deep diaphragmatic breathing= oxygenates muscles, reduces fatigue
INVESTIGATIONS ADVISED -MRI/X-RAY of lumbosacral spine and SI joints- if pain worsens -Vitamin d3 and calcium every 3 months -DEXA sacn- to monitor osteopenia -ESR/CRP= markers of inflammation -HLA-B27= to rule out ankylosing spondylitis -Thyroid profile and CBC= for general health
LIFESTYLE MODIFICATIONS -Regular sunlight= 20-30 min daily morning sunlight -Maintain posture= avoid prolonged sitting or bending, use firm bed, not soft mattress -Gentle daily walk= 20-30 min improves blood flow to joints -Sleep= go to bed early, avoid late night -Stress management= chronic stress increases vata- meditation helps -Avoid exposure to cold wind , staying hungry long, or overexertion
Your condition can be managed and improved very well with ayurvedic treatment if approached systematically
The key is consistency- chronic inflammatory conditions take 3-6 months of disciplined therapy and lifestyle correction to show deep improvement
DO FOLLOW
HOPE THIS MIGHT BE HELPFUL
THANK YOU
DR. MAITRI ACHARYA
Avoid sour, fermented and processed foods. Regular exercise. Increase intake of raw vegetables and fruits. Take morning sunlight at least for10to15 minutes. Cap. Gufispon 2-0-2 Cap stresscom 1-0-1 Tab. Asthishrunkhla 2-0-2 Follow up after 2weeks
Don’t worry take mahayoga Guggulu with gold 1tab bd, vatavidhwasini ras 1tab bd,maharasna spathaka kahshayam 20ml bd and kativasti with maha Vishagarba tail+dhanwantari tail enough
You will almost certainly require high-dose Vitamin D supplementation as prescribed by a doctor to quickly raise your levels, followed by a maintenance dose.
Dietary Adjustments:
Avoid Vata-Aggravating Foods: Reduce dry, cold, raw, and light foods. Limit pungent, bitter, and astringent tastes.
Favor Warm, Cooked Foods: Eat warm, nourishing, and easily digestible meals. Use healthy fats like Ghee.
Avoid Ama-Forming Foods: Reduce processed foods, curd/yogurt, and heavy-to-digest items.
3. Lifestyle and Exercise Balanced Activity:
Gentle Exercise: Focus on mild to moderate activities like Yoga (specific asanas as advised by a Vaidya), deep breathing (Pranayama), and meditation. This helps with strength, flexibility, and stress management.
Avoid Over-Exertion: Do not stress the lower back or hips. Avoid prolonged sitting or standing, running, or climbing stairs if they worsen your pain.
Rest: Ensure adequate rest and sleep (ideally before 10 PM).
Self-Care:
Abhyanga (Oil Massage): Daily or weekly self-massage with warm, medicated oils (like Mahanarayana Taila or Sesame oil) is highly recommended to pacify Vata, lubricate joints, and strengthen bones.
4. Manage Dust Allergy (Kaphaja/Vataja Pratishyaya) While managing your primary conditions, keep your dust allergy in check to prevent it from taxing your immune and inflammatory system.
Avoid Triggers: Minimize exposure to dust.
Incorporate gentle movement, sunlight, and self-massage into your daily routine.
1) yograj gugglu-1 tab 3 times after food
2) giloy ghan vati -1 tab 3 times after food
3) ashwagnadha churna- 1 tsf after food 2 times
Here are some changes you need to do to help you recover from pain.
✔️Do✔️ Include ragi millet in your diet Inclued black eyed pea in your diet Boiled egg one every alternate day Dinner as early as possible 1-2 tsp of cow ghee in the diet Dal and boiled chicken as source of protein
🧘♀️Yogasan🧘♀️ Hastapadasan Pashimotanasan Vrukshasan Trikonasan Tadasan Naukasan Veer Bhadrasan
❌Dont❌ Tea and coffee Aerated drinks Addictions Continuous sitting in one position for more than an hour. Late night using screen
💊Medication💊
Tab. Ampachak Vati 2 tabs twice a day before food Tab. Asthiposhak Vati 1 tab twice a day before food Cap Arnopein (S.G.Phytopharma) 2 caps twice a day before food Syp. Dasmoolarishta 3 tsp twice a day before food.
Mild massage with luke warm sesame seed oil. Exposure to morning sun after massage. Hot water bath after sun exposure.
Sunthi sidh Castor Oil 3 tsp at bed time with a cup of hot water
Trayodashanga guggulu 1-0-1 Ashwagandha cap 0-0-1 Peedantaka vati 1-0-1 Dashamoola aristha 15-0-15 ml with equal water Include calcium rich foods
Hlo rajesh ji,
Nothing to worry , firstly want to know your slr with both legs. Any previous medical history? Or surgery?
As it’s chronic will advice you both oral + panchakarma treatment from your nearby panchkarma centre.
Oral treatment - 1) shalaki mr 1-0-1 after food 2) cap. Rheumo 1-0-1 after food 3) shalaki liniment for local application 4) trifla churn 1 tsf HS with Luke warm water
Panchkarma therapies-
1) abhyanga with mahanarayan taila with nadi swedana for 7 days 2) kati basti with mahanarayan taila for 7 days
Follow up after 10 days
Start with Dashamoolarist 15 ml twice daily after food with water Ashwagandha churan 0-0-1tsp at bedtime with warm milk Mahayograj guggul 1-0-1 after food with water Giloy ghanvati 1-1-1 after food with water Mahavatvidhvansh vati 1-0-1 after food with water Visit nearby ayurvedic centre for kati basti., Abhyangam i.e. full body massage Avoid sour fermented foods. Need bedrest when in pain Wear sacroilliac belt during the day. Avoid travelling on rough roads., or sitting on 2 wheelers.
Chronic back pain and the addition of inflammatory sacroiliitis it’s significant, especially when combined with osteopenia and low Vitamin D levels. In Ayurveda, such conditions are typically associated with imbalances in the Vata dosha, which governs movement and dryness in the body. To help manage your situation, focus on balancing Vata, supporting bone health, and improving overall strength.
First, focus on your diet. Include warm, nourishing foods that calm Vata—think about khichdi, ghee, and stews with grounding vegetables like sweet potatoes and squash. Aim for cooked meals at regular intervals; avoid raw or cold foods which can aggravate Vata. Incorporating spices such as ginger, turmeric, and ashwagandha can help reduce inflammation and strengthen the tissues. Ensure adequate calcium intake through sesame seeds or almonds and consider Ayurvedic rasayanas like Shatavari or Amalaki for general vitality.
Hydration is crucial, but favor warm fluids like herb-infused teas (ginger or tulsi), avoiding cold drinks. Also, daily self-massage (abhyanga) with warm sesame oil can nurture the body, enhance circulation, and soothe the joints.
Physical activity should be gentle and without strains—think yoga that’s suitable for your condition, such as gentle stretching or restorative practices. Walking regularly, ideally in the morning sun, can provide some important sunlight exposure for Vitamin D synthesis.
Given your Vitamin D level is lower than desirable, it would be essential to maintain moderate sunlight exposure daily for about 15-20 minutes, exposing as much skin as possible. Alongside, you might consider a Vitamin D supplement, but do consult an healthcare provider about specifics—overdoing supplements can have adverse effects.
Stress-management is key—meditation or pranayama could help you maintain a balanced mental state, essential for your recovery. These should be personalized to your comfort and capacity.
Ensure that you follow-up with medical professionals, especially for periodic checks on your bone density and inflammation markers, and to adjust dietary and supplement plans appropriately. If symptoms worsen or new ones arise, seek medical advise promptly to avoid complications.
In your situation, addressing your chronic back pain involves a combination of dietary, lifestyle, and specific herbal remedies. The inflammatory nature of sacroilitis, coupled with findings of osteopenia and low vitamin D levels, indicates a need to strengthen your bone health and manage inflammation.
First, focus on diet that balances your doshas and supports bone strength. Increase intake of calcium-rich foods like sesame seeds, leafy greens, and almonds. Ensure adequate protein from sources such as lentils and tofu to support bone tissue, or asthi dhatu. Also, include anti-inflammatory spices like turmeric and ginger in your meals to help mitigate inflammation.
Since vitamin D is crucial in calcium absorption, exposing your body to sunlight, preferably around noon for 15-20 minutes daily can be helpful. Supplementation might be necessary, but consult with a healthcare provider before proceeding. Regular gentle exercises such as yoga and stretching can aid flexibility without straining the sacroiliac joint. Poses like Tadasana and Bhujangasana can gently support back muscle strength and alleviate some discomfort.
Herbal formulations like Ashwagandha and Shatavari provide overall nourishment and strength to body, supporting vata balancing and bone health. Boswellia, known for its anti-inflammatory properties, can also be integrated to support joint comfort.
Don’t overlook the importance of proper rest and stress management as they are key in managing chronic conditions. Engage in practices like meditation or deep-breathing exercises to help maintain a calm vata. Finally, follow up with healthcare professionals, since medication adjustments and other interventions might be required to address your osteopenia and optimize your healing process.
