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A 54 year old woman diagnosed as Rheumatoid arthritis associated with hypertension and type 2 diabetes was reported to be treated through an integrative approach which includes Naturopathy, Yoga and Acupuncture. The patient complains of moderate to severe pain, swelling and morning stiffness in multiple joints especially over bilateral small joints, elbow, shoulder, knees and hip. Hydrotherapy, mud therapy, massage therapy, yoga therapy and acupuncture were given for 10 days as a supportive treatment. There was improvement in pain, ESR, FBS, PPBS counts. These therapies are reported to have analgesic action. Mud therapy may reduce the inflammation. Sulphur minerals present in mud might get absorbed through skin results in analgesic effect. The action over thermo and mechano receptors through hydro therapy may block nociceptors there by reducing pain. Muscle relaxation achieved through massage might be the cause for pain reduction through massage therapy. Pain reduction through acupuncture might be through modulation of nor adrenaline and serotonin signalling system.  Formation of endogenous opioids, somatostatin and other neurotrophins may block the passage of pain signals. Yoga reduces stress and has action over musculo- skeletal system. Stress itself can act as triggering factor for rheumatoid arthritis.<ref name=Moov/>
 
A 54 year old woman diagnosed as Rheumatoid arthritis associated with hypertension and type 2 diabetes was reported to be treated through an integrative approach which includes Naturopathy, Yoga and Acupuncture. The patient complains of moderate to severe pain, swelling and morning stiffness in multiple joints especially over bilateral small joints, elbow, shoulder, knees and hip. Hydrotherapy, mud therapy, massage therapy, yoga therapy and acupuncture were given for 10 days as a supportive treatment. There was improvement in pain, ESR, FBS, PPBS counts. These therapies are reported to have analgesic action. Mud therapy may reduce the inflammation. Sulphur minerals present in mud might get absorbed through skin results in analgesic effect. The action over thermo and mechano receptors through hydro therapy may block nociceptors there by reducing pain. Muscle relaxation achieved through massage might be the cause for pain reduction through massage therapy. Pain reduction through acupuncture might be through modulation of nor adrenaline and serotonin signalling system.  Formation of endogenous opioids, somatostatin and other neurotrophins may block the passage of pain signals. Yoga reduces stress and has action over musculo- skeletal system. Stress itself can act as triggering factor for rheumatoid arthritis.<ref name=Moov/>
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A 45 year old female with multiple joint pain associated with swelling, morning stiffness, movement restricted and loss of appetite. She was diagnosed with amavata. Treatment includes [[deepana]]-[[pachana]] with amapachanavati for 1 week. It was followed by internal administration of cow’s ghee in escalating dose pattern for 5 days. Fomentation was done for the next 3 days which was followed by therapeutic purgation ([[virechana]]) with Trivritaavaleha (100gm) and castor oil (20ml). After completion of [[virechana]] and diet protocol (samsarjana krama), the 40% reduction in pain and stiffness of joints. RA factor was reduced from 94 IU/ml to 50 IU/ml after [[virechana]]. The patient was put on specific diet pattern after [[virechana]]. After 3 months of treatment, there was significant reduction in all signs and symptoms of amavata. IgE was reduced from 680 kU/L to 53.7 kU/L.<ref name=Gupta>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata(rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5. </ref>
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A 45 year old female with multiple joint pain associated with swelling, morning stiffness, movement restricted and loss of appetite. She was diagnosed with amavata. Treatment includes [[deepana]]-[[pachana]] with amapachanavati for 1 week. It was followed by internal administration of cow’s ghee in escalating dose pattern for 5 days. Fomentation was done for the next 3 days which was followed by therapeutic purgation ([[virechana]]) with Trivritaavaleha (100gm) and castor oil (20ml). After completion of [[virechana]] and diet protocol (samsarjana krama), there was 40% reduction in pain and stiffness of joints. RA factor was reduced from 94 IU/ml to 50 IU/ml after [[virechana]]. The patient was put on specific diet pattern after [[virechana]]. After 3 months of treatment, there was significant reduction in all signs and symptoms of amavata. IgE was reduced from 680 kU/L to 53.7 kU/L.<ref name=Gupta>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata(rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5. </ref>
    
===Research updates===
 
===Research updates===
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