A Comprehensive Review on Role of Ayurveda in the Management of Ankylosing Spondylitis

Abstract

Background: Ankylosing Spondylitis (AS) is a chronic, progressive autoimmune spondyloarthropathy characterized by axial inflammation and potential bony ankylosis. Despite the efficacy of modern biological, challenges regarding cost, accessibility, and long-term safety persist. This review systematically evaluates the role of Ayurvedic interventions—focusing on Panchakarma and herbo-mineral formulations—in managing AS symptoms and slowing radiological progression.
Materials and Methods: A systematic search of electronic databases (PubMed, AYUSH Research Portal, and Google Scholar) was conducted for studies published between 2010 and 2026. Inclusion criteria focused on clinical trials and case series evaluating Ayurvedic protocols, specifically those utilizing the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Functional Index (BASFI) as primary outcome measures.
Results: Synthesis of the literature indicates that multi-modal Ayurvedic therapy—comprising Deepana-Pachana (metabolic regulation), Virechana (purgation), and Vaitarana Basti (medicated enema)—leads to a statistically significant reduction in BASDAI scores (ranging from 30% to 50% improvement). Evidence suggests that Guggulu-based formulations and Boswellia serrata act as potent NF-κB and 5-LOX inhibitors, providing a biochemical basis for reduced synovial inflammation. Furthermore, integrated protocols were associated with improved spinal mobility and a reduction in the required dosage of conventional NSAIDs. Conclusion: Ayurveda offers a comprehensive, disease-modifying approach to Ankylosing Spondylitis by addressing the "Gut-Joint Axis" and systemic Vata imbalance. While current clinical data is promising, standardized large-scale Randomized Controlled Trials (RCTs) are essential to establish Ayurveda as a primary or adjunctive standard of care in global rheumatology.