Brief Answer:
need further details to establish metabolic Osteoarthritis(OA)

Detailed Answer:
Dear
Thanks for contacting Ayurveda with your health concern and before I further go into the treatment/management aspect do let me know:

1. Are both disease independent of one another or is it diabetes induced OA?

PS. Is it age related or obesity induced OA, i.e. do mention her weight and body type

2. Do, let me know about his BMI (body mass index) since people with type 2 are obese, and also her age (53) both are risk factors for diabetes and OA.

3. Do let me know about her other blood parametres like: blood pressure, weight, lipid profile, protein in urine.

PS. recent studies shows an increased incidence of OA in patient with syndrome X

4. What are her present blood sugar reports?

Do revert back with your concerns.

Dr. Munish Sood
Consultant Physician
Naimittika

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Brief Answer:
symptomwise management

Detailed Answer:
Dear
Thanks for reverting back and going by her weight (obese), it seems to me that she is suffering from "Avarana XXXXXXX Sandhi-Gata-Vata'

PS. In Ayurveda we hold that in obese patients there is excessive production of XXXXXXX (fat) dhatu which cause obstruction to the flow of essential nutrients to next dhatu (tissue) i.e. Asthi (bone), Majja (bone marrow), & Shukra (semen) leading to their kshaya (degeneration) and thus aggravating the Vata which then due to the obstruction circulate in whole body and since bone & vata are similar in properties thus gets settled in the joints and thereby causing sandhi gata vata (OA) so line of management should be:

 1. Consult a good/qualified Ayurveda Physician who will verify for Saam/Niraam XXXXXXX & thereafter will only treat as Sandhi gata Vata...If saam avastha no massage of/with oil should be prescribed..otherwise go for amapachana first.

2.Diet:
avoid:spicy,deep fried,very oily and pungent food recipes, peas, chick pea, green gram, late night awakening, excess walking/eating

take: old brown rice, black gram, horse gram, brinjal, garlic, pomegranate, almonds, black grapes, sesame, coconut water, hard bed.

3. exercises: (quadriceps),avoidance of poor posture,limitation of excess joint loading , use of walking stick, avoid sitting on floor & climbing stairs as far as possible, use commode.

4. 
. dashmoolarishta:30ml tid daily.
..triphala choorna at bed time
. drug of choice is karaskara (karaskara ghrita to be given)
.in order to control inflammation of the joints,boswellia gum or phellodendron bark is suggested.

.Lavan Ardrak bhakshan is recommended (Baidyanath medicine)

.janu basti is recommended

.shuddha kapilu 100mg
 Malla sindur 1250 mg
Tryodashang guggulu 500mg
Shunthi churna 1gm
.. With lukewarm water ...

. maharasnadi kwatha 10ml in morning
. mahavishagarbha/kupilu oil for massage

5. keep a regular check on blood sugar (diabetic diet) and give attention to retinopathy, nephropathy & neuropathy and care of the feet is important

PS. you may Consult an Orthopedic surgeon for other possibilities and if interested I can courier you the medicine(s) on disounted rates

Dr. Munish
Naimittika

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Brief Answer:
further assistance

Detailed Answer:
Dear
Thanks for reverting back.

1. Since you have mentioned about her ongoing problem thus will first prescribe medicine which will not interfere with her blood sugar level and at the same time will increase her immunity, only then will prescribe medicin(s) which you can consult with an Ayurveda physician there for better dosage and intetaction(s)

2. Initially the medicine prescribed will be directed towards eliminating the excess XXXXXXX (ama pachan) and increasing the immunity alongwith external application of oil and will cost approximately 1800/- month.

Dr. Munish
Naimittika

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