Integrative approach combining Ayurveda, counselling, Yoga and meditation with conventional management of Ankylosing Spondylitis - A case report.

Lifelong medications are required for symptomatic relief in Ankylosing Spondylitis (AS). We report the potential of an integrative approach in reducing dependence on steroids and pain medications in chronic AS. A 59-year-old HLA-B27 positive male patient suffering from AS for 40 years sought Ayurvedic treatment for relapse of pain, stiffness, fatigue, intermittent constipation and disturbed sleep. Ayurvedic diagnosis was Amavata (a clinical condition characterised by joint inflammation) The patient was managed as outpatient for eleven days and hospitalised for thirty three days. Internal medicines and external therapies with diet modification, lifestyle adjustments, counselling, Yoga and IAM Technique (Integrated Amrita Meditation Technique ) were administered during the hospital stay. At yearly follow up, C-Reactive Protein was reduced to 15.7 mg/L from the baseline value of 37.5 mg/L, and ESR from 103 mm/h to 8 mm/h indicating reduction in inflammation. The dose of NSAID and DMARD (Disease Modifying Antirheumatic Drug) could be reduced from once in twenty-four hours to once in eighty-four hours and steroids from twice daily to once in a week. There was significant reduction in pain and stiffness. Integration of Ayurveda and Yoga with conventional treatment can reduce drug dependence and improve quality of life in AS.