Bakshi Kavita, Balkrishna Acharya, Varshney Anurag
Department of Allied and Applied Sciences, University of Patanjali, Haridwar, Uttarakhand, India.
Clinical Research Division, Patanjali Research Foundation, Haridwar, Uttarakhand, India.
Ann Neurosci. 2025 Aug 9:09727531251357658. doi: 10.1177/09727531251357658.
Osteoarthritis (OA) is a degenerative joint disease increasingly linked to neuroinflammation, and a heightened response of nociceptive neurons called central sensitisation, leading to persistent pain and functional decline. Neuroinflammation, along with dysfunction in serotonergic and noradrenergic pathways, and chronic activation of the hypothalamus pituitary adrenal (HPA) axis, prolongs the pain sensations. Conventional treatments, including Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids, primarily offer symptomatic relief but fail to address these central mechanisms while posing risks of adverse effects.
This narrative review explores alternative approaches, specifically Ayurveda and yoga-based interventions, as potential strategies to mitigate neuroinflammation and pain hypersensitivity in OA.
A comprehensive literature search was conducted across databases of PubMed, ScienceDirect, Scopus and Google Scholar from the year 2005 to 2025 using multiple keywords related to OA, central sensitisation, yoga, and Ayurveda. Published studies were reviewed for outcomes related to central sensitisation and OA.
Ayurvedic herbs consistently have been shown to have positive results in modulating inflammatory mediators and oxidative stress without adverse effects. Yoga has been shown to regulate the HPA axis, enhance vagal tone, and promote neuroplasticity, all of which contribute to pain modulation. Furthermore, mindfulness and meditation practices stimulate the release of endogenous opioids, thereby reinforcing descending pain inhibitory pathways. Both interventions contribute to OA management by supporting weight control, improving metabolic function, enhancing executive-level modulation of pain perception, and promoting better sleep quality. Their active analgesic effects, combined with a holistic mind-body approach, offer a safe and sustainable strategy for long-term OA management.
Yoga and Ayurveda have shown reliable results in providing safe and effective management of chronic OA accompanied by central sensitisation. However, there is a need for large-scale studies to integrate these into the mainstream treatment regimens.
骨关节炎（OA）是一种退行性关节疾病，越来越多地与神经炎症以及伤害性神经元的高反应性（称为中枢敏化）相关联，导致持续性疼痛和功能衰退。神经炎症，连同血清素能和去甲肾上腺素能通路功能障碍以及下丘脑-垂体-肾上腺（HPA）轴的慢性激活，延长了疼痛感觉。包括非甾体抗炎药（NSAIDs）和阿片类药物在内的传统治疗主要提供症状缓解，但未能解决这些中枢机制，同时还存在不良反应风险。
本叙述性综述探讨替代方法，特别是阿育吠陀和基于瑜伽的干预措施，作为减轻OA中神经炎症和疼痛超敏反应的潜在策略。
使用与OA、中枢敏化、瑜伽和阿育吠陀相关的多个关键词，在2005年至2025年期间对PubMed、ScienceDirect、Scopus和谷歌学术数据库进行了全面的文献检索。对已发表的研究进行了关于中枢敏化和OA相关结果的综述。
阿育吠陀草药一直被证明在调节炎症介质和氧化应激方面有积极效果且无不良反应。瑜伽已被证明可调节HPA轴、增强迷走神经张力并促进神经可塑性，所有这些都有助于疼痛调节。此外，正念和冥想练习刺激内源性阿片类物质的释放，从而加强下行性疼痛抑制通路。这两种干预措施通过支持体重控制、改善代谢功能、增强对疼痛感知的执行水平调节以及促进更好的睡眠质量，有助于OA的管理。它们的积极镇痛作用，结合整体身心方法，为OA的长期管理提供了一种安全且可持续的策略。
瑜伽和阿育吠陀在为伴有中枢敏化的慢性OA提供安全有效的管理方面已显示出可靠的结果。然而，需要大规模研究将这些纳入主流治疗方案。
