Sandhigata Vata is a disease associated with aging. This particular form of Vatavyadhi is mostly found in Vriddhavastha as a result of Margavarodha, which restricts daily tasks like dressing, walking, taking a bath, and so on, leaving patients incapacitated or handicapped. Treatment options include NSAIDs, calcium supplements, and finally joint replacement. In this case, arthroplasty was advised due to bilateral osteoarthritis in the knees. Pain, edema, range of motion, and walking distance all improved significantly once the therapy was completed. Internal medicine, Janu Pizhichil, and Panchtikta Ksheer Basti therapy were used to successfully treat the patient. Case: A 65 years old male patient was clinically diagnosed as a case of Sandhivata presented with the following chief complaints from 1 month. It was associated with swelling in B/L knee joint with pain, tingling sensation in right unilateral knee joint. Management: Patient was treated with Janu Pizhichil (oil bath for knee joint), Panchtikta Ksheer Basti (medicated enema) and internal medication like Panchatikta Ghrit Guggulu. Conclusion: It can be concluded that use of Baahyaparimarjan Chikitsa (classical external Ayurvedic treatment) in the background of accurate diagnosis can cure the patients suffering from osteoarthritis also no osteoporotic changes were observed in 1 month. Being safe, devoid of adverse effects, ayurvedic management is the only option to avoid painful intervals, advancement of the disease and repeated use NSAIDs.