Punarnava (Boerhavia diffusa) is widely used in traditional Ayurvedic medicine for managing gout and other joint-related conditions. In Ayurveda, gout is understood as Vatarakta, a disorder associated with the accumulation of ama (toxins) and vitiated Vata dosha, often manifesting as joint inflammation and pain. Punarnava is classified as a "mutrala" (diuretic) and "shothahara" (anti-inflammatory), and is believed to help reduce swelling, remove excess fluids, and aid in detoxification. Its reputed ability to promote uric acid excretion and relieve joint pain forms the basis of its traditional use for gout.

Scientific studies on punarnava’s effectiveness specifically for gout remain limited. Some preclinical research shows anti-inflammatory, analgesic, and uricosuric effects in animal models, which could be beneficial in gout management. For example, extracts of Boerhavia diffusa have demonstrated significant reduction in inflammation and lowered uric acid levels in animal studies. However, human clinical trials are lacking, and direct evidence for its efficacy in treating gout in people is insufficient.

In summary, punarnava’s use in gout is primarily justified by a long history of traditional use, supported by preliminary pharmacological findings but lacking robust clinical validation. Thus, the evidence level is rated as 2—traditional foundation with some scientific plausibility but incomplete human data.