E-ISSN:2456-3110

Case Report

Cervical Spondylosis

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 12 December
Publisherwww.maharshicharaka.in

Efficacy of Marma Chikitsa in pain management of Cervical Spondylosis - A Single Case Study

Uikey RR1*, Marwaha R2, Gupta P3, Bhalerao N4
DOI:10.21760/jaims.8.12.45

1* Rahul Ratan Uikey, Post Graduate Scholar, Dept of Rachna Sharir, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

2 Rita Marwaha, Professor HOD, Dept of Rachna Sharir, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

3 Pankaj Gupta, Associate Professor, Dept of Rachna Sharir, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

4 Nisha Bhalerao, Associate Professor, Dept of Rachna Sharir, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.

Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral discs of the neck as well as the contents of spinal canal. It is characterized by neck pain radiating to shoulders, arms, head and person is unable to perform daily routine work. Patient aged 47 years came to our institute with the complaint of headache, pain and stiffness in cervical region & pain is radiated to hand, tingling sensation in hand, restricted movement of cervical spine for 6 month. He was diagnosed as case of cervical spondylosis. MRI of cervical spine suggested protrusion at C5-C6 level causing anterior thecal sac compression & bilateral moderate neural foraminal narrowing with left exiting nerve compression. In this case study effect of Marma Chikitsa in pain management of cervical spondylosis is evaluated. This case study shows that pain in cervical spondylosis may be successfully managed by Marma Chikitsa.

Keywords: Cervical spondylosis, Greevastambha, Marma Chikitsa

Corresponding Author How to Cite this Article To Browse
Rahul Ratan Uikey, Post Graduate Scholar, Dept of Rachna Sharir, Pt Khushilal Sharma Govt Ayurveda College, Bhopal, Madhya Pradesh, India.
Email: 		Uikey RR, Marwaha R, Gupta P, Bhalerao N, Efficacy of Marma Chikitsa in pain management of Cervical Spondylosis - A Single Case Study. J Ayu Int Med Sci. 2023;8(12):295-298.
Available From
https://jaims.in/jaims/article/view/2850

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-10-13 2023-10-23 2023-11-03 2023-11-13 2023-11-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 23.66

© 2023by Uikey RR, Marwaha R, Gupta P, Bhalerao Nand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Rahul Ratan Uikey et al. Efficacy of Marma Chikitsa in pain management of Cervical Spondylosis

Introduction

Ayurveda places great emphasis on prevention and encourages the maintenance of health. Ayurveda is popular for its extensive natural healing ways that work on illnesses and improving the general wellness of the body and mind. Marma science is one of the extraordinary gems in the huge treasure of Ayurvedic knowledge. Marma is a Sanskrit word which refers to any weak or sensitive part of body. Marma’s are the vital points in the body where Prana exist.

Cervical Spondylosis is an age-related wear and tear affecting spinal disk of neck characterized by headaches, pain and stiffness in the neck, tingling sensation, numbness and weakness in the arms, and person is unable to perform daily routine work. Age, gender and occupation are the main risk factor for cervical spine.[1]

There is no exact clinical entity mentioned in classics like Cervical Spondylosis but it can be correlated with Greeva Stambha, a disorder of Vata. Acharya Charak described the disease first by the name of “Greeva Stambha” among the eighty types of Vata Nanatamaja Vikar.[2] The symptoms of Vata Vyadhi (various neurological and musculoskeletal disorders) are Sankocha (constriction of organs), Parva Stambha (stiffness in joints), Asthibhed (pain in bones), Spandana and Gatrasuptta (numbness),[3] which are completely corelated with that of Cervical Spondylosis.

General treatment of Greeva Stambha

As no specific line of treatment is described for Greevastambha in Ayurveda text, so general line of management of Vatavyadhi such as Abhyanga (massage), Svedana (sudation), Mridu Virechana (mild purgation) and Basti procedures can be adopted.[4]

Case Report

A 47 year old male patient teacher by occupation consulted in the outpatient department of Pt. Khushilal Sharma Government Ayurveda college, Bhopal (MP) with the complaint of headache, pain and stiffness in the cervical region & pain is radiated to hand, tingling sensation in hand, restricted movement of cervical spine for 6 month. Symptoms were aggravated by prolonged sitting and standing.

He was diagnosed as a case of cervical spondylosis. He was taking analgesics and anti-inflammatory medicine for pain management.

History of Past Illness

No history of hypertension, diabetes mellitus or any other serious illness

Surgical history : NAD

Personal history

  • Bowel - Constipated
  • Appetite - Normal
  • Micturation - Normal
  • Sleep - Disturbed due to pain
  • Allergy and addiction - Nil

Clinical Findings

On physical examination general health of the patient was good his pulse was 78/min, BP was 120/90 mm of Hg, the patient was afebrile. He has Vata-Kapha Prakrati, Madhyam Vayah, Madhyam Satva, Avara Vyayama Shakti. The range of motion of cervical spine was restricted. On examination tenderness was found over C5-C6 vertebras. There was no significant finding on lab investigation. Magnetic resonance imaging (MRI) of cervical spine suggested posterior disc osteophyte complex with left paracentral disc protrusion at C5-C6 level causing anterior thecal sac compression & bilateral moderate neural foraminal narrowing with left exiting nerve compression.

Treatment

The treatment involved administration of Marma therapy. The details of administration are as follows.

Marma Therapy

The present study includes stimulation of 5 Marma points that is Ansa, Ansaphalak, Krakatika, and Vidhura Marma & these will be stimulated for 15 - 18 times on an average in single sitting.[5]

Table 1: Marma points stimulated in Greeva Stambha

SNMarmaStimulation timeSitting of Marma ChikitsaTotal time
1.Ansa0.8 secTwo times a day15 days
2.Ansaphalak0.8 secTwo times a day15 days
3.Krakatika0.8 secTwo times a day15 days
4.Vidhura0.8 secTwo times a day15 days
5.Kakshadhara0.8 secTwo times a day15 days

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Rahul Ratan Uikey et al. Efficacy of Marma Chikitsa in pain management of Cervical Spondylosis
  • A steady and moderate pressure will be applied slowly and gently.
  • Pressure will be increased gradually depending upon patient strength.
  • During the therapy, therapist was supposed to continuously watch the facial expression of the patients.

Assessment Criteria

1. Neck pain

CriteriaGrading
No pain0
Mild and intermittent pain1
Moderate pain2
Severe pain3

2. Neck stiffness

CriteriaGrading
No stiffness0
Mild Stiffness1
Moderate stiffness2
Severe stiffness3

3. Radiating pain in arm

CriteriaGrading
Absent0
Mild intermittent pain radiating to arms1
Moderate pain radiating to arms2
Severe pain radiating to arms3

4. Restricted Movement

a) Flexion

CriteriaGrading
No restriction able to touch interclavicular line0
Upto 2 cm difference between the chin and the interclavicular line1
More than 2-4 cm difference the chin and interclavicular line2
More than 4 cm difference3

b) Extension

Normal - 130 degree0
Moving upto - 120 degree1
Moving upto - 110 degree2
Moving <110 degree3

c) Lateral Rotation

Complete rotation0
Rotation with mild difficulty1
Rotation one side only2
No rotation3



Observation

ParameterBefore TreatmentAfter treatment
Neck pain20
Neck stiffness10
Radiating pain in arm21
Flexion20
Extension21
Lateral Rotation10

Discussion

In modern era, peoples are much more inclined to computer usage. Thus, cervical spondylosis is emerging problem. As Marmas are the seats of Prana, the vital life force that governs the physical and subtle processes of the body, therefore, through the stimulation of Marmas, the flow of Prana in different body parts can be modulated in such a way that it can be used to remove blockages, and decrease or enhance the physical and subtle energy currents within the body, resulting in the corresponding healing effect. According to Ayurveda, the main etiological factor for Greevastambha is vitiated Vata. Since Prana is connected to Vata Dosha, hence Marma Therapy can be especially useful in treating the Vata disorders. Out of the five forms of Vata Dosha, Vyana Vayu, that is associated with the skin, as well as the movement and circulation of the Prana, can be most closely linked to the Marmas. Thus, stimulation of the Marmas can balance the Vyana Vayu and Vata Dosha, resulting in the corresponding healing effect in diseases like Greevastambha.[6]

Nowadays, therapeutic interventions normally used for its treatment are physiotherapy, hot fomentation, use of cervical collar, analgesics, steroids, etc. Using analgesics, NSAIDS, steroids doesn’t necessarily show satisfactory effect and also have adverse effect. As Pain is the major symptom which affects the person’s day to day activities, so pain management is major target. Marma Chikitsa immediately relaxes the neck muscles and releases the spasm[7] which help in decreasing pain and stiffness Therefore, Marma Chikitsa can be a nonmedicinal and non-invasive approach in pain management of cervical spondylosis.




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Conclusion

The case report shows significant improvement. So, if Marma Chikitsa practiced well, can be used as an alternative therapy for pain management of cervical spondylosis. It improves the quality of life of patients and side effects of analgesics can also be prevented.

References

1. Singh S, Kumar D, Kumar S. Risk factors in cervical spondylosis. J Clin Orthop Trauma. 2014;5:221-226.

2. Shastri K. The Caraka Samhita of Agnivesha, Vol. 1, Su. 20. Edited by Dr. Gangasahaya Pandeya. Varanasi: Chaukhambha Sanskrit Sansthan; 2012. p. 269.

3. Chaturvedi G. Chikitsa Sthan. Charaka Samhita of Agnivesha Elaborated by Charaka & Drudhabala, part-2, Ch. 28, Shloka 23. Reprinted. Vidhyotini Vyakhya Choukhambha Bharti Academy Prakashan; 2011. p. 780.

4. Pandey G, editor. Pt. Kashinath Sastri Vidhyotini Hindi commentator of Caraka Samhita of Agnivesa- 2nd volume, Chikitsa Sthan Vatavyadhi Chikitsa Adhayay chapter 28 verse 75-83. Varanasi: Chaukumba Sanskrit Sansthan; 2006. p. 791-792.

5. Joshi SK. Marma Science and Principles of Marma Therapy. 1st ed. Delhi: Vani Publications; 2010. ISBN: 81-89221-64-7. p. 46.

6. Frawley D, Ranade S, Lele A. Ayurveda and Marma therapy. Delhi: Chaukhambha Sanskrit Pratishthan; 2015.

7. Phull G, R. Clinical Approach to Marma Chikitsa. 2nd ed. IP Innovative Publication Pvt. Ltd.; 2019. ISBN: 978-93-5300-962-5. p. 188.


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