Journal of Ayurveda and Integrated Medical Sciences

Introduction

The term ‘Ayurveda’ is derived from the Sanskrit words Ayur (life) and Veda (science or knowledge). Thus, Ayurveda translates to knowledge of life. Marma is very important and unique concept of Ayurvedic Sharir. Acharya Sushruta, Charak, and Vagbhatt has mentioned Marma in their respective texts. The Marma are points in the body where Mamsa, Sira, Snayu, Asthi and Sandhi conjoin. Marma are the sites where Tridosha (Vata, Pitta and Kapha) are present with their subtle forms; Prana, Oja and Tejas. They also contain three Gunas namely Sattva, Raja, Tama and soul or life force (Bhutatma).^[1] Stimulation of Marma points for the management of various diseases is called Marma Chikitsa. Acharya Sushruta has described 107 Marma in Sharir Sthana and often describes Marma as Shalyavishyaardh.^[2] The healing through Marma Chikitsa affects the Chakras, Doshas and physical health. The purpose of Marma Chikitsa is primarily to manipulate subtle energy or Prana, but they are also very effective for relieving stiff muscles and boosting circulation.

Tennis elbow, also known aslateral epicondylitis or enthesopathy of the extensor carpi radialis origin is a condition that can result from overuse of the muscles and tendons in the elbow. Tennis elbow was first described by Runge in 1873 and eventually given the name Lawn tennis arm by Henry Morris writing in the lancet in 1982.^[3] Despite its name, it occurs to people whose job involves repeated movements such as plumbers, painters, carpenters. Tennis elbow is often due to damage to a specific forearm muscle extensor carpi radialis brevis (ECRB).When the ECRB muscle is weakened from overuse, microscopic tears form in the ECRB tendon where it attaches to the lateral epicondyle. 1 to 3% of adult population in each year affects with tennis elbow.^[4] It affects people of all ages but it is most common in adults between the ages of 30 and 60. The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months which radiates from the outside of the elbow into the forearm and wrist. The other symptoms such as weakened grip strength, and tenderness. There is usually no specific injury associated with the start of symptoms. The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands.

Each Marma was stimulated for 0.8 sec over 15-18 times.

A steady and moderate pressure was applied slowly and gently.

Assessment criteria

NRS (Numerical Rating Scale) for assessment of pain.

Grading of pain

No pain - 0

Mild pain - 1-3

Moderate pain - 4-6

Severe pain - 7-10

Observation

Table 1: Grading of pain

Results

Observations during treatment are mentioned in table 1. As Marma Chikitsa was given to patient, there is significant relief in the pain from day 1 to 10^th day and grip strength of his left arm also increased.

Discussion

Ayurveda is a way of living. It is not merely a treatment modality but a complete system to provide a holistic health at physical, mental and social level. Marma Chikitsa, the art of treating specific vital points on the human body - is one of the greatest healing secrets of Ayurveda. It can be used to detoxify, strengthen and revitalize the body, for rejuvenation and relaxation or to release