Introduction

Duchenne Muscular Dystrophy (DMD) is a severe X-linked recessive disorder, primarily inherited from carrier mothers. However, a smaller percentage of cases result from de novo mutations.^[3] The condition typically manifests around the age of four, with rapid progression leading to loss of ambulation and wheelchair dependence by the age of 10 to 12 years.^[4] Dystrophin, a structural protein, plays a critical role in anchoring the actin cytoskeleton of muscle fibers to the extracellular matrix. Its absence disrupts cellular integrity, resulting in repeated cycles of muscle fiber degeneration, fibrosis, and impaired regeneration. Clinically, DMD presents with Proximal muscle weakness, notably in the pelvic and shoulder girdles, Difficulty performing activities such as climbing stairs or rising from the floor, A characteristic Gowers’ sign, where patients use their hands to "walk up" their bodies due to hip and thigh muscle weakness, Calf pseudohyper-trophy, resulting from fatty infiltration and fibrosis rather than true muscle growth, Associated signs include Achilles tendon contractures, toe-walking, and compensatory lumbar lordosis. Laboratory findings typically show markedly elevated serum creatine phosphokinase (CPK) levels, indicative of muscle membrane damage.^[5] In Ayurvedic literature, DMD bears resemblance to Sahaja Mamsa Shosha, as described by Acharya Sushruta. This condition is characterized by muscle wasting due to the depletion of Mamsa Dhatu (muscle tissue) and subcutaneous fat, aligning closely with the modern pathophysiological understanding of DMD.^[6] From an Ayurvedic standpoint, the progression of DMD is viewed as a Dhatu Kshaya (degeneration of body tissues), and treatment is tailored according to the predominance of Doshas involved—primarily Vata. The therapeutic goal is to nourish and strengthen muscle tissue, reduce degeneration, and improve overall quality of life through Panchakarma therapies, internal medications (Rasayana), and supportive physical rehabilitation.

Case Report

A 9 years old child was brought with complaints of standing without support, inability to walk, place foot on ground, difficulty in sitting in squatting position in the last 6 year of age. He had taken treatment before but found no result, then he came for our hospital for further management.

Udwarthana f/b Parisheka with Dashamoola Qwatha (DMQ) and Sarvanga Abhyanga with Ksheerabala Taila f/b Nadi Sweda was done alternate 2 days followed by Niruha Basti with Rajayapana Ksheera Basti and Anuvasana Basti with Ashwagandha Ghrita. Pichu Bandhana to B/L Lower limbs with Ksheerabala Taila, Physiotherapy was advised. All these procedures were performed for 10 days. Panchakarma procedures advised are mentioned below. Shamana Aushadha was also prescribed along with procedures and upon discharge.

Panchakarma Procedures

Shamana Aushadha

Diagnostic Assessment

Sroto Pareeksha: Mamsavaha, Medovaha Srotas

Symptoms: Standing without support, inability to walk, place foot on ground, difficulty in sitting in squatting position in the last 6 year of age.

Diagnosis: Elevated CPK Levels (10000U/L).

Observations and Results

Gradual improvement in the child’s symptoms was observed over the course of the three treatment sittings After the 1st Sitting the child reported mild relief in generalized weakness. He showed initial improvement in motor function, as he was able to stand without support briefly. However, he remained unable to sit in a squatting position, and there was persistent difficulty in retaining footwear, as slippers continued to slip off his feet. After the 2nd Sitting Notable relief in bilateral calf muscle pain was reported. Muscle tightness showed signs of reduction, contributing to improved comfort during walking and standing.

Mustadi Rajayapana Basti was employed for its Sadhyo Balajanana (instant strength-enhancing) and Rasayana (rejuvenative) effects.^[14] The herbal constituents possess Vatashamaka properties, support Udana Vata, and enrich Rasa Dhatu. Deepana and Pachana Dravyas Enhance Agni^[15] which is central to proper Dhatu formation and metabolic transformation.^[16]Anuvasana Basti with Ashwagandhadi Ghrita addresses muscle weakness and degeneration, aiming to balance Vata Dosha. Pichu Bandhana with Ksheerabala Taila Supports muscle integrity and reduces contractures. In addition to these Panchakarma procedures, physiotherapy was advised to strengthen muscles. Ashwagandharishta Contains Ashwagandha, Daruharidra, Vacha, and Chitraka, providing Balya (strengthening) and Rasayana actions. Mahisha Dravaka Prepared from Dusparsha, Eranda, Vasa, Ashwagandha, Musta, and Mahisha Mamsa, which helps counteract Mamsa Shosha (muscle wasting). Over three treatment sessions spaced 30 days apart, the patient showed significant improvements in gait, much to the family’s satisfaction. Use of Shamana Aushadha enhanced the efficacy of the Panchakarma treatments, reinforcing Ayurveda’s holistic approach to managing DMD symptoms.

Conclusion

Duchenne muscular dystrophy is a neuromuscular disorder. There is no satisfactory treatment for DMD in allopathic system of medicine. This article is an attempt to present a case of DMD, effectively managed by Ayurvedic principles. It improves the lifestyle of patients.

References