Indian Journal of Natural Sciences www.tnsroindia.org.
©IJONS
Vol.7 / Issue 39 / December 2016 International Bimonthly ISSN: 0976 – 0997
RESEARCH ARTICLE
Effectiveness of Varmam and Thokkanam Therapy in Azhal Keel Vayu
(Osteoarthritis)
C.Senthamil Rajam* and R.Manickavasagam
Medical Officer, Marutham Siddha Hospital, Manapparai,Tiruchirapalli Dt.,TamilNadu,India.
Received: 5 Aug 2016 Revised: 10 Sep 2016 Accepted: 22 Oct 2016
Address for correspondence
Dr.C.Senthamil Rajam
Medical officer,Marutham Siddha Hospital,
Manapparai,Tiruchirapalli Dt,
TamilNadu,India.
Email:
[email protected]This is an Open Access Journal /article distributed under the terms of the Creative Commons Attribution License ( CC BY-NC-ND
3.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
All rights reserved.
ABSTRACT
Azhal Keel Vayu (Osteo arthritis) is a most common disease of joints mainly in elderly people. Mostly
knee, lower back and neck are involved. Even though OA is common in elderly people, one in two adults
develops symptoms of OA during their lifetime.Short and immediate response is achieved in Siddha
system of medicine (one of the Indian traditional system of medicine) through various types of the
external therapies like Varmam therapy (Stimulating certain points in the body by pressing manually)
and Thokkanam (massage therapy) combined with Indian siddha traditional medicines.Varmam and
Thokkanam – This technique is one of the specialities of Siddha system of Medicine.It is the stimulation
and the Manipulation method of the vital points in the body. Marutham Siddha Varma Hospital is
rendering medical service to OA patients with these specialised therapies.This study was carried out in
patients who came to Hospital OPD during the period of Dec 2014 to Jul 2015. 30 OA patients were
studied in this trial. The prognosis of those patients with respect decrease in symptoms like pain, stiffness
and improvement of physical function was studied using Osteo Arthritis Index.
Keywords : Azhal Keel Vayu, OA, Varmam, Thokkanam, Siddhamedicine, OA Index.
INTRODUCTION
Azhal Keel Vayu is a disorder of the Joints due to aggravated Vatham and pitham in joint Space. Major Symptoms are
crepitation, Pain,swelling and Tenderness.In Siddha literature charecteristics of Azhal keel vaayu is represented as,
“Pithakkeel VaayvuThannar
Piranku keel muttu vinki”.
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Indian Journal of Natural Sciences www.tnsroindia.org. ©IJONS
Vol.7 / Issue 39 / December 2016 International Bimonthly ISSN: 0976 – 0997
Senthamil Rajam and Manickavasagam
Azhal keel Vayu is characterised by the breakdown of cartilages (the tissue that cushions the ends of the bones
between joints), bony changes of the joints, deterioration of tendons and ligaments and various degrees of
inflammation of the joint surface. The goal of OA Treatment is to reduce pain andto improve the joint
function.People turn their focus on Traditional system of medicines for better management. Siddha system of
medicine approaches the OA Patients with Oral Anti-Vatha, Analgesic siddha medicines in addition with Varma
(Stimulation of Vital points) and Thokkanam (Manipulation Therapy).In Marutham Siddha Hospital, The OA
patients are treated with internal Siddha medicines in combination with Varmam and Thokkanam Therapy.
Aims and Objectives
To ensure the efficacy of Varmam, Thokkanam in OA.
MATERIALS AND METHODS
The OA patients who visited the Marutham Hospital for treatment were enrolled in the study. 30 OA patient who
visited our OPD between Dec 2014 to Jul 2015 were included in this study.Patients were divided into 2 groups, each
group 15patients.One group of patients treated with both Siddha internal medicines and Varmam Therapy. Another
group of patients only treated with Siddha internal medicines.
Internal Siddha medicines
1. AmukkaraChooranam – 1 Gms BD with Honey. Mix with Arumuga chendooram – 100 mgs BD with Honey.
2. Rasagandhi Mezhugu Capsule. – 1 caps BD with Buttermilk.
Varma Points
Patients were given following Varma points Therapy.
1. Moto Varmam- center point of base of patella
2. Asaivuthirikannu Varmam- middle of medial and lateral border of patella
3. NaaithalaiVarmam- apex of patella
Oseto arthritis Questionnaire was developed and analysed for 1st day, 15th day and after 1 month with the following
index.
Osteoarthritis Index
Name:____________________________________________ Date:________________
Instructions: Please rate the activities in each category according to the following
Scale of difficulty: 0 = None, 1 = Slight, 2 = Moderate, 3 = Very, 4 = Extremely
Circle one number for each activity_________________________________________
Pain 1. Walking 0 1 2 3 4
2. Stair Climbing 0 1 2 3 4
3. Nocturnal 0 1 2 3 4
4. Rest 0 1 2 3 4
________________ 5. Weight bearing 0 1 2 3 4
Stiffness 1. Morning stiffness 0 1 2 3 4
__________________ 2. Stiffness occurring later in the day 0 1 2 3 4
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Indian Journal of Natural Sciences www.tnsroindia.org. ©IJONS
Vol.7 / Issue 39 / December 2016 International Bimonthly ISSN: 0976 – 0997
Senthamil Rajam and Manickavasagam
Physical Function
1. Descending stairs 0 1 2 3 4
2. Ascending stairs 0 1 2 3 4
3. Rising from sitting 0 1 2 3 4
4. Standing 0 1 2 3 4
5. Bending to floor 0 1 2 3 4
6. Walking on flat surface 0 1 2 3 4
7. Getting in /out of car 0 1 2 3 4
8. Going shopping 0 1 2 3 4
9. Putting on socks 0 1 2 3 4
10. Lying in bed 0 1 2 3 4
11. Taking off socks 0 1 2 3 4
12. Rising from bed 0 1 2 3 4
13. Getting in/out of bath 0 1 2 3 4
14. Sitting 0 1 2 3 4
15. Getting on/off toilet 0 1 2 3 4
16. Heavy domestic duties 0 1 2 3 4
RESULTS AND DISCUSSION
Patients taking internal medicine along with Varma treatment (Fig.1)
After 1st visit, 15thDay visit and After 1 month OA Index Score were analysed.
At the time of 1st visit, patients OA index Score for pain, stiffness and physical function was found to be 4, 3, 4.
At the time of 2nd visit (15th Day Visit), patients OA index Score for pain, stiffness and physical function averagely fall
of 2, 2, 3.
At the time of Final visit, patients OA index Score for pain, stiffness and physical function averagely fall to 1, 1, 2.
Patients taking internal medicine along with out Varma treatment (Fig.2)
After 1st visit, 15thDay visit and After 1 month OA Index Score were analyzed.
At the time of 1st visit, patients OA index Score for pain, stiffness and physical function was found to be 4, 3, 4.
At the time of 2nd visit (15th Day Visit), patients OA index Score for pain, stiffness and physical function averagely fall
of 3, 3, 3.
At the time of Final visit, patients OA index Score for pain, stiffness and physical function averagely fall of 2, 2, 3.
Summary
OA patients undergoing Varma treatment along with internal medicines showed better improvements than patients
taking internal medicines without Varmam therapy.
CONCLUSION
From this study, it is concluded that the siddha medical Treatment with Varmam and Thokkanam shows very good
improvement in OA Patients, Particularly in reducing the symptoms like Pain, Stiffness and Physical action. From
the above study It is finally concluded that Varmam and Thokkanam Therapies along with internal Siddha
medicines effective in management of OA.
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Indian Journal of Natural Sciences www.tnsroindia.org. ©IJONS
Vol.7 / Issue 39 / December 2016 International Bimonthly ISSN: 0976 – 0997
Senthamil Rajam and Manickavasagam
REFERENCES
1. Varmamaruthuvathin adipadaihal –author-Dr. T.Kannan Rajaram,Siddha Medical Literture Publishers,1st Editon
2006.
2. Varma maruthuvam- author-Dr. T.Kannan Rajaram Siddha Medical Literture Publishers,1st Editon 2006.
3. External therapies of Siddha medicine- Dr.Thirunarayanan,Center for traditional research,Chennai,1st
Edition,2010.
4. Special medicines in siddha- Dr.Thiagarajan,Department of Indian Medicine & Homeopathy,Arumbakkam,2nd
Edition,Chennai.2006.
5. Text book of Varma science-T. Rajendran,Moolachal Publicshers,1st edition,2007.
6. Essentials of medical physiology- K. Sembulingam, 6th edition 2016,Jaypee publishers.
7. Text book of orthopaedics- 4th edition- 2010,Jhon ebenazor, Jaypee publishers.
8. http://www.m.webmed.com/pain-management/picture-of-the-knee.
9. http://www.medicinenet.com/script/main/mobileart.asp?article=115333.
10. http://en.m.wikipedia.org/wiki/knee.
Osteo arthritis Index Score Tables
Table 1.Patients taking internal medicine along with Varma treatment
Symptoms OA OA Index Score - OA Index Score – After 4 week OA Index Score – After
Before Treatment Treatment 4 week Treatment
Pain 4 2 1
Stiffness 3 2 1
Physical 4 3 2
Function
Table 2. Patients taking internal medicine without Varma treatment
Symptoms OA OA Index Score – OA Index Score – After 2 week OA Index Score – After
Before Treatment Treatment 4 week Treatment
Pain 4 3 2
Stiffness 3 3 2
Physical 4 3 3
Function
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Indian Journal of Natural Sciences www.tnsroindia.org. ©IJONS
Vol.7 / Issue 39 / December 2016 International Bimonthly ISSN: 0976 – 0997
Senthamil Rajam and Manickavasagam
4.5
4
3.5
3
2.5
2 Pain
1.5 Stiffness
1 Physical Function
0.5
0
Before Therapy After Therapy(at After Therapy
the end of 2nd
week)
Osteo arthritis Index Score diagrams
Fig. 1.Patients taking internal medicine along with Varma treatment
4.5
4
3.5
3
2.5
2 Pain
1.5 Stiffness
1 Physical Function
0.5
0
Before Therapy After Therapy(at After Therapy
the end of 2nd
week)
Fig.2.Patients taking internal medicine without Varma treatment
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