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International Journal of Ayurveda and Traditional Medicine Treatment of Manyastambha (Torticollis) with Marma therapy: A Case Study

Authors:
  • Ayurvedshala
CASE REPORT IJATM.2019;1(1):21-23.
International Journal of Ayurveda and Traditional Medicine
Treatment of Manyastambha
(Torticollis) with Marma
therapy: A Case Study.
Suresh Maharjan1
1Ministry of Social Development, Health Directorate, Province 1, Dhankuta, Nepal.
ABSTRACT
Marma are the vital points of our body that when injured may lead to death. There are 107 Marma points in our body. The
form of treatment in which these points are manipulated to attain the desired health effect is known as Marma
therapy. An
acute case of neck pain and neck stiffness presented at Kayachikitsa OPD, Tribhuvan University Ayurveda Teaching Hospital
(TUATH) was clinically diagnosed as Manyastambha (~Torticollis). During the clinical examination his neck was found
turned to the right side and there was almost complete restriction of neck movement in any direction. The case was planned
to be treated with Marma therapy mainly the manipulation of bilateral Amsamarma
along with Snehana and Swedana
. After
the treatment of about twenty five minutes the patient regained the complete range of neck movement with slight pain at the
extreme point of movement. After taking Kaishor Guggulu for 15 days, he got complete relief from the neck problem. Amsa
Marma
manipulation can be used to give instant relief from Manyastambha
(~Torticollis) very effectively.
_________________________________________________________________________________
Keywords: Amsa Marma; Marma therapy; Manyastambha;
Torticollis.
________________________________________________________________________________
INTRODUCTION
With changes in lifestyle and food habits, vitiation of
Vata is prominent and prevalence of Vatvyadhi is
increasing day by day. Among hundreds of manifestations
of Vatvyadhi
(disease/ syndrome),Manyastambha is one
of the common presentations physicians have to face.
Ruja (~pain) and Sthambha (~stiffness) are the major
clinical presentations of Manyastambha
. In Amarkosha
Manya
’ is described as ‘Greevapaschat Sira
(~any
tubular vessel at neck region)’ and Stambha as stiffening.
Literally Manyastambha is correlated with torticollis, a
musculoskeletal disorder where spasm of muscles of
shoulder and neck causes stiffness and pain. Some authors
also correlate this presentation with ‘cervical spondylosis’
also.
Marma are the vital points of our that when injured may
lead to death. There are 107 Marma points in our body.
The form of treatment in which these points are
manipulated to attain the desired health effect is known as
Marma
therapy.6
CASE REPORT
A 17 years old male presented at TUATH, Kayachikitsa
Outdoor Patient Department (OPD no 23422) with a
complaint of neck stiffness and pain. A day before while
he was on the way home on the bus he rested with his
head tilting right side on seat, suddenly he lifted his head
IJATM I VOL 1 I ISSUE 1 I DEC 2019
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Suresh Maharjan. Treatment of Manyastambha (Torticollis) with Marma therapy: A Case Study.
to give way to a passenger and at that time he noticed
mild pain in his neck. He tried to rest back as before but
the pain continued. So, he tried to keep his head straight.
He had a feeling of heaviness and pain while moving his
head. He ignored the pain as it was mild.
Back home, he slept with a high pillow at night. In the
morning he felt heaviness on his neck and pain during
moving his head. The pain became severe by college time.
In spite of the pain he left for college in a local bus as
usual. On the way, he had more pain but felt a sort of
relief on turning his head to the right side. After a while,
he experienced pain even with his head turned to his right
side. He got off the bus, walked to college and attended a
class. His pain got worse, making it difficult for him to
stand and move his head. As the pain became unbearable
his friends brought him to the Kayachikitsa OPD at
TUATH.
Upon arrival at OPD, he was thoroughly examined. His
shoulders were shrugged up and his head was turned to
his right side at around 600to the axial line. He was not
able to stand straight himself. He seemed to have
experienced severe pain and was taking a shallow breath.
He didn’t complain about dizziness, nausea and vomiting,
headache, fever and any sort of trauma.
His blood pressure was normal (120/80 mm Hg) and
pulse beat was 80/min. On local examination, his bilateral
Amsa
1, 5,Amsaphalaka
2, 5,Brihati
3, 5 and Krikatika
4, 5
Marma were found severely tender. Tenderness was more
on the right side than on the left side. He completely lost
his passive range of neck movement except the slight
neck flexion. His leftward circular movement, neck
extension, circumduction, right and left lateral flexion
were completely lost. He was not suggested for any
laboratory and radiological examination.
The consent was taken while taking the photographs and
for taking the data of the patient for a research article. The
patient was convinced for confidentiality of the data.
Management
The case was clinically diagnosed as Manyastambha
(~Torticollis). It was planned to treat the case with
Marma
therapy along with Snehana
and Swedana
.
Preparation of the patient:
Patient's bilateral neck, shoulder and periscapular region
were smeared with sesame oil. The area was given a
gentle massage for about five minutes along with Nadi
Sweda
.
Marma therapy
The right Amsa Marma
1, 5 of the patient was pressed
downward and inward with the right index finger and the
patient chin was rested on the left palm. Then, the Marma
was given a circular massage (anti-clockwise) while being
pressed. Simultaneously the head was gently rotated
towards left with the help of left palm till his head turned
to around 750left and was again brought to straight
position. At the normal straight position, the head was
then flexed forward to touch the chest and was extended
backwards with the help of the left palm. During the
period the pressing and circular massage of Amsa
Marma
1, 5 and Nadi Sweda was continued. The same
procedure was repeated with left Amsa Marma
1, 5 of the
patient. Then the Amsaphalaka
2, 5 and Brihati Marma
3,5
were massaged with pressure along with Nadi Sweda
. The
whole procedure lasts for about 25 minutes.
Post procedure:
The patient was suggested for complete neck movement
passively. He was also advised for iso-metric neck
exercise and not to take high pillow and bend the neck in
any direction for a longer time. He was then prescribed 1
gm of Kaishor Guggulu twice a day to be chewed on an
empty stomach for 15 days.
Outcome
During the therapy, the patient felt a slight pain. He was
very cautious while moving his head, when he was asked
to move his head after completing the therapy. He
regained the complete range of neck movement with
slight pain at the extreme point. After 15 days, he got
complete relief from the neck problem.
Follow up
The patient came for follow up on the scheduled date.
From the first day of the therapy till the date, he didn’t
have any related signs and symptoms. But he was very
conscious about the pain for the first few days.
22 IJATM I VOL 1 I ISSUE 1 I DEC 2019
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Suresh Maharjan. Treatment of Manyastambha (Torticollis) with Marma therapy: A Case Study.
1
2
3
Figure 1. Performing Right Amsa Marma
massage. Figure 2. Performing Left Amsa Marma
massage. Figure 3. Patient gains the range
of movement at the end of Marma
therapy.
DISCUSSION
The patient while travelling in the evening maintains the
wrong position of neck that leads to mild neck pain.
Instead of correcting the position, he further maintained
the wrong position of neck during the night and the
following morning that leads to severe spasm of neck
muscles, especially trapezius and sternocleidomastoid
muscles. The spasm of the muscles ultimately lead him to
Manyastambha (~torticollis). The Amsa Marma
1, 5 was
chosen to treat the case, Amsa Marma is a type of
Snayumarma
useful to release the spasm of neck muscles.
The case was treated with Marma therapy as described
and got relief within 25 minutes.
In the clinical examination of the patient, the neck was
found turned to the right side and the patient was unable
to move his neck in any direction except slight flexion of
neck. His bilateral Amsa,
Amsaphalaka
2, 5
, Brihati
3, 5 and
Krikatika
4, 5 Marma (~vital points of the body) were found
severely tender. So, the case was planned to be treated
with Marma therapy with Snehana and Swedana.
CONCLUSIONS
Amsa Marma manipulation can be used to give instant
relief from Manyastambha
(~torticollis) very effectively.
The case series on large population is recommended for
future study.
ACKNOWLEDGEMENT
I am thankful to the Hospital faculties and staff for their
valuable support.
REFERENCES
1. Ranade S, Lele A, Frawley D. The Secrets of
Marma.Reprint ed. Delhi-110007: Chaukhamba Sanskrit
Pratisthan; 2005. p. 75.
2. Ranade S, Lele A, Frawley D. The Secrets of Marma.
Reprint ed. Delhi-110007: Chaukhamba Sanskrit
Pratisthan; 2005. p. 74.
3. Ranade S, Lele A, Frawley D. The Secrets of Marma.
Reprint ed.Delhi-110007: Chaukhamba Sanskrit Pratisthan;
2005. p. 73.
4. Ranade S, Lele A, Frawley D. The Secrets of Marma.
Reprint ed. Delhi-110007: Chaukhamba Sanskrit
Pratisthan; 2005. p. 82.
5. Sushruta. Sushruta Samhita Purvarddha II with Hindi
commentary by Shastri A. Reprint ed. Varanasi-221001:
Chaukhamha Sanskrit Sansthan; 2007. p. 50-58.
6. Marc Halpern. The Importance of Marma Therapy in
Ayurvedic Practice.[Internet] Available from:
https://www.ayurvedacollege.com/blog/importance-marma-
therapy-ayurvedic-practice/
Source of Support: Nil
Conflict of Interest: None Declared
Consent: The consent was signed by the patient and
the original article is attached with the patient’s chart
© The Author(s) 2019. This work is licensed under a Creative
Commons Attribution 4.0 International License. The images or other
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IJATM I VOL 1 I ISSUE 1 I DEC 2019
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23
ResearchGate has not been able to resolve any citations for this publication.
Delhi-110007: Chaukhamba Sanskrit Pratisthan
  • S Ranade
  • A Lele
  • D Frawley
Ranade S, Lele A, Frawley D. The Secrets of Marma. Reprint ed. Delhi-110007: Chaukhamba Sanskrit Pratisthan; 2005. p. 74.
Sushruta Samhita Purvarddha II with Hindi commentary by
  • Sushruta
Sushruta. Sushruta Samhita Purvarddha II with Hindi commentary by Shastri A. Reprint ed. Varanasi-221001: Chaukhamha Sanskrit Sansthan; 2007. p. 50-58.
The Importance of Marma Therapy in Ayurvedic Practice
  • Marc Halpern
Marc Halpern. The Importance of Marma Therapy in Ayurvedic Practice.[Internet] Available from: https://www.ayurvedacollege.com/blog/importance-marmatherapy-ayurvedic-practice/