Available via license: CC BY-NC-SA 4.0
Content may be subject to copyright.
ISSN: 2322 - 0902 (P)
ISSN: 2322 - 0910 (O)
IJAPR | April 2022 | Vol 10 | Issue 4
150
International Journal of Ayurveda
and Pharma Research
Case Study
EFFECT OF JAMBIRA PINDA SWEDA IN THE MANAGEMENT OF AVABAHUKA
Bidhan Roy
Lecturer, Department of Panchakarma, Raghunath Ayurved Mahavidyalaya and Hospital, Purba Medinipur, Contai,
West Bengal, India.
Article info
Article History:
Received: 29-03-2022
Revised: 11-04-2022
Accepted: 18-04-2022
KEYWORDS:
Avabahuka, Frozen
Shoulder, Adhesive
Capsulitis, Jambira
Pinda Sweda.
ABSTRACT
Ayurveda is boon for mankind. Panchakarma is the most important part of Ayurveda to
uproot the disease as well as achieving the perfect balance of vitiated Doshas, Dhatus and
Agni. Avabahuka is a disease that affects the day to day activities like cooking, dressing,
bathing, eating etc. Shoulder pain is a common clinical symptom of Avabahuka. The
symptom of Avabahuka may be correlated with frozen shoulder because symptoms as well
as pathogenesis are more or less similar to Avabahuka. Acharya Vangasena had mentioned
Swedana Karma for Avabahuka. Aim: To evaluate the effectiveness of Jambira Pinda Sweda
in the management of Avabahuka. Method: In our Panchakarma OPD 56 years old female
patient came with complain of pain in the right shoulder joint and unable to perform her
normal daily activities. Patient was admitted to the Panchakrma IPD of R.A.M&H and she
had been treated with Jambira Pinda Sweda for 15 days. Result: After taking Panchakarma
therapy, patient showed marked improvement of the symptoms like Shula (Pain),
Sthambha (Stiffness) etc. Conclusion: It was found that Jambira Pinda Sweda had
significant role in the management of Avabahuka.
INTRODUCTION
The word Avabahuka is composed of two
words Ava and Bahuka [1]. Ava means dysfunction or
separation. Bahuka is the upper limb which is one
among the Shadangas. Avabahuka is a disease caused
by Kupita Vata Dosha localizing around Amsa Pradesh
causing the Soshana of Amsa Sandhi, there by leading
to Akunchana of Sira at that site and giving rise to
Bahupraspanda Haratvam which means restriction
range of motion[2].
As the sign and symptoms of Avabahuka is
much similar to the disease Frozen Shoulder, the
disease Avabahuka can be correlated with the disease
Frozen Shoulder. Often referred to as Frozen Shoulder ,
Adhesive Capsulitis is characterized by pain and
restricted movement of the shoulder, usually in the
absence of intrinsic shoulder disease. Adhesive
Capsulitis may follow bursitis or tendinitis of the
Shoulder or may be associated with Systemic disorder
Access this article online
Quick Response Code
https://doi.org/10.47070/ijapr.v10i4.2340
Published by Mahadev Publications (Regd.)
publication licensed under a Creative
Commons Attribution-NonCommercial-
ShareAlike 4.0 International (CC BY-NC-SA
4.0)
such as Diabetes mellitus. Prolong immobility of the
arm contributes to the development of adhesive
capsulitis. Pathologically, the capsule of the shoulder is
thickened and a mild chronic inflammatory infiltrate
and fibrosis may be present[3]. Pain and Stiffness
usually develop gradually but progress rapidly in some
patients. Night pain is often present in the affected
shoulder and pain may interfere with sleep[4]. The
shoulder is tender to palpation and both active and
passive movement are restricted[5]. One of the
treatment of Frozen shoulder is NSAIDs[6]. Intra-
articular corticosteroid is widely used as a
conservative treatment for shoulder. Long term use of
these drugs causes harmful effect on the patient. That
is why, we have to find out new treatment approaches
to uproot the disease.
In the present case study, we administerd
Jambira Pinda Sweda as a treatment modality of the
disease Avabahuka.
MATERIALAS AND METHODS
Case Report
A 56 years old female patient came to the OPD
of R.A.M &H with pain and stiffness of shoulder joint
since 5 months. She was unable to do her daily
activities. She took allopathic treatment but patient did
not get any relief.
Bidhan Roy. Effect of Jambira Pinda Sweda in the Management of Avabahuka
IJAPR | April 2022 | Vol 10 | Issue 4
151
Personal History
Appetite: Normal
Micturation : 4 to 5 times per day
Bowel habit: constipated
Sleep: Disturbed
BP: 130/80 mm of Hg
Astavidha Pariksha (Eight fold examination)
Nadi: Vata kaphaja
Mutra : 4 to 5 times per day
Mala : Vivandha
Jihwa : Aliptha
Sabda : Prakut
Sparsha: Sheeta, Khara
Drik: Samanya
Akrithi: Madhyama
Dasavidha Pariksha (Ten fold examination)
Prakrithi : Vata Kaphaja
Vikriti: Sira, Snayu
Satwa: Madhyama
Sara: Madhyama
Samhana : Madhyama
Satyma : Sarvarasa
Aharashakthi: Avara
Vyamashakthi: Madhyama
Vaya: Madhyam
Diagonostic Criteria:
Painful movement of Shoulder joint
Stiffness
Restricted range of motion of Shoulder joint.
Assessment Criteria:
The effect of therapies was evaluated under the following criteria:
A. Subjective Parameter
Table 1: Scoring on the basis of Bahu praspanditahara
Table 2: Scoring on the basis of Shula (Pain)
Shula (Pain)
Score
No pain
0
Mild pain, particulary on moving the shoulder but able to continue the
routine work without diffficulty
1
Moderate pain, felt on movement and also at rest, interfere routine work
2
Severe pain, felt on movement and also at rest, unable to carry most of the
routine work
3
Table 3: Scoring on the basis of Stambha (Stiffness)
Stambha (Stiffness)
Score
No stiffness
0
Mild stiffness, particularly during shoulder movement, able to continue
routine work with difficulty
1
Moderate stiffness, unable to continue work with difficulty
2
Severe stiffness, felt on movement and also at rest interfering routine work
3
B. Objective Parameter
Goniometer is used for assessment of joint mobility/range of motion of shoulder joint.
Table 4: Scoring on the basis of Flexion
Flexion (In degrees)
Score
161-180
0
141-160
1
121-140
2
<120
3
Bahupraspanditahara
Score
Can do work unaffectedly
0
Can do strenuous work with difficulty
1
Can do daily routine work with great difficulty
2
Can not do any work
3
Int. J. Ayur. Pharma Research, 2022;10(4):150-153
Available online at: http://ijapr.in
152
Table 5: Scoring on the basis of Extension
Extension (In degrees)
Score
51-60
0
41-50
1
31-40
2
<30
3
Table 6: Scoring on the basis of Abduction
Abduction (In degrees)
Score
161-180
0
141-160
1
121-140
2
<120
3
Table 7: Scoring on the basis of Internal rotation
Internal rotation (In degrees)
Score
71-90
0
51-70
1
31-50
2
<30
3
Table 8: Scoring on the basis of External rotation
External rotation (In degrees)
Score
71-90
0
51-70
1
31-50
2
<30
3
Treatment Protocol
Swedana by Jambira Pinda Sweda for the period of 15 days. Before Swedana karma, Abhangya by Tila taila
Observation
Table 9: Observation of Parameters
Parameters
BT
AT
Bahupraspanditahara
3
0
Shula
3
1
Stambha
2
0
Flexion
2
0
Extension
3
1
Abduction
3
1
Internal rotation
3
0
External rotation
2
1
RESULT AND DISCUSSION
Swedana is one of the prime treatment
modalities which plays an important role to subside
the pain of Shoulder joint by its Sthambhaghna,
Gouravaghna and Sitaghana guna[7]. Acharya
Vangasena had mentioned Swedana for the treatment
of Avabahuka. In the present study, we use Jambira
Pinda Sweda for the treatment of Avabahuka. Jambira
Pinda Sweda composed of different ingredients like
Jambira, Methi, Neem oil, Shatahva, Tila, Haridra,
Kulatha, Lasuna, Saindhava.[8]
Bidhan Roy. Effect of Jambira Pinda Sweda in the Management of Avabahuka
IJAPR | April 2022 | Vol 10 | Issue 4
153
According to Sushrut,Vyanavata take the role
for proper functioning of all types of motor functions
like Prasarana, Akunchana, Vinamana, Unnaman,
Tiryakagamana[9]. Sleshaka Kapha lubricates the
shoulder joint for the movement of the shoulder joint
.Vitiation of Vata and Kapha of the Amsa Pradesh leads
to the disease Avabahuka.
Jambira has Amla rasa, Ushna virya which
causes Shamana of Vata Kapha in the Shoulder joint
and the Ushna and Snigha guna of Swedana subsided
the symptoms of Avabahuka [10].
Patient was relieved from the symptoms of
Avabahuka by the Jambira Pinda Sweda. Panchakarma
procedure like Swdana not only mitigate the disease
but also uproot the disease pathogenesis.
CONCLUSION
This case study reflected the potentiality of
Jambira Pinda Sweda in the management of Avabahuka
i.e Frozen Shoulder and it also shows that the above
procedure is safe as well as effective for Avabahuka
with in the short span of time. From the above case
study, it can be said that Avabahuka can be managed
by Jambira Pinda Sweda. More research work is needed
for long time and big sample size to evaluate the
effectiveness of Jambira Pinda Sweda in the
management of Avabahuka.
REFERENCES:
1. Bahadur Radhakanthadeva. Shabdakalpadrum.
Delhi; NAG Publishers; 1987.p.565
2. Shastri Ambikadutta. Sushrut Samhita.Vol.1.
(Nidana Sthana-1/82). New Delhi. Chaukhambha
Publications; 2014; p.304
3. Harrison. Harrison’s Principles of Internal
Medicne. Vol.2. 18th Edition. Europe; Mc Graw
Hill;2011.p.2861
4. Goldman Lee & Schafer I. Andrew. Goldman’s Cecil
Medicine. 24th Edition. Philadelphia; Elsevier
Saunders; 2012.p.1679
5. Harrison. Harrison’s Principles of Internal
Medicne. Vol.2.18th Edition. Europe; Mc Graw Hill;
2011.p.2861
6. Harrison. Harrison’s Principles of Internal
Medicne.Vol.2.19th Edition. Europe; Mc Graw Hill;
2015. p.2249
7. Sharma.K.R & Dash Bhagwan. Charak Samhita.
Vol.1 (SutraSthana-22/11). Varanasi;
Chowkhamba Sanskrit Series Office;2017.p.120
8. Kar kanti Pulak. Essentials of Panchakarma
Therapy. Hoogly; Chhonya; 2012.p.149.
9. Vaidya Trikamji Jadhavji. Sushrut Samhita with
Nibandha sangraha commentary of Dalhana
acharya and Nyayachandrika Panjika of Gayadasa
(Nidana Sthana-1/17-18). Varanasi. Chaukhamba
Sanskrit Sansthan; 2017.p.260.
10. Sharma.K.R & Dash Bhagwan. Charak Samhita.
Vol.1 (Sutra Sthana-22/16). Varanasi;
Chowkhamba Sanskrit Series Office; 2017.p.388.
*Address for correspondence
Dr. Bidhan Roy
Lecturer,
Department of Panchakarma,
Raghunath Ayurved Mahavidyalaya
and Hospital, Purba Medinipur,
Contai, West Bengal, India.
Email: bidhanroy545@gmail.com
Cite this article as:
Bidhan Roy. Effect of Jambira Pinda Sweda in the Management of Avabahuka.
International Journal of Ayurveda and Pharma Research. 2022;10(4):150-153.
https://doi.org/10.47070/ijapr.v10i4.2340
Source of support: Nil, Conflict of interest: None Declared