Applied Anatomy of Siravyadha in Medial Marginal Vein in Context of Plantar Fascitis

Phase 3

Recruiting

Conditions: Other specified acquired deformities of musculoskeletal system. Ayurveda Condition: VATAKANTAKAM,

Brief Summary: Plantar fasciitis is the utmost common cause of chronic pain beneath the heel in adults, making up 11-15% of the foot symptoms requiring professional care. It is estimated that 1 in 10 people will develop plantar fasciitis during their lifetime. Although plantar fasciitis occurs at all ages, the highest risk of occurrence of it is in 40 â€“ 60 years of age. In Ayurveda, the condition may be considered under a *vatavyadhi* called *vatakantaka* for which *Acharya Sushruta* mentions *siravyadha* as treatment.  The site for *siravyadha* in *vatakantaka* is mentioned in Sushruta Samhita as 2 *angulas* above *kshipra marma*2. This site is relevant to the course of dorsal venous arch. However, there are conventional practices prevalent in Kerala where *siravyadha* is done in the medial aspect of *gulpha sandhi* which is also observed to give good relief. The conventional site for *siravyadha* is relevant to the medial marginal vein. This study is aimed at understanding the applied anatomy of *siravyadha* in dorsal venous arch and medial marginal vein in view of the areas of foot it drains.

Null Hypothesis:  There is no anatomical significance to *siravyadha* in medial marginal vein and dorsal venous arch in plantar fasciitis

Primary Alternate Hypothesi:  There is anatomical significance to *siravyadha* in medial marginal vein and dorsal venous arch in plantar fasciitis

Recruitment & Eligibility

Inclusion Criteria

1.Patients between 30 yrs.
60yrs of age, selected irrespective of sex, religion, occupation and socioeconomic status were diagnosed on the basis of signs and symptoms found in Plantar fasciitis 2.Plantar heel pain provoked by first few steps in morning, by standing after prolonged sitting or by prolonged standing. 3.Tenderness localized at the origin of plantar fascia on medial calcaneal tubercle. 4.Positive Windlass test.

Exclusion Criteria

1.Calcaneal spur 2.Calcaneal stress fracture 3.Previous treatment with ultrasound within 3 months 4.Previous foot surgeries.
5.Tarsal tunnel syndrome.
6.Generalized inflammatory disorders associated with diagnosis of plantar fasciitis including Rheumatoid arthritis, Ankylosis Spondylitis, Reiterâ€™s disease, Gout or Lupus.
7.Neoplastic conditions, Nerve entrapment syndromes 8.Participants with impaired circulation to lower extremities 9.Subjects with referred pain due to sciatica and other neurologic disorders 10.Corticosteroid injections to heel, preceeding 3 months.
11.Use of pain control (NSAIDS, Analagesics), steroids, heel pads or orthoses at time of recruitment.
12.Any other major illnesses.

Primary Outcome Measures

Name	Time	Method
The pain will be assessed using visual analogue scale pain scoring	1 week

Secondary Outcome Measures

Name	Time	Method
Efficacy of pain releif of siravedha in median marginal vein and dorsal venous arch will be assessed and compared	1 year

Locations (3): PDEAs College of Ayurved and Research Centre
🇮🇳
Pune, MAHARASHTRA, India
Purnayoo Arogya Nikethanam
🇮🇳
Wayanad, KERALA, India
Yenepoya Ayurveda Medical College and Hospital
🇮🇳
Kannada, KARNATAKA, India
PDEAs College of Ayurved and Research Centre
🇮🇳Pune, MAHARASHTRA, India
Dinesh Naik
Principal investigator
9145458644
drdineshnaik27@gmail.com