An Open Clinical Trial On Varmam Manipulation (Varma Thadaval) With Arkathy Thailam For The Management Of Kumbavatham (Periarthritis Shoulder) Reporting At Ayothidoss Pandithar Hospital,National Institute Of Siddha.

BACKGROUND: Siddha system is one of the ancient system of medicine for maintaining healthy life and for the treatment for diseases. This system was bestowed by the great Siddhars after attaining spiritual knowledge through physical perfection and spiritual salvation. Varmam is one of the unique therapeutic procedure of Siddha system of Medicine. Varmam points in the body can be determined by anatomical location, finger breadth measurement, thread measurement.

Varmam is one of the component of martial arts. It may possess therapeutic approaches and medicines to cure ailments. There are numerous vital points in the human body that are located in the junction of nerves, bones, muscles, ligaments, internal organs. These are interconnected by channels in definite way and governing on various vital activities of human body. when we regulate these vitals points using different manipulation technique it produces therapeutic efficacy. There are 108 Varmam points in human body. Apart from these points, many Varmam points are mentioned in Varmam literatures.In Yugi Vaidhya Chinthamani, vatha diseases are classified into 80types.Kumbavatham is one among 80 types of Vatha diseases. Kumbavatham is characterized by pain,restricted movements in shoulder joint an darm,burning sensation in eyes and cheeks,giddiness and twitching over the scalp, pain below the umbilicus,burning sensation in the tongue.In modern medicine kumba vatham may be correlated with Periarthritis shoulder.Adhesive capsulitis, also known as “frozen shoulder,” is a common shoulder disease that clinically presents with pain, stiffness, and dysfunction and is pathologically characterized by inflammation and contracture of the glenohumeral capsule. Although there are differences in the literature, adhesive capsulitis has a high prevalence rate of 2–5% in the general population, with the highest prevalence observed among women between 40 and 60 years of age. Adhesive capsulitis consists of the first “freezing (painful)” stage with increased pain and stiffness for several months, a second “frozen (stiff)” stage resulting in loss of rangeof motion (ROM) of the shoulder, and a third “thawing (recovery)” stage, in which pain and ROM recover.

A shoulder pain and disability index (SPADI) was used to measure the pain and disability associatedwithshoulderpathology.TheSPADI is a self-administered index consisting of 13 items divided into two subscales: pain and disability.

The universal goniometer(orinternational standard goniometer)is the most commonly used tool for measuring ROM at large joints, such as the shoulder and hip. A joint’s ROM is usually measured by the number of degrees from the starting position of a segment to its position at the end of its full range of the movement.The most common way this is done is by using a double-armed goniometer

. Although there is conventional management like NSAID, intraarticular steroids, physiotherapy, acupressure and yoga, the recovery from this condition is prolonged. The Siddha system of medicine is one of the ancient systems that practised in India possess various treatment modalities to treat various musculoskeletal conditions. Varmam therapy is a non-invasive therapy used in pain management

OBJECTIVE:

To evaluate the effectiveness of Varmam manipulation (Varma thadaval) with Arkathy thailam(external) in the management of Kumbavatham (PERIARTHRITIS SHOULDER) using SPADI scale and Goniometer.

METHODOLOGY: A total of 30 diagnosed patients of Kumbavatham (Periarthritis Shoulder)

within the age limit of 30 to 60 years willing to participate in the study by signing the consent form

will be enrolled in the study based on inclusion criteria. patient with  uncontrolled diabetes mellitus ,recent upper extremity injury and/or fractures,  , Infective arthritis , Dislocation of shoulder joint , Pregnancy and lactating women will be excluded

OUTCOME:

1. SPADI score less than 20%
2. Reduction in pain
3. Improvement in Range of Movement

RESULTS AND DISCUSSION : The result will be statistically analysed

KEYWORDS: Arkathy thailam,Varmam manipulation,Periarthritis shoulder.