Avabahuka Frozeen shoulder Dr Mahesh 20-03-2022.pptx

The Avabahuka disease is nearer to Frozen shoulder of musculoskeletal disorders.
Avabahuka is a Vata vikar as per Ayurveda that affects the ansha sandhi i.e. shoulder joint. The description available in Charak samhita, Sushruta samhita, Ashtanga Hridaya etc. The pain, stiffness, and decreased ROM range of motion is a classical feature of a frozen shoulder.
The treatment of frozen shoulder is possible in Ayurveda through drugs and various treatment modalities depending on the stages of the case.

1. AYURVEDIC APPROACH OF PAIN MANAGEMENT OF FROZEN SHOULDER (AVABAHUKA) Dr. Mahesh Kumar M.S.(Ay .) Assistant Professor 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 1

2. I ntroduction Shoulder pain is popular musculoskeletal complaints, common in the primary care setting. Proper history taking and examination , site and location of pain helpful in making the diagnosis . Exploration of the causes of common shoulder disorders is required as it may be managed with conservative approach. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 2

3. The shoulder joint/Ansha Sandhi -major joint of upper limb, -excessively movable joint, -ball and socket type of joint, -formed by humerus , clavicle scapula bone. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 3

4. Gati of shoulder joint- RANGE OF MOTION ( R.O.M.) Most movable joint of human body acting in the conjunction of pectoral girdle. Like ……. FLEXION- 0-180i EXTENSION- 0-40 ABDUCTION – 0-180 ADDUCTION INTERNAL/medial ROTATION- 0-80 EXTERNAL/lateral ROTATION- 0-90 Circumduction 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 4

5. Causes of Shoulder Pain Articular Causes and periarticular causes. Glenohumeral (GH) and acromoclavicular (AC) arthritis, instability. Fracture,infection etc Ligamental lesion Periarticular Causes Rotator cuff tendinitis, Bicep tendinitis Bursitis Adhesive capsulitis

6. Frozen shoulder [adhesive capsulitis, ] The “frozen shoulder” (FS) of modern science, a common musculoskeletal disorder with features of pain ( shool ), stiffness ( stambha ), and decreased range of motion ( bahu-praspandithar ) of shoulder joint. It effects day to day activity and quality of life by restricting shoulder joint movement and its functions. 20-03-2022 Avabahuka-Frozen shoulder Dr Ma STAGES - hesh Kumar AAIMCON 2022 6

7. Frozen shoulder STAGES- The Freezing (painful stage), Frozen (stiffness stage), thawing (resolving stage) are the stages of FS . The common treatment plan are use of NSAID’s , oral or injectable steroid , physical therapy, surgical intervention. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 7

8. In Ayurveda : Correlation .. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 8 =======

9. Avabahuka ? The Avabahuka disease is a Vatavikar affects the Ansha sandhi (shoulder joint) and is mentioned in Ayurveda -Sushruta Samhita, Charak Samhita , Ashtanga Hridaya etc. Clinically, it is commonly observed in diabetic patient, elderly person, traumatic shoulder etc. in form of “ adhesive capsulitis ” or “ periarthritis of shoulder region”. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 9

10. AVABAHUKA Ashtanga Hridaya Nidana sthana 15/43 …. .. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 10

11. Aetiology The general causes of Vatavikar are responsible 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 11 External factor Internal factor marma abhighaat “ STABDHABAAHUTA ” Trauma at neck site Clavicle fracture Practice of vatavardhak aahaar-vihaar

12. Clinical features 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 12

13. Samprapti ghatak Dosha - व्यान वायु , श्लेषक कफ Dushya – सिरा , स्नायु , मांस , कंडरा, अस्थि Shrotash –मांस वह , अस्थि वह Shrotodushti – संग , विमार्ग गमन Rogmarga – मध्यम रोग मार्ग Udbhav sthana - पक्वाशय Vyakta sthan - बाहु Adhisthaa n- अंश प्रदेश , अंश संधि Vyadhi swabhaav – चिरकारी 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 13

14. Assessment of Avabahuka 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 14

15. DIFFERENT TREATMENT MODALITIES In spite of practices still the satisfactory results gap exists. So Ayurvedic approach via various treatment modalities may act option for FS . एतेन चिरकाल निरंतर क्रियेति दर्शयति (डलहण ) 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 15

16. .. The common one is Snehana (oleation), Swedana (fomentation), marma therapy, agnikarma, Nasya, Snehapaan, anti-inflammatory drugs etc. In Avabahuka practice vatavyadhi chikitsa. And avoid siravedhana (Sushruta chikitsa 5/23) 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 16

17. A. SNEHAN /Abhyang/स्वेदन स्थानीय अभ्यंग एवं स्वेदन Abhyanaga (massage) by Dashmool Taila . Pressure applying with medicated vatahara oil Swedana/sudation by Dashmool Kwath 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 17

18. B UPNAAHA & Bandhan Mentioned by Sushruta when vitiated vata situated at snayu, sandhi- asthi site. Upnaaha sweda e.g , Atasi Upnaaha, Dashmool+ Atsi powder poultice, leaves of Arka , Eranda , saindhava salt. Bandhan – Asthi -sandhi sthairya cha (Sushruta) Gophana bandha at Ansha sandhi (Sushruta), swastika bandha also at joint site., “ Avipreet bandhe vedanopshanti ”.( sushruta ) 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 18

19. C. AGNIKARMA Intentional therapeutic heat burn therapy(ITHBT) Vata & kapha shamak property treat the pain and stiffness The bindu type agnikarma will perform at tender site of shoulder region, posterior and lateral aspect of shoulder region. with help of cuppor shalaka. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 19

20. D . NASYA 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 20 Snaihik nasya BRINHAN NASYA Vaataad tail Pratimarsha Nasya by Anu Taila .

21. E . MARMA THERAPY Marma therapy a non-pharmacological treatment is frequently in practice for pain management of FS. The proper stimulation of Ansha marma point, a type of Vaikalyakar Marma at shoulder region reduces the pain intensity. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 21

22. F . SNEHAPAAN स्नेहपान , स्नेहपान के पश्चात भोजन 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 22 Meal after Snehapaan स्नेह पान के पश्चात भोजन BRINHAN SNEHAPAAN

23. G. Bahu-parivartanam ( Yogratnakar ) This is a physiotherapy exercise of shoulder region. H. YOGA AND ASANA Surya namaskar 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 23

24. I. Sanshaman /medicines/drugs Vatahar drugs Rasna , Eranda , Bala , Rasayana – Ashwagandha Mahanarayna oil, Mahamash oil Guggulu - Tryodashana G, Saptavinshati G. Prasariniyadi Kashaya – (SAHASHRAYOGA) Patra- Pinda Sweda NIDAN PARIVARJANA 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 24

25. CONCLUSION Avabahuka (Frozen shoulder) disease is Vatavikar at ansha sandhi. So t he general vata-vyaadhi chikitsa is applicable in Avabahuka also . The Ayurveda approach for pain management is Nidan parivarjana (avoid the cause), Snehan (oleation), Upnaaha (poultice), agnikarma (intentional therapeutic heat burn therapy), bandhan (bandaging), mardan (massage), Nasya , Marma therapy. These methods are effective in subsiding strength of pain and stiffness, finally improve the range of motion. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 25

26. Conclusion…………………… The Ayurveda treatment modalities for frozen shoulder (painful shoulder) is effective, cost effective, easy to adopt and reduces the pain and stiffness . These are practiced routinely in Ayurveda discipline but needs more exploration for validation. 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 26

27. AVABAHUKA , FROZEN SHOULDER THANKS FOR YOUR PATIENCE watching… . धन्यवाद THANK YOU 20-03-2022 Avabahuka-Frozen shoulder Dr Mahesh Kumar AAIMCON 2022 27