Traditional marma manipulation and snigdha agnikarma in osteoarthritis of knee: a quasi-experimental study

Abstract

Osteoarthritis is a prevalent degenerative arthritic disorder that affects the global population. A non-surgical treatment which provides symptomatic relief can help most of the patients to avoid surgeries. Clinically it is similar to sandhigatavata, presenting shulapradhanavedana, sandhisopha with ‘vatapurnadruthisparsa’ and restricted movements of the joint. According to Acharya Sushruta, treatment of sandhigatavata includes sneha, upanaha, agnikarma, bandhana and unmardana. Since pain is the cardinal symptom of this condition, two procedures among the aforesaid treatment principle were selected for comparing its effect in alleviating pain. So, snigdha agnikarma which is indicated in diseases affecting sandhi, asthi, sira and snayu, and unmardana or traditional marma manipulation were studied. The study was a quasi-experimental clinical trial done on the 0^th, 7^th and 14^th day in groups A and B respectively, with 22 participants in each group. All the 44 participants were recruited through purposive sampling, from patients with symptoms of OA knee registered in the O.P.D and I.P.D. of Shalyatantra, P.N.N.M. Ayurveda Medical College and Hospital, Cheruthuruthy, satisfying the inclusion and exclusion criteria. Traditional marma manipulation and snigdha agnikarma were administered in groups A and B respectively. The clinical assessment was based on the parameters; pain, stiffness and physical function using WOMAC scale; swelling, crepitus and tenderness by grading scales and range of motion using goniometric readings. The parameters mentioned in the assessment criteria were assessed on 0^th, 14^th, 28^th and 42^nd day. The results were statistically analyzed and it was found to be statistically significant in reducing all the parameters in both groups, but no significant difference between the effect of both procedures was noted. Thus, both interventions were found to be equally effective in terms of overall treatment effect.