Effective Management of Frozen Shoulder: A Case Report
Life Sciences-Ayurved
DOI:
https://doi.org/10.22376/ijlpr.2023.13.6.L502-L509Keywords:
Frozen shoulder, Palliative treatment, Range of motion, geriatric, Enema.Abstract
Frozen shoulder affects shoulder joints. Ayurveda links it to Vata-vitiated Avabhahuk. Frozen shoulders occur when aggravatedVata dries out its binding elements and constricts shoulder veins. This disorder restricts shoulder movement due to Sira constriction.Since aggravating variables cause all motor functions and joint ranges of motion, treating a frozen shoulder should focus on pacifying Vataand Kapha. The main aim of the presentcase is to assess the role of comprehensive management of a frozen shoulder in a geriatricfemale patient by using Panchakarma (purification therapy) and Shamana (palliative) in Ayurveda. And the objective is to reduce theduration of treatment and cure the medical condition with the greatest possible benefit. It is a single case study of a seventyyears oldfemale patient who has represented herself with complaints such as Pain and Stiffness in her right shoulder joint with its restrictedmovement, inability to lift a completely right hand in an upward direction, difficulty while walking due to pain in both knee joints for fourmonths. The comprehensive regime using was prescribed for purification therapy treatment (local massage with Dashmoola Oil, PatraPinda Sudation, Nasal instillation with Anutail (oil), Janu Basti (knee joint retention enema) with Sahcharadi oil, and medicated enemaregimefor 16 days. Simultaneously palliative treatment (Syrup Armex, Sinhanad Guggul, Aamvatari rasa, and Syrup Vatamritam for a consecutivemonth. After one month of follow-up, there was significant relief in clinical features of the disease, along with gross improvement in therange of motion of the affected shoulder joint. The afore-said regime based on comprehensive management in Ayurveda inducesencouraging results in a patient with frozen shoulders within a short duration. Hence it's essential due to increasing cases in day-to-daylife. So, it was concluded that the present results were due to the analgesic, anti-inflammatory & nourishing properties of Ayurvedainterventions. All the above-said treatment protocol is effective in the frozen shoulder without causing any adverse event.
References
Abrassart S, Kolo F, Piotton S, Chih-Hao Chiu JC, Stirling P, Hoffmeyer P et al. 'Frozen shoulder’ is ill-defined. How can it be described better? EFORT Open Rev. 2020 May;5(5):273-9. doi: 10.1302/2058-5241.5.190032, PMID 32509332.
Carmignano SM. Frozen shoulder: symptoms, causes, diagnosis, and treatment. InShoulder surgery for RC pathology, arthropathy and tumors 2022 Feb 4. IntechOpen.
Sorte K, Ade V, Sawarkar P, Parwe S, Nisargandha M. Comparative Evaluation of Manjishthadi Oil and Mahamasha Oil Nasal instillationin the Management of Frozen Shoulder (Frozen Shoulder)-A study protocol.
Millar NL, Meakins A, Struyf F, Willmore E, Campbell AL, Kirwan PD et al. Frozen shoulder. Nat Rev Dis Primers. 2022 Sep 8;8(1):59. doi: 10.1038/s41572-022-00386-2, PMID 36075904.
Dyer BP, Burton C, Rathod-Mistry T, Blagojevic-Bucknall M, van der Windt DA. Diabetes as a prognostic factor in frozen shoulder: a systematic review. Arch Rehabil Res Clin Transl. 2021 Sep 1;3(3):100141. doi: 10.1016/j.arrct.2021.100141, PMID 34589691.
Antari NKAJ, Kinandana GP, Negara AA. The Addition Effect Of Scapulothoracic Joint Mobilization In Intervention Of Ultrasound And Glenohumeral Joint Mobilization In Increasing Range Of Motion And Functional Ability In Individual With Frozen Shoulder. Sport Fit J. 2021 Sep;9(3):166-75. doi: 10.24843/spj.2021.v09.i03.p04.
Rees JL, Kulkarni R, Rangan A, Jaggi A, Brownson P, Thomas M et al. Shoulder pain diagnosis, treatment and referral guidelines for primary, community and intermediate care. Shoulder Elbow. 2021 Feb;13(1):5-11. doi: 10.1177/1758573220984471, PMID 33747136.
Brun SP. Idiopathic frozen shoulder. Aust J Gen Pract. 2019 Nov;48(11):757-61. doi: 10.31128/AJGP-07-19-4992, PMID 31722459.
Cho CH, Bae KC, Kim DH. Treatment strategy for frozen shoulder. Clin Orthop Surg. 2019 Sep 1;11(3):249-57. doi: 10.4055/cios.2019.11.3.249, PMID 31475043.
She LC, Wang HY, Liu MF, Lin YK, Chen SM. The relationship between self-perceived health and clinical symptoms in patients with frozen shoulders. Int J Environ Res Public Health. 2022 Nov 3;19(21):14396. doi: 10.3390/ijerph192114396, PMID 36361275.
Pandey V, Madi S. Clinical guidelines in the management of frozen shoulder: an update! Indian J Orthop. 2021 Apr;55(2):299-309. doi: 10.1007/s43465-021-00351-3, PMID 33912325.
Paul A, Rajkumar JS, Peter S, Lambert L. Effectiveness of sustained stretching of the inferior capsule in the management of a frozen shoulder. Clin Orthop Relat Res. 2014 Jul;472(7):2262-8. doi: 10.1007/s11999-014-3581-2, PMID 24664198.
Almureef SS, Ali WM, Shamsi S, Al Zahrani MB. Effectiveness of mobilization with conventional physiotherapy in frozen shoulder: a systematic review. Int J Recent Innov Med Clin Res. 2020;2(4):22-9.
Bodnar J. Corticosteroids and oral surgery. Anesth Prog. 2001;48(4):130-2. PMID 11724221.
Cavalleri E, Servadio A, Berardi A, Tofani M, Galeoto G. The effectiveness of physiotherapy in idiopathic or primary frozen shoulder: a systematic review and meta-analysis. Muscle Ligaments and Tendons J. 2020 Jan 1;10(1):24. doi: 10.32098/mltj.01.2020.04.
Jayakody MI, Gunarathna ED, Kulathunge RD. Management of Avabhahuka (frozen shoulder) through Sri Lankan Ayurveda treatment protocol: A case study. Int J AYUSH Case Rep. 2019 Jul 8;3(2):177-87.
M.r. YB, Ebnezar J. Role of Nasya Karma (nasal instillation therapy) in Apabahuka (frozen shoulder)– a qualitative systematic review. J Ayu Her Med. 2021;7(4):281-8. doi: 10.31254/jahm.2021.7412.
Bagali PH. Pain management in Frozen Shoulder. J Ayurveda Integr Med Sci. 2018 Jun 30;3(03):119-23.
Costa C, Sudarshan A. A comparative clinical study on the efficacy of Nasal instillationwith Pinyaka/Panchamula Oil and Swalpa Masha Oil in Apabahuka wsr to frozen shoulder. J Ayurveda Integr Med Sci. 2020 Aug 31;5(04):31-6.
Hasan SJ, Dawre MK, Barela LB, Hulwale NS, Yadav S. A review study on frozen shoulder (frozen shoulder) and its management by shuchivedhan.
Ashtankar P, Sawarkar P. Comprehensive Ayurvedic management of Sandhigatavata: a case report. J Indian Sys Medicine. 2019 Oct 1;7(4):249. doi: 10.4103/JISM.JISM_71_19.
Joshi A, Mehta CS, Dave AR, Shukla VD. Clinical effect of Nirgundi Patra pinda sweda and Ashwagandhadi Guggulu Yoga in the management of Sandhigata Vata (osteoarthritis). Ayu. 2011 Apr;32(2):207-12. doi: 10.4103/0974-8520.92588, PMID 22408304.
M.r. YB, Ebnezar J. Role of Nasya Karma (nasal instillation therapy) in Apabahuka (frozen shoulder)– a qualitative systematic review. J Ayu Her Med. 2021;7(4):281-8. doi: 10.31254/jahm.2021.7412.
Mishra A, Shrivastava V. Evaluation of efficacy of Marma therapy with janu basti in the management of janu sandhigata vata (osteoarthritis of knee) [international journal]. Dev Sanskriti Interdis Internat J. 2020 Jan 31;15:29-45. doi: 10.36018/dsiij.v15i.139.
Baria R, Joshi N, Pandya D. Clinical efficacy of Panchamuladi Kaala Basti (enema) in the management of Amavata (Rheumatoid Arthritis). Ayu. 2011 Jan;32(1):90-4. doi: 10.4103/0974-8520.85737, PMID 22131764.
Ashtankar P, Sawarkar P. Comprehensive Ayurvedic management of Sandhigatavata: a case report. J Indian Sys Medicine. 2019 Oct 1;7(4):249. doi: 10.4103/JISM.JISM_71_19.
Mohan M, Sawarkar P. Ayurvedic management of Gridhrasi with special respect to sciatica: a case report. J Indian Sys Medicine. 2019 Apr 1;7(2):131. doi: 10.4103/JISM.JISM_38_19.
Wadnerwar N, S R PK, Deogade M, Kadu A. Comparative study of efficacy of Gunja Beeja lepa and Shunthi Churna lepa in inflammatory Conditions of Arthritis - A Randomized Controlled Single Blinded Clinical Study. Int J Ayurvedic Med. 2020;11(2):200-4. doi: 10.47552/ijam.v11i2.1390.
Sawarkar P, Deshmukh M, Sawarkar G, Bhojraj N. A Comparative Efficacy Study of the Panchtikta Ghrita Matra Vasti and Panchtikta Ghrita Marsha Nasya in Cervical Spondylosis. Int J Ayurvedic Med. 2020 Jul 3;11(2):218-27. doi: 10.47552/ijam.v11i2.1432.
Mohan M, Sawarkar P. Contribution of Ayurveda for the management of Swarabheda: A case study. J Indian Sys Medicine. 2019 Jul 1;7(3):178. doi: 10.4103/JISM.JISM_59_19.
Sawarkar G, Sawarkar P. Role of Ayurveda in the management of Apasmara: A case study. J Indian Sys Medicine. 2019 Oct 1;7(4):245. doi: 10.4103/JISM.JISM_63_19.
Das B, Ganesh RM, Mishra PK, Bhuyan G. A study on Apabahuka (frozen shoulder) and its management by Laghumasha taila nasya. Ayu. 2010 Oct;31(4):488-94. doi: 10.4103/0974-8520.82048, PMID 22048545.
Sawarkar P, Sawarkar G. Management of scapular dyskinesia through comprehensive approach-A case study. J Indian Syst Med. 2018 Oct 1;6(4):218.
Nirmal B, Hivale US, Gopesh M. Management of Avabahuk (frozen shoulder) with abhyanga sudation, Pratimarsha Nasal instillationAnd Ayurveda medicines: A case study.
Tikale S, Umate K, Tiwari M, Dhande N. An Ayurvedic Approach of Pinda Sweda and its Different Modalities. Int J Curr Res Rev. 2021;13(8):26-9. doi: 10.31782/IJCRR.2021.13816.
Ayu RB, Kumar DS. Mode of Action of Medicated enema in Neurological Disorders (Vata Vyadhi)-A Conceptual Study.
[cited Mar 13]Available from: https://www.indiamart.com/proddetail/aarmex-syrup-18903430412.html; 2023.
Swati Tikale et al. Role of panchakarma and ayurvedic drugs in the management of Amavata: A case study. Drugs Cell Ther Hematol. 2021,P.N.797-802;10(1) (ISSN: 2281-4876).
Bhat VG, YR. NH, Kamath S. Management of Amavata with Amavatari Rasa individually and along with Valuka sweda.
[cited 8/4/2023]Available from: https://www.tradeindia.com/products/vatamrut-syrup-c6986755.html.
Published
How to Cite
Issue
Section
Copyright (c) 2023 Dr. Gaurav Sawarkar, Dr. Shilpa Yerme, Dr. Punam Sawarkar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
