WDS73: 'Avabahuk' (Frozen-shoulder) by. Dr. D. C. Katoch, Dr. Pawan Madaan, Dr. Riruraj Verma, Prof. Satish Panda, Dr. Ravikant Prajapati, Dr. Ankur Sharma, Dr. Manu Vatsa, Dr. Shashi Jindal, Prof. Giriraj Sharma, Prof. Sadhana Babel, Dr. Radheshyam Soni & others

[11/2, 6:07 PM] Dr. Rituraj Verma: 

Joint ds.

Anatomically jaoint is कफ  dominant because कफ दोष has binding property with स्निग्ध and slashna गुण which keeps articulating structure together.

*"Slish aalingane"* is the basic nature of कफ. Moreover संधि is कफ स्थान.

Sleshak kapha is located in संधि. Functionally संधि is वात dominent because of चल गुण.

A healthy joint has normal वात-कफ equilibrium.

Most of the joint ds. are the result of वात ,कफ vitiation.

[11/2, 6:15 PM] Vd V. B. Pandey Basti U. P: 

संधिवात कटिवात अवबाहुक विशाची यहां तक कि गृध्रसी सभी मे  कफ दोष का महत्वपूर्ण भूमिका है।विशेष रूप से आवरण के रूप में।

[11/2, 6:17 PM] Dr. Rituraj Verma:

 In some cases of सन्धिरोग, especially chronic धातुगत stages,there will be धातुपाक with पित्त involvement,. धातुपाक will lead to destruction of the joint structures. 

Autoimmune mediated joint ds. Have धातुपाक.

धातुपाक will gradually lead to धातुक्षय with वात प्रधान degenerative joint conditions.

[11/2, 6:20 PM] Dr. Rituraj Verma: 

Ji sir !

[11/2, 6:21 PM] Vd V. B. Pandey Basti U. P: 

Sir in tt.of Sandhi vaat I always think of Kaphavritta vaat and always prefer Rasson   kalp bd.Even Mahanarian tail with milk up to 20 ml also yield results.

[11/2, 6:25 PM] Dr. Rituraj Verma:

 Frozen shoulder -basically it comes under उपधातुप्रदोषज व्याधि invalving मांस and कण्डरा related अंश सन्धि.

It is pathology where वात and कफ together lead to a स्तंभ in joint. शीत गुण and रुक्ष गुण leads to संधि स्तब्धता.

[11/2, 6:26 PM] Vd V. B. Pandey Basti U. P: 

Sir the basic problem is lack of knowledge and experience as well regarding etiology or in Ay.termimology Tridosh .Once it's clear many of the problems get dissolved.

[11/2, 6:28 PM] Vd V. B. Pandey Basti U. P: 

I found Nirgundi ghan batti quit effective in frozen shoulder.

[11/2, 6:32 PM] Dr. Rituraj Verma:

 Frozen shoulder in modern 

It called as Adhesive capsulitis.

Results from tendinitis involving entire rotator cuff muscles.

Glenohumeral restriction is present.

More common in diabetes.

[11/2, 6:39 PM] Dr. Rituraj Verma: 

महावात विध्वंस रस also useful sir ji

[11/2, 6:42 PM] pawan madan Dr: 

You have touched the very important concept of 

धातुपाक

धातुक्षय

धातु दुष्टि

धातु वृद्धि

All these play imp role in every pathology at different stages.

[11/2, 6:45 PM] Dr Ramanuj Soni New Delhi: 

Upnaha is also beneficial in this condition....🙏

[11/2, 6:50 PM] Dr. Rituraj Verma:

 Yes sir

[11/2, 6:55 PM] Dr. Rituraj Verma: 

जी सर जी इसलिये पोस्ट किया इस पर चर्चा हो एवं ज्ञान प्राप्त हो

[11/2, 7:00 PM] Dr. Rituraj Verma: 

Examination of joint-

Look, feel and move (LFM)

Inspection, palpitations ane range of movement

[11/2, 7:06 PM] Dr. Rituraj Verma:

 Painful joint- वात

Tenderness-पित्त

Swelling- कफ

Swelling in joint and limbs- कफ and आम

Redness and temperature-पित्त-रक्त

Pain and stiffness- वात and कफ

Pain and tenderness- वातपित्त

Pain and swelling- वातकफ

Numbness and heaviness- कफ

Fluctuating swelling -वात

[11/2, 7:07 PM] Dr Ramanuj Soni New Delhi: 

Nice sir👌

[11/2, 7:07 PM] Dr Gurpreet: 

nasya is also very much beneficial in frozen shoulder.

[11/2, 7:07 PM] D C Katoch Sir: 

You made it so simple. 👍🏽

[11/2, 7:08 PM] Dr. Rituraj Verma: 

ब्रह्मन नस्य एवं प्रतिमर्श दोनों उत्तम है।

[11/2, 7:09 PM] Dr Sidram Guled: 

very nice said sir...

best observed in

vatarakta

amavata

sandivata

[11/2, 7:09 PM] Dr Ramanuj Soni New Delhi: 

Sir kya pitta ki involvement ko hi dhatupaka kaha ja sakta h ...ya dhatupaka ko asses krne ka koi aur bi criteria ho sakta h?🙏

[11/2, 7:12 PM] D C Katoch Sir: 

Most painful, difficult to diagnose and treat is रक्तावृत सन्धिगत वात ।

[11/2, 7:14 PM] Vd V. B. Pandey Basti U. P: 

सर नमन इतना आसान भी नहीं होता विभेदक निदान रोग से जयादा पूछने पर वह सहयोग नहीं करता।बेहतर अनुभव है उपशय अनुउपशय का परयोग ः

[11/2, 7:15 PM] Prof. Surendra A. Soni: 

https://kayachikitsagau.blogspot.com/2018/09/wds59-dosha-pak-dhatu-pak-role-of-visra.html

दोष पाक और धातु पाक चिन्तन । डॉ रामानुज ।

[11/2, 7:15 PM] Dr Ramanuj Soni New Delhi: 

Thank u sir🙏

[11/2, 7:16 PM] Vd V. B. Pandey Basti U. P: 

रक्तावृत संधिवात में रोगी अंगुली रखकर बताएगा दर्द कहाँ पर है कैशोर गुग्गुल is the choice of med

[11/2, 7:23 PM] Dr. Rituraj Verma: 

RA अच्छा उदाहरण है धातुगत एवं धातुपाक के लिए ।

[11/2, 7:28 PM] Vd V. B. Pandey Basti U. P: 

सर बेहतर होगा हम एक मत होकर किसी एक ही जोडों के रोग पर चर्चा करें जिससे एक सही दिशा मिले।

[11/2, 7:34 PM] Dr. Rituraj Verma:

 धातुपाक- joint destruction

धातुक्षय- joint deformity

[11/2, 7:35 PM] Dr. R S. Soni, Delhi:

 संभवतः यहाँ धातुपाक से आपका तातपर्य *कोथ* से है।🤔

[11/2, 7:38 PM] Vd V. B. Pandey Basti U. P: 

धातु क्षय संधि वात व धातु पाक आमवात के मुख्य लक्षण हैं।

[11/2, 7:53 PM] Dr. Ravikant Prajapati M. D, BHU.: 

Sharing my little understanding🙏🙏🙏

Jis Joint pain me Dabane par dard badh jata hai wo --- *Kaphavrtta vata* hai ( strotoavarodh increases on applying pressure over it)

Jis Joint pain me Dabane pe  araam milta hai ------ *Dhatukshyaj Vatavriddhi* ( Akash and vayu mahabhoot in asthi dhatu decreases on applying pressure) 

Jis Joint pain me pt. Joint ko touch bhi na karne de ya joint ko touch karte hi peeda badh jaye ...(always with Usna spasha )....(may be with or without Swelling ) ------ *Raktavritta vata or Pittavritta vata* ( due to paka or Vidagdihata of rakta)

[11/2, 8:05 PM] Dr. Ravikant Prajapati M. D, BHU.: 

Sir par mai kewal sandhi-vata ke baare me hi baat kar raha hu......... Aamvata aur vatarakta me aur bhi symptoms Assoc. Hote hain...

[11/2, 8:07 PM] Dr Sidram Guled: 

Sir what i feel any of the sandi vikara....present either like a sandivata, amavata, or vatarakta... may not be disease proper...only sandhigata lakshanas

[11/2, 8:11 PM] Dr. Ravikant Prajapati M. D, BHU.: 

🙏🙏 yes sir there are many stages of disease progress..........

Avarana----> Dosha prakopa -------> Dhatupaka -----> Dhatukshya-------> Dhatuvikriti

[11/2, 8:33 PM] Dr Sidram Guled: 

definately we need to differentiate all these variations and treat accordingly....

[11/2, 8:39 PM] Prof. Surendra A. Soni: 

Painful joint- वात

👉🏻OA

Tenderness/burning-पित्त

👉🏻Synovitis

Swelling/coldness- कफ

👉🏻Srotorodha

Swelling in joint and limbs- कफ and आम

👉🏻RA

Redness and temperature-पित्त-रक्त

👉🏻Kroshtuk-sheersha

Pain and stiffness- वात and कफ

👉🏻AS, FS

Pain and tenderness- वातपित्त

👉🏻RA /Vat-rakta/Post traumatic

Pain and swelling- वातकफ

👉🏻VK Gridrasi

Numbness and heaviness/coldness- कफ

👉🏻DVT

Fluctuating swelling -वात

👉🏻Vat-sancharan

Dr. Rituraj ji !

[11/2, 8:46 PM] Vd V. B. Pandey Basti U. P: 

Shunthi With Various Anupan beneficial in all above conditions.

[11/2, 8:55 PM] Dr Sachin Gajare:

 Most of frozen shoulder Pts which I seen r daibetic,

In which I noticed pitta Pradhan lakshans,

I have got very good result with the help of Rasna-Erandadi kashayam tablet.

2 bid/tds after meal.

Single remedy.

Along with this exercise .

As kandara is rakt dhatu Mal Raktmokshan is also a useful panchkarm along with nasya of mash tail.but never tested as only rasna-erandadi kashayam tablet never give chance to do.

[11/2, 9:01 PM] Dr Sachin Gajare:

 Mostly Post traumatic /post compression (specialy at night during sleep) causes frozen shoulder

[11/2, 9:03 PM] Dr. Ravikant Prajapati M. D, BHU.: 

Thank you sir ....for sharing your experience on Frozen shoulder.....🙏🙏🌹🌹

[11/2, 9:09 PM] Dr Rajanish Pathak: 👏🏻👏🏻

[11/2, 9:13 PM] Prof. Deep Narayan Pandey: 

Excellent experience-sharing. 

👌👌

[11/2, 9:17 PM] Dr Rajanish Pathak:

 In Fascitis/sarcoma condition ....VP 

Rakta mansa dusti

[11/2, 9:21 PM] Dr Rajanish Pathak:

 Sir.... In college students asked alz a question that.... In pharmacy saction.... There are so many oil preparations for various vaatjanya vikaras.... So there is a confusion in their mind.... That is it not possible that... Only few oils, why not take for practice if all are vaatshamak 🙏🏼😌😌....there actual question was regarding mode of action of oils in sense of dosha n dusya involvement

[11/2, 9:27 PM] sunaina dr. mumbai:

 I found mahsmash thailam nasyam,Pana and abhyangam very effective along with Rasnasaptak quatha

[11/2, 9:28 PM] sunaina dr. mumbai: 👌👌

[11/2, 9:42 PM] Dr. Rituraj Verma: 

इसीलिये गुरुजन के मार्गदर्शन की आवश्यकता है बच्चे को सहृदय धन्यवाद सोनी सर ।

[11/2, 9:43 PM] Dr. Mrityunjay Tripathi, Gorakhpur: 👏👏🌹🌹👏👏

[11/2, 9:49 PM] sunaina dr. mumbai: 🙏🏻🙏🏻

[11/2, 9:55 PM] Dr. Ravikant Prajapati M. D, BHU.: 

🙏🙏 Also *Mahanarayan taila* *paan* and *nasya* very effective in Chronic Frozen shoulder . I had treated 3 cases which are in chronic stage.

Karpasthyadi nasya and abhayanga is also effective additional in newly diagnosed cases.

[11/2, 10:50 PM] Prof. Surendra A. Soni: 

This is superficial rough literally understanding. Plenty of things to be looked in execution of management as per 10 vidha pariksha.

डॉ ऋतु राज जी ।

[11/2, 10:52 PM] Dr. Rituraj Verma: Ji sir ji

[11/2, 10:54 PM] Dr Gurpreet: 🙏🙏

[11/2, 10:55 PM] Prof. Surendra A. Soni:

 1. Contents of oil ? Dominance of Ras ? Guna ? Veerya ? Vipak ?

2. Methodology of preparation ?

3. Oil used ?

4. Classical indications/Falashruti ?

5. Rogadhikar mentioned ?

These are few points to be observed during the use of specific oil.

Dr. Rajaneesh !!👍🏻☝🏻

[11/2, 11:01 PM] Dr. Sadhana Babel, Pune: 

Aditypak gugul 

Upnah swed of arandmul mohri til atasi

[11/2, 11:01 PM] Dr. Sadhana Babel, Pune: 👍🏻

[11/2, 11:03 PM] Dr Gurpreet: 

u are right sir.. Punjab me to tkr cases itne jyada ho rhe hai ki lagta hai kuch years me above 50 years sabke artificial joints hi hoge

[11/2, 11:36 PM] Dr. Rituraj Verma:

 OA is  basically disease with अस्थिधातु क्षय.it is similar to संधिगत वात.

OA more severe in वात काल and वात प्रकृति individual.

There will be वात associated शोफ in OA. Flexion and extension movements are affected due to वातप्रकोप.

The खर गुण of अस्थि is lost in OA leading to degeneration of joint.

The पृथ्वी महाभूत related sarabhava of अस्थि is gradually क्षय in OA.

[11/2, 11:40 PM] Dr. Rituraj Verma:

 So  गंध तेल इम्प्रूव अस्थिसार

प्रवाल भस्म ,श्रृंगभस्म,कुकुटण्ड त्वक भस्म are provides खर गुणto अस्थिधातु

[11/2, 11:41 PM] Dr. Rituraj Verma:

 जषद भस्म बहुत उत्तम परिणाम देती है सन्धि रोगों में ।

[11/2, 11:43 PM] Dr. Rituraj Verma:

 मैं कहि गलत होरहा हु तो कृपया गुरजन मार्गदर्शन करें ।

[11/3, 12:57 AM] Dr Vinod Mittar, Bhiwani:

 Paanarth mahanaryan oil lena hoga ya narayan oil, pichae kuch gurujano ne objection kiya h?

[11/3, 7:01 AM] Dr Rajanish Pathak: 

Yeah soni sir... 

Aj kal k students bas andhere me tir chalate... Unko isko dhyan dena hota to ayurveda kitna aage jata 🙏🏼🙏🏼👍🏼👍🏼

[11/3, 8:08 AM] Dr Shashi Jindal: 

Good morning everyone, every post in this group is intellectually elite in terms of Aayurveda, feel blessed as one member of this group,  thanks to administrators of the group. 💐💐🙏🏼

I want to share my own experience of frozen shoulder.  

It was a great experience,  and helped  me to understand many of the ayurvedic principles.  I did not take any analgesic even in acute condition. I used lahsun and ginger those days in large amounts.  Vegetable, stuffed prantha, milk all I consumed contained only lehsun and ginger with large amounts of ghee.

It took one and half year for total recovery.

🙏🏼🙏🏼🙏🏼

[11/3, 9:00 AM] Dr Manu Vats, Patiala: 

Thanks for sharing..

But Frozen shoulder is common in Diabetic patients..

Just 2 days back 40yrs old male with history of uncontrolled diabetes for last 5yrs, chief complaints of stiffness, pain and restricted upwards movement of right shoulder..

Chief complaint for last 1month Diagnosed and treated from ortho as Frozen shoulder

X ray shows sclerotic changes in Right shoulder..

So I considered vaatkaffz. Sandhivaat..

Advised only..

Goghrit 1tsfwith shunthee 2gm b.d. 

Pls comment.. and advice approach🙏🙏

[11/3, 9:01 AM] Dr Manu Vats, Patiala: 

Patient asked for Agnikarma as recommended to him by some other doctor..

But I refused

[11/3, 9:15 AM] Dr Shashi Jindal: 

sir I am non diabetic.

But as charak has advised ghrit as abhyas yogya dravya, it can be used by diabetics also. Shunthi in ghrit is a very good analgesic and anti inflammatory. It is rasayan also. 

You can advise rason ksheer pak.

[11/3, 9:22 AM] Dr Manu Vats, Patiala: 

Sir here in this case what I am thinking.. due to uncontrolled diabetes degeneration must have started at multiple lesions..as here Sclerotic changes in right shoulder ..so these changes must have started anywhere in body..

So only local treatment will not be sufficient...had to take at samprapti or pathological level also🙏

[11/3, 9:39 AM] Janardan Hebbar Dr: 

Guggulu tiktaka ghrita, prasarinyadi kashaya, kaishora guggulu, ksheerabala taila orally kottamchukkadi taila locally 

Patra pinda sweda. 

But please try tit tar once 🙂

[11/3, 9:49 AM] Dr. Satish Jaimini Choumu, Jaipur: 

सटीक जानकारी दी सोनी जी ये आज की अधिकतम समस्याएं हैं ।

[11/3, 10:05 AM] Dr. Rituraj Verma:

 Frozen shoulder-

दोष-वात,कफ

दुष्य-मांस,कण्डरा

अधिस्थान- अंश सन्धि

वात प्रकोप- स्तब्धता, स्त्रोतोरोध to local रक्तवहा स्त्रोत्स

प्रमेह भी एक व्यंजक हेतु है in vascular pathology.

चिकित्सा- वातकफ शामन,स्त्रोतोमार्दव,बल्य-कण्डरा एवं स्नायु

[11/3, 10:13 AM] Dr. Rituraj Verma:

 🙏 लेकिन exercise से ही इसमे ज्यादा आराम होता है ऐसा अनुभव रहा है ।

[11/3, 10:25 AM] Dr Shashi Jindal:

 cycling and pulli, most useful 👍🏼🙏🏼

[11/3, 11:03 AM] D C Katoch Sir:

 अजवायन + कपूर पोटली को गर्म सैन्धवादि तैल में डिप करके frozen shoulder में  सेंक करें - चिकित्सा प्रायशः सफल होगी।

[11/3, 11:07 AM] Dr. Rituraj Verma:

 🙏 thanks sir ji

[11/3, 11:09 AM] Dr Ankur Sharma, Delhi:

 Generally i advise

👉 rheumasyl oil which contain mahavishgarbh mahanarayan mahamash oil panchguna oil combination

Followed by warm roti over affected area to maintain heat

Prolonged vasodilation ~⬆ natural analgesic endorphin 

Followed by

Hot fomentation with

Salt

Water

Fresh 

Garlic

Rai seeds

Ginger  

Castor leaf

+patanjali peedantak kwaath5~10gm

During phase of stiffness

Exercises.

fresh aak and dhatura leaf etc can be added

 Camphor lavang oil

Dhatura are very good analgesic locally.

[11/3, 11:14 AM] Dr. Rituraj Verma:

 सर जी वात व्याधि,ओर आवरण जैसे गम्भीर विषय पर गुरुजन के  मार्गदर्शन की अतिआवश्यक्ता हैं ।

[11/3, 11:16 AM] D C Katoch Sir: 

Volatile elements present in ajwain and kapoor could be more penetrative, fast acting and effective in frozen shoulder condition. I usually ask my patients to add kapur and ajwain in all analgesic  oilz for augmenting their possible effect.

[11/3, 11:16 AM] Prof. Satish Panda K. C: 

Frozen Shoulder (Ababahuk) एक वातिक नानामत्ज विकार हे।

 तैल नस्य बहुत ज्यादा कारगर होता है।

पत्र पिंड स्वेद pain में अति शीघ्र लाभ देगा।

योगराज गुग्गुलु oral दे।

Daily  circle exercise of effected shoulder।

3 to 5 days में लाभ मिल जाता हे।

[11/3, 11:20 AM] Prof. Satish Panda K. C: 

With out diabetes also frozen shoulder occur

[11/3, 11:26 AM] Dr Shashi Jindal: 

Frozen shoulder and local treatment,  every disease is tridoshaj. 

Ultrasonic massage,hot fomentation and physiotherapy is advised. 

Heat oil steam are effective for vaat, heat and movement (exercise) for kf, and tarpan for pitt. Usually there is kf vaat predominance in early phase and vaat in late phase.

Kfaj metabolites are excreted via lymphatics,  as lymphatics do not have valves , muscular movements helps to drain the kfj dravyas from inflammatory nodules, which is helped by massage and exercise.  oil application with soft compression is useful, it helps drainage of inflammatory metabolites via venous  channels. 🙏🏼

[11/3, 12:15 PM] pawan madan Dr: 

It is a truth that the more massage you do on frozen shoulder the more stiffness is produced.

[11/3, 12:18 PM] Dr Shashi Jindal: 

pressure massage on nodules only, on other parts very soft, like sahlana.

[11/3, 12:22 PM] Dr. Rituraj Verma: 

रुक्ष स्वेद ज्यादा उत्तम है ।

[11/3, 12:23 PM] Dr Ankur Sharma, Delhi: 

👍🙏In fact camphor is wonderful muscle relaxant

It's  special utility

Can be used to relax anal sphincter during spasmodic proctalgia  (parikartika~very painful unpleasant)

But avoid in cases of ulcerative mucosa.

[11/3, 12:23 PM] Dr Shashi Jindal: 

yes sir

[11/3, 12:23 PM] Dr Divyesh Desai: 

Drug induce( Quinolone) frozen Shoulder?

Kindly expert opinion

Diabetic Arthropathy ?

Neuropathy? Brachial plexus symptoms?

Avbahuk / विश्वाची ? 

आगंतुक पैथोलॉजी?

सुभाष सर के हिसाबसे ही अलग अलग सम्प्राप्ति बनाकर ही चिकित्सा सूत्र बनाना चाहिए?

जय आयुर्वेद, जय धन्वंतरि।।

[11/3, 12:53 PM] Dr Manu Vats, Patiala: 

Thanks Dr Katoch Sir...Your small inputs are very valuable..Still I am trying to get details of Sharpunkha in bronchitis or laryngitis..

Got literature but still trying to get Shastrokt reference..

Thank u once again and Regards💐🙏

[11/3, 12:57 PM] Dr. Sadhana Babel, Pune: 

One query

Always seen frozen shoulder in dm pts more 

What is resason or pathophysiology behind this 

 Why shoulder ?

[11/3, 1:02 PM] Dr Manu Vats, Patiala: 

Yes that's what I mentioned above.. Sclerotic changes are manifestations of uncontrolled D.M. ..so it must be at other lesions..but here only it's a  symptom which is just visible or patient complaining..

Though reason behind it ..should also be find out

[11/3, 1:17 PM] Dr Shashi Jindal: 

👌👍🏼🙏🏼💐kaf will melt without vitiating vaat.👍🏼🙏🏼

[11/3, 1:18 PM] D C Katoch Sir:

 स्कन्ध प्रदेश के स्नायु-कण्डरा-सिरा-अस्थिसन्धि आदि का मधुमेह रोगियों में स्रोतोसंग-ग्रह-स्तम्भ प्रायः अधिक होने का कारण उनका कफस्थान 

(उरःप्रदेश) में आश्रित होना लगता है।

[11/3, 1:24 PM] Dr Shashi Jindal: 

In my case what I noticed was main joint involved was shoulder joint, but all supporting  muscles were also stiff, it included back, thoracic and even lower back muscles were stiff and were hindering the shoulder movements. 

Once when I told physiotherapist that I have pain in my back also, he moved my leg for examination at an angle , it released movement in my shoulder joint . It was amazing, anatomically shoulder movements are linked with pelvic movements also.🙏🏼

[11/3, 1:26 PM] Dr. Rituraj Verma:

 frozen shoulder develops as a result of perivascular inflammation and fibroblastic proliferation, followed by capsular fibrosis and contracture

[11/3, 1:27 PM] Dr. Rituraj Verma: 

In diabetic pt.

Due to कफ दोष

[11/3, 1:29 PM] Shantanu Das Prof KC: 

Aditya paka gugula... pl ref...

[11/3, 1:36 PM] Dr Manu Vats, Patiala: 

Yes Got it...appears very logical....So First line of treatment should be shushak potli....to reduce AAMJ SHOF....

Thereafter any oil locally or Nasya should be started...Isn't it Sir ?

[11/3, 1:37 PM] Dr. Rituraj Verma: 

Reference : Vangasena vata vyadhi adhikaranam

Aditya means Sun, Paka means processed or prepared in. Adityapaka Guggulu means a Guggulu preparation which is prepared by repeatedly processing the ingredients in the heat of Sun

[11/3, 1:44 PM] Dr Rameshwar Rao Rane: 

What are the ingredients and indications ??

[11/3, 1:50 PM] Dr. Sadhana Babel, Pune: 

sapta vaaraan su gugguluhi 

(Ref – Chikitsa Saara Sangraha 214-216)

The below mentioned are ingredients of Adityapaka Guggulu:

Haritaki – Terminalia chebula – 1 pala quantity (48 grams approximately)

Bibhitaki – Terminalia bellirica – 1 pala quantity (48 grams approximately)

Amalaki – Phyllanthus Emblica / Emblica officinalis (Indian gooseberry) – 1 pala quantity (48 grams approximately)

Pippali – Piper longum (long pepper) – 1 pala quantity (48 grams approximately)

Twak – Cinnamomum zeylanicum (Cinnamon) – ½ pala quantity (24 grams approximately)

Ela – Elettaria cardamomum (cardamom) – ½ pala quantity (24 grams approximately)

Guggulu – Commiphora mukul – 5 pala quantity (240 grams approximately)

Dashamula Kashayam – Decoction of roots of 10 herbs – For Bhavana and paka of ingredients (impregnation, triturating and processing of the ingredients)

[11/3, 1:51 PM] Dr. Sadhana Babel, Pune: 

Sandhivat vata 

Ashti majja gat vat

Neuromuscular, skeletomascular

[11/3, 2:16 PM] Prof. Satish Panda K. C: 

Most common conditions likely to come up in a shoulder examination

► Frozen shoulder

► Acute calcific tendonitis

► Rotator cuff tear

► Winging of the scapula

► Bicipital tendonitis

► Osteoarthritis

► Referred pain from the cervical spine or the heart

[11/3, 2:55 PM] Dr Sukhveer Verma:

 *Frozen Shoulder - Marm Chikitsa- Immediate Relief*

[11/3, 3:02 PM] Dr. Ravikant Prajapati M. D, BHU.: 

🙏Sir......Ye Tit Tor Treatment ...... Clearly looks like Ours *Marma Chikitsa*....... Physiotherapist stimulated so many marmas cleverly....... Like ..... Ansa Marma, kshipra, kurchshira, Ani, Urvi Marma etc.

I had tried Marma chikitsa so many times and got Good results instantly...... especially in Frozen shoulder and sciatica.🙏🙏

[11/3, 3:05 PM] Dr. Ravikant Prajapati M. D, BHU.: 

Yes sir......very effective....

Prof. Dr. Sunil Joshi Sir had treated so many cases by Marma Chikitsa only..🙏🙏

[11/3, 3:05 PM] Janardan Hebbar Dr:

 Yes sir. This looks less complicated and simpler version but highly effective.

[11/3, 3:08 PM] Dr. Ravikant Prajapati M. D, BHU.: 

Agree sir...... Simple and Coolest way of stimulating Ansa Marma ..... Credit goes to the Physiotherapist...🙏

[11/3, 4:09 PM] pawan madan Dr: 

THANKS DR Sadhna ji

[11/3, 4:10 PM] pawan madan Dr: 

very nice DR VERMA JI

[11/3, 4:27 PM] pawan madan Dr: 

*ANSA STAMBHA, AVABAAHUKA -

(VAATA VYAADHI with LOSS OF FUNCTION)

FROZEN SHOULDER*

*MEANING OF AVABAAHUKA* – 

Literal meaning of AVABAAHUKA is the – spasm of the arm

In AYURVEDA this term has been used to denote a special condition of the shoulder joint in which the result is the spasm of the arm or stiffness or dysfunction of the arm.

*DEFINITION AND SAMPRAAPTI* - 

अन्सदेशस्थितौ वायुः शोष्यित्वाम अन्स बन्धनम 

सिराश्च आकुन्चयो तत्रस्थश्च जन्यति अवबाहुकम – सुश्रुत निदान स्थान १/८२

-the VAATA DOSHA in the area of the shoulder when vitiated, it causes the atrophy like condition of the shoulder joint because of the contraction of the SIRA (here SIRAA means the soft tissues present in this area), then this state is called AVABAAHUKA.

अन्समूल स्थितौ वायुः सिराः सन्कोच्य तत्रगाः

बाहु प्रस्पन्दितहरम जनयति अव्बाहुकम – 
अष्टान्ग हृद्य निदान स्थान १५/४३

-VAATA when situated in the base of the shoulder or root of the shoulder in a vitiated state, it brings the SIRAA (here SIRAA means the soft tissues present in this area) in a contracted stage, as a result of which the movement or the normal functions of the arm are prohibited or suppressed. This condition is called as AVABAAHUKA. 

*ROOPA* –

-stiffness of shoulder joint

-contractions of the soft tissue structures in the area of the shoulder

-BAAHU PRASPANDITA HARAM - normal function at the shoulder joint like flexion, extension etc are obstructed or restricted

-rigidity of the arm in its movements

-there is atrophy of the soft tissues around the shoulder with or without above symptoms.

[11/3, 4:46 PM] pawan madan Dr: 

In reality the medicines work only in the initial stages of the frozen shoulder or AVABAHUKA. ----------------- when it is recent like from few days to few weeks -- TRIPHALA GUGGULU in high dose acts very good - 1 gm tds + any local treatment like oil RHUMASYL as said by ANKUR JI. -----------------  when it becomes old like from 3-4 months --- it will take 8-12 weeks -- with TRYODASHANG GUGGULU 1.5 GM BD + PANCHAMRIT LOH GUGGULU 250 MG BD + AGNITUNDI VATI 250 MG BD. -------------- but when the frozen shoulder is older than that --- it usually developd chronic adhesions and is not curable -------- even giving steriodal medicines doesnt sure the disease and the patient has to do some exercises for ever as per the condition and stage.

[11/3, 4:59 PM] Dr Bhadresh Nayak, Surat: 

For frozen shoulder I do marma chikista along with manipulation of shoulder girdle within two sitting majority of the patient movement comes normal

Dashmul rasna with garlic is medicine

Mahamash tail abhayang

Bruhan nasya

I teach patient marma points to apply twice a day

[11/3, 5:01 PM] Prof. Deep Narayan Pandey: 

I am deeply interested in *preventive strategies* of this problem. Can you kindly suggest?

[11/3, 5:01 PM] Dr Bhadresh Nayak, Surat: 

True

Link between Kati and janu sandhi

Shoulder with thoracic and lumber are common bcz they are interconnect by muscle spinal cord and ligaments

[11/3, 5:01 PM] D C Katoch Sir: 

Conclusion is kapha sthan dusti leads to Siraadi sankoch to cause Avabahuk.

[11/3, 5:02 PM] pawan madan Dr:

 Exercise prevents but in limited dose.

[11/3, 5:03 PM] Prof. Deep Narayan Pandey: 

Thank you. कुछ विस्तार में पथ्य अपथ्य? निदान परिवर्जन ?

[11/3, 5:04 PM] Dr Bhadresh Nayak, Surat: 

Sirji every person must educated about marma to preventing majority of spine joint and psychology disorder

I do in my practice out come is excellent

[11/3, 5:05 PM] Dr Bhadresh Nayak, Surat: 

I no need to go sampraptivighatan protocol

Sorry for this comment

[11/3, 5:06 PM] D C Katoch Sir: 

Which type of exercises ? Nutritive exercise  or strenous ?

[11/3, 5:07 PM] Dr Bhadresh Nayak, Surat: 

Similarly shoulder and elbow alliment is also important to treat frozen shoulder

[11/3, 5:11 PM] Dr. R S. Soni, Delhi:

 इस रोग का मुख्य कारण *कुटिल मुद्रा* जन्य वात प्रकोप है, अतः आसान, शैय्या, स्नान, अभ्यंग, मैथुन, वेग विसर्जन आदि के समय कुटिल मुद्रा से बचना चाहिए।

*अभ्यंग का नियमित सेवन।*

*अधारणीय वेगों का समय पर विमोचन।*

*विशेष रूप से शीत और वर्षा में ऋतु अनुकूल विहार विशेष।*

🙏🙏

[11/3, 5:13 PM] Prof. Deep Narayan Pandey: 

धन्यवाद आचार्य। उपयोगी रणनीति आपने बताई।

[11/3, 5:13 PM] D C Katoch Sir: B

est pathya for frozen shoulder is madhur aushadh siddha tail and worst apathya is strenuous exercise & leafy vegetables and salad, cold foods.

[11/3, 5:16 PM] D C Katoch Sir: 

कुटिल मुद्राओं के साथ साथ  जो कफवर्धक आहार करते हैं ।

[11/3, 5:16 PM] Prof. Deep Narayan Pandey: 

*आप लोग अपना बुढ़ापा तो सुधार ही लेंगे पर आप लोगों के साथ रहने पर हमारा भी बुढ़ापा सुधरे रहने का योग है।* 

😄🙏

[11/3, 5:21 PM] Dr. R S. Soni, Delhi: 

🙏🙏

अर्थात ये प्रारम्भ में आवरण जन्य वात प्रकोप के कारण होने वाला रोग हुआ।

पुनश्च जीर्ण होने पर क्षय जन्य वात प्रकोप के लक्षणों से ये अधिक कृच्छ्र साध्य हो जाता है।

[11/3, 5:23 PM] pawan madan Dr:

 Only some active extension flexion by the patient itself.

🙏

Abhyanga always increaSes the stiffness in such cases practically...🤔

[11/3, 5:26 PM] Dr. R S. Soni, Delhi: 

सर ये मैंने बचाव के उपाय बताए हैं।

रुग्णावस्था की बात भिन्न है🙏😌

[11/3, 5:28 PM] Dr Sukhveer Verma: 

Only exercise

& Regular Nasya

[11/3, 5:36 PM] Dr. R S. Soni, Delhi:

 वृंहण नस्य🤔

[11/3, 5:38 PM] Prof. Surendra A. Soni: 

Very well described pawan ji !!

🙏🌻👌🏻👌🏻

[11/3, 5:41 PM] Dr. Rituraj Verma: 

Joint care 

1.good posture

2.good exercise

3.good food

4.good mind

[11/3, 5:42 PM] Prof. Satish Panda K. C: 

अभ्यंग, पत्र पिंड स्वेद के बाद में mild circle exercise करवाये, कोई side effect नही होगा।

Try कर के देख ले।🙏🏻

[11/3, 5:50 PM] Dr Manu Vats, Patiala: 

Great very well explained..Pawan Sir !

My doubt is only ONE.

As Katoch Sir also explained Kaff janya stabdhata..

So initial stage only shushak potli should be advised rather than abhyang or any snehan nasya??

[11/3, 6:03 PM] Vd V. B. Pandey Basti U. P:

 Very well explained step wise Dr Pawan jee .As per my experience Naadi Sweda is sometimes useful.

[11/3, 6:06 PM] Prof Giriraj Sharma: 

आचार्य श्री पवन जी नमस्कार !

बहुत अच्छा विवेचन किया है ।

बहुत मनन के उपरान्त जिज्ञासा उतपन्न हुई कि सिरा एवं स्नायु जन्यं विकृति है । जब यह सब तो चिकित्सा सिद्धान्त मेद धातु, स्रोतः,  के   शमन शोधन का क्यो नही करते है । 

क्योकि मेद से ही स्नायु एवम सिरा उतपन्न हो रहे है । तो दीपनिय पाचनिय , शमन चिकित्सा में मेद को नजर अंदाज कर देते है ।

सु निदान में स्नायु जन्य व्याधि या स्नायु गत व्याधि ही उल्लेखित है ।

स्नायु गत व्याधि में *खरता* स्नायु का स्वभाव है सिरा का *मृदु* मेद स्वयम मातृज मृदु भाव है ।

इस सिद्धान्त  पर अगर मनन करे एवं चिकित्सा सिद्धान्त बनाये तो इन व्याधियों पर शीघ्रता से परिणाम मिल सकते है ।

🙏🏼🙏🏼🙏🏼🙏🏼🌹🙏🏼🙏🏼🙏🏼🙏🏼

[11/3, 6:07 PM] Dr Rahul Pathania: 

Some chiropractors boast of correcting frown shoulder in 2 sittings🤔

[11/3, 6:15 PM] pawan madan Dr: 

जी सर

आपका कथन उचित ही है।

ये कफ वातज व्याधि है।

त्रिफला गुग्गुलु एवं अग्नितुण्डि 

एवम

पंचामृत लोह गुग्गुकु मेद व कफ पर प्रभावी रूप से कार्य करता है।

[11/3, 6:16 PM] Prof. Surendra A. Soni: 

There are two types of avabahuk seen in dalhan commentary...

☀1. Dhatukshayaja/pure vatik Avabahuk- 

where sneha/brinhan nasya has been indicated. 

तत्र यः स्नेहनार्थं शून्यशिरसां ग्रीवास्कन्धोरसां च बलजननार्थं दृष्टिप्रसादजननार्थं वा स्नेहो विधीयते तस्मिन् वैशेषिको नस्यशब्दः । तत्तु देयं वाताभिभूते.......नासारोगास्यशोषावबाहुकाकालजवलीपलितप्रादुर्भावदारुणप्रबोधेषु वातपैत्तिकेषु मुखरोगेष्वन्येषु च वातपित्तहरद्रव्यसिद्धेन स्नेहेनेति ।।२२।।

Su. Chi. 40

Here Siravedha is contraindicated. Su. Chi. 5/23

👇

गृध्रसीविश्वाचीक्रोष्टुकशिरःखञ्जपङ्गुलवातकण्टकपाददाहपादहर्षावबाहुकबाधिर्यधमनीगतवातरोगेषु यथोक्तं यथोद्देशं च सिराव्यधं कुर्यात्, *अन्यत्रावबाहुकात्;* वातव्याधिचिकित्सितं चावेक्षेत ।।२३।।

Dalhan👉🏻धातुक्षयनिमित्तवातकोपजनितोऽवबाहुकः, अतोऽन्यात्रावबाहुकादिति वाक्येन सिराव्यधो निषिध्यते।

☀2. Kaphavritta vataja avabahuk-

Here Rukshopakram is advised. Here Dalhan quoting Acharya Gayi...

गयी तु, अन्यत्रावबाहुकाद् वातव्याधिचिकित्सितमवेक्षेतेति सम्बध्नाति; तथाहि वातव्याधिचिकित्सिते यत् स्नेहस्वेदादिकं तदवबाहुके कफस्थानसम्भवत्वेन कफावृतवातजे विरुद्धं, तत्र हि स्वेदनस्यादिकं विधेयं रूक्षमेवः, न तु "सिराव्यधं कुर्यादन्यत्रावबाहुकात्" इति सम्बन्धः, यतोंऽसशोषेऽवबाहुके च सिरामोक्षस्य सिराव्यधविधाने चोक्तत्वात्। 

Here abhyanga and swedan are advised as poorvakarma of Siravedha if anyone wishes to do....

👇

गृध्रस्यादिषु वातव्याधिचिकित्सिते कृते पश्चाच्छोणितावरणं निश्चित्य सिराव्यधो विधेय इति।।२३।।

Su. Chi. 5

Pawan ji !!🙏

[11/3, 6:18 PM] pawan madan Dr: 

BADHIYA SIR --- mast --- thanks for completing....😀

[11/3, 6:29 PM] Dr. Rituraj Verma: 

सहृदय धन्यवाद गुरुवर इसीलिये ये विषय छेड़ा था

[11/3, 6:41 PM] Dr Shashi Jindal: 

🙏🏼

Treatment of snayugt vyadhies is similar to vaat vyadhies as per Charak.

Vaat vitiation- from aamashya, koshth, pakvashya, or guda. 

If it is from aamashya it has kaf anubhandh(aam/niram)
if from kosth  pittanubandh (aam/niram pitta) 
pakvaashya and guda pure vaat(ruksh).

Chikitsa is accordingly. 🙏🏼

[11/3, 6:53 PM] Dr Manu Vats, Patiala: 

Thanks for giving a Final Shape to discussion..🙏💐

[11/3, 7:24 PM] Prof. Satish Panda K. C: 

In frozen shoulder, the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.

**************************************************************************

Above discussion held on 'Kaysampraday" a Famous WhatsApp-discussion-group  of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC) 
Professor & Head

P.G. DEPT. OF KAYACHIKITSA

Govt. Akhandanand Ayurveda College

Ahmedabad, GUJARAT, India.

Email: surendraasoni@gmail.com