Ayurvedic Pain Management

 Pain is one of the commonest symptoms which forces people to seek medical help; it is also one of the leading causes of chronic disability and adverse quality of life. It may arise from trauma, disease, inflammation or nerve damage. Pain can be classified in various ways. Duration wise, it can be classified as acute and chronic; it is termed chronic when lasting for more than three months. There are different known types of pain and these include breakthrough pain, bone pain, nerve pain, phantom pain, soft tissue pain and referred pain.

Pain perception is determined by a persons’ genetics, personality, emotional build, lifestyle and the memory of past experience. The need for pain control medications can be significantly reduced with the help of relaxation, meditation, deep breathing, music therapy, yoga and tai-chi, positive thinking and mind-body techniques which combine imagery with relaxation as well as biofeedback. These have been discussed in detail elsewhere.

Here, Ayurvedic pain management will be discussed in detail. This includes several treatment modalities which are outlined as follows:

Snehan: This is basically lubrication of the body using medicated oils. This can be either external or internal. Oil of sesame is considered the best oil for this purpose. Massage with oil has neuro-hormonal effects and may help release endorphins, thereby reducing pain sensation. Snehan therapy is useful for arthritis, insomnia, paralysis, tremors, nervous exhaustion, constipation, and other neurological derangements

Swedan: This implies hot fomentation which is meant to induce sweating. This procedure stimulates peripheral nerve endings which transmit heat and pain sensations, and is effective in relieving pain. Swedan is suggested for different pains like earache, headache, neurological pain, pain due to constipation, and absence or retention of urine. It is also indicated for stiffness, arthritis, muscle and tendon spasms and tremors.

Agnikarma: This procedure utilizes heat to bring about a burn in a small, preselected area; this is therefore a therapeutic cautery. This is probably one of the most effective techniques for pain control and is used for treating heel pain, osteoarthritis, and frozen shoulder. Several physiological hypotheses come into play here, including selective heat and pressure perception which competes with pain, counter nerve irritation, detoxification due to increased blood supply, and bringing about muscle relaxation.

Raktamoksan: This involves blood-letting, and includes removal of blood using a syringe (venesection), cupping, and the use of leeches. Blood-letting is useful for regional as well as generalized pain control. Severe and throbbing pain and burning sensation can be controlled quickly using this procedure.

Leech therapy: This reduces pain by counter pain and burning sensations, bringing about liquidification of blood, and treating inflammation. This procedure is usually used to treat migraine, intractable tension headache, painful clots, and gangrene wounds.

Viddhakarma: This procedure consists of piercing of specific vital points known as marmas; this causes release of endorphins, thereby controlling pain. In day-to-day clinical settings, a sterile insulin needle is usually used for this purpose. This procedure serves many purposes but is usually helpful in headache, eye-ache, tonsillitis, nasal blockage, renal colic, pain related to nerve defects, joint pain, radiated pain etc. A combination of piercing and cauterization can be used and is known as Viddhagni karma.

Lepankarma: This consists of application of medicated pastes on the skin to relieve inflammatory conditions as well as muscle and tendon spasm.

Bastikarma: This is the use of medicated enema wherein medicines are introduced into the rectum in liquid form. This procedure is known to affect the sympathetic nerves, which in turn act via the hypothalamus-pituitary-adrenal axis to release hormones to reduce pain and inflammation. Basti is useful for many disorders including chronic constipation, sciatica, lower back pain, arthritis, gout, and rheumatism. It also heals numerous neurological disorders like Parkinson’s disease, muscular dystrophy, paraplegia, hemiplegia, poliomyelitis, osteoporosis, and muscle and nerve atrophy. 

Miscellaneous modalities: These include Shirodhara (oil drip on the forehead), abhyang (massage), pichu (medicated cotton swab), anjan (medicated eyeliner), netratarpan (local basti over eyes), karnapuran (medicated oil for ears), karnadhupan (smoke therapy for ears), kawal-gandush (medicated gargles), hrudaya basti (localized oil dam procedure over heart area), Prushta basti and katibasti (localized oil dam procedures over upper and lower back). Each modality is designed to treat or cure some specific medical condition causing pain and other symptoms.

Ayurvedic herbs: These include herbs like turmeric, ginger, cinnamon, cloves, garlic, cardamom, tulsi, yashtimadhu, neem, ashwagandha, nirgundi, guggulu, and shallaki, which have anti-oxidant, digestive, detoxifying, stimulant, analgesic, and anti-inflammatory properties and thereby reduce pain.

Yogic procedures: These include asanas, purification procedures, meditation, and breathing techniques which bring about relaxation of muscles, tendons and ligaments, reduce stress, calm the mind, induce good sleep, and reduce inflammation on a long term basis. Different yogasanas can be prescribed for different types and locations of pain.

Satvavjay treatment: These include counselling and mind-body techniques to conquer pain.

In this way, people affected with both acute as well as chronic pain can use a combination of Ayurvedic pain management techniques to treat their pain on a long term basis. An accurate diagnosis by a qualified and experienced Ayurvedic practitioner is a must. Likewise, it is best to take professional help for handling acute pain and for planning long term treatment, and long term pain management. What works best for one person may not work for someone else; also, different stages of pain-causing diseases may require different management in the same individual.  However, it is an established fact that regular adherence to an effective pain management programme can significantly reduce and treat pain.

Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com

Pain Management

Pain is one of the commonest symptoms which forces people to seek medical help; it is also one of the leading causes of chronic disability and adverse quality of life. It may arise from trauma, disease, inflammation or nerve damage. Pain can be classified in various ways. Duration wise, it can be classified as acute and chronic; it is termed chronic when lasting for more than three months. There are different known types of pain and these include breakthrough pain, bone pain, nerve pain, phantom pain, soft tissue pain and referred pain.

Pain perception is determined by a persons’ genetics, personality, emotional build, lifestyle and the memory of past experience. The need for pain control medications can be significantly reduced with the help of relaxation, meditation, deep breathing, music therapy, yoga and tai-chi, positive thinking and mind-body techniques which combine imagery with relaxation as well as biofeedback. Such mind-body techniques include altered focus, dissociation, sensory splitting, mental anesthesia, mental analgesia, pain transfer, time transfer, symbolic and positive imagery, and counting. These strategies can be used for about half an hour, thrice a week. It is best to take professional help to get started with such techniques.  

Physical therapy and occupational therapy can help with both acute and chronic pain. Simple, everyday activities like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain and also by stretching and relaxing stiff and tense muscles, ligaments and joints. Hypnosis, joining pain counseling groups, sharing experiences, and meeting with family and friends also helps to reduce the burden of pain perception. Spiritual help may also help to cope up with chronic pain.

Diluted essential oils can be used for local application as well as for inhalation to relieve various pains such as headache, toothache, muscular sprain, arthritis and neuropathic pain. These oils include lavender, rosemary, peppermint, eucalyptus, cloves, and capsaicin. Ginger and turmeric powder can be used both orally as well as for local application. Fish oil taken orally has also demonstrated good pain control.

Therapeutic massage can be used for pain relief since it relaxes muscles, ligaments, tendons and joints and helps reduce inflammation. The application of cold press and ice, as well as heat application also helps in a similar manner. Cold applications are usually used within the first 48 -72 hours, after which heat application is more beneficial. Both are used for about 20-30 minutes 2 or 3 times daily. Neurostimulation can also be used for pain control; these include TENS, spinal cord stimulator, acupressure and acupuncture.

It may be necessary to use pain control medications to control and treat acute pain, and also in some instances of chronic pain. These medications include non-steroid anti-inflammatory drugs, muscle relaxants, analgesics, antidepressants and neuromodulators. The most commonly used over-the-counter drugs are NSAIDs such as paracetamol, aspirin, ibuprofen, etc. Drugs should be used preferably with professional medical advice. If these do not work, doctors may use more potent analgesics, steroids, local injections, or give surgical advice.

Certain lifestyle changes can relieve pain. For the obese or overweight people, the best recommendation is to reduce some weight. People who eat a balanced diet, drink plenty of water, get enough sleep and manage stress levels may be less likely to have chronic pain.

Ayurvedic pain management is a complete system which includes different modalities like medications, snehan, swedan, blood-letting, agnikarma, vedhan, basti, localized treatments, and mind control. These will be discussed elsewhere.

In this way, people affected with chronic pain can use a combination of relaxation, medicines, local applications, diet, exercises and mind-body techniques to treat their pain on a long term basis. An accurate diagnosis by a qualified and experienced medical practitioner is a must. Likewise, it is best to take professional help for handling acute pain and for planning long term treatment, and long term pain management. What works best for one person may not work for someone else; also, different stages of pain-causing diseases may require different management in the same individual.  However, it is an established fact that regular adherence to an effective pain management programme can significantly reduce and treat pain.

Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com