October 27, 2009

Marma chiktsa in the management of Knee pain caused by Scoliosis,kyphosis due to shortened limb .

                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

A short History of the case : 

 Mr.K.C.S came to my clinic SPKVCC in the start of October 2009, complaining of bilateral knee pain while walking.
On subjecting him to screening I found the para spinal muscles at his back to be taunted, associated with the features of Kyphosis, Lordoisis and scoliosis. This is a rare combination of spinal deformity come across by many of us. On asking him to walk I found that he was flexing (bending) his knees to almost 15 degree and his gait were little bit limping in spite of bending the knees. He could not sleep in supine position, if does so would feel much pain at the back and knees due to overstretching of the para-spinal muscles. The vector of the pelvis was tilting obliquely, which means that he must be having variation of length in either one of the leg. And of course his right leg was shorter than the left one.

Mr.K.C.S, while explaining the history of his ailments, said that he had a fall from the height nearly 20 feet, some 20 years back, while working in a transformer since he was an Electrical Dept. employee, in charge of maintaining the current supply. This fall had caused him fracture at the neck of Right femur. It was duly rectified by conducting internal fixation of the fractured bones with Mac Murray’s Osteotomy method, which was a popular surgical intervention by that time.

But, unfortunately, his destiny made him to suffer another fall from a height of 18 feet, once again after two years of the previous episode and now he broke up his left femur at it’s neck region. Mac Murray’s Osteotomy was conducted for this limb too.

It is only after this second surgery, he developed Limb Length Discrepancy, and not after his first surgery.It is this limb length discrepancy, as of my opinion, has led to a great mechanical strain for the longer limb (Left leg over here) thereby causing a greater displacement, vertically, against the centre of body. This variation in the vector of planes had caused an asymmetrical gait, especially while landing the shorter leg (Right leg in this case) and longer legs respectively. Wearing a shoe lift would have helped him maintaining the symmetrical position of both of his limbs. But, he had not opted for it, considering the fact that such shoes were of much weight in those days, unlike the present scenario. 

Slowly, because of the above reasons, he started developing the vertebral deformities in the following order, Scoliosis-Kyphosis-Lordoisis.

Observations during & after the course of Marma Chikitsa treatment:

The main complaint of Mr.K.C.S was his Knee joint pain. Since he had no degenerative changes in his knees, I explained him that the cause of the knee pain was the deformity in his vertebral column. We decided to conduct Marma Chikitsa, for 10 days, specifically to tailor suit and rectify his spinal deformity.

Astonishingly from 2nd sitting onwards, his body showed a collective response to the treatment. The distance of the lumbar curvature got reduced by 1 cm.It was calculated with a natural mole present10 centimeters from the ground level, near  on the right flank. After the completion of 10th sitting of Marma Chikitsa the mole was found to be present 9 centimeters above the ground level.

In the same way the distance of mid point of superior iliac spine which was 14.7 cms from ground level on 2nd sitting came down reducing to 12.8 cms on the completion of 10th sitting of Marma Chikitsa.

The S.L.R test was 5 degree and 0 degree on right and left limbs respectively on the first day before starting the treatment. The subject started getting relief from knee pain after the second day of treatment, and the S.L.R test showed a moderate improvement with 15˚ on right side and 20˚ on left side.After completion of 10 days of treatment S.L.R. test revealed 50˚ in right leg and 70˚ in left leg.

The gait which was limping, with 15˚ bent knees and swaying to right side before treatment got improved after 10 days, with almost a straight vertebral column but with minimal scoliosis and 5˚ bent knees. There was much variation in the swaying to right side while walking and he felt nil pain in knees while walking.
The above details explained may better be viewed in the images shown below.

The result obtained after the treatment was so satisfactory to the patient, since he was able to walk freely with out any pain in the knee, and that was able to sleep in supine posture devoid of any pain or stretching at his back, and that he was able to ride his bi-cycle with out any distress, he was over whelmed with joy and blessed me for the relief given to him. All I had to say to him was that the credit given by him is not owed by me, but to the Almighty, because without whose blessings to both of us, the success of the treatment would’ve not been a reality.  


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