Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||
A male aged 48 years, adiabetic and non-hypertensive presented with the following symptoms,approached Dr.Bhat at SPKVCC some 3 months ago.
Daxina amsha sandhi vedana (Pain in Right shoulder)
associated with amsha sandhi graham (Stiffness of shoulder) &
reduced R.O.M (range of movement) since 6 months.
O /E Abduction & circumduction & Flexion difficult ;
Stiffness present in the Middle fibres of Deltoid + Supraspinatus muscle (reason for painful abduction); and also in Long head of Biceps brachii (which gets originated from Supra-glenoid tubercle of scapula- causing difficulty in flexion).
Tenderness elicited: - In Supra-glenoid tubercle – 3+; Corocoid process 2+
While examining for the R.O.M, coarse crepitations felt in the regions of supra-Glenoid tubercle & corocoid process (due to the stiffness of the Supraspinatus & long head of Biceps brachi muscles pulling the Acromio clavicular joint).
Raising the shoulder was unequal (in the sense he was able to lift his left shoulder to the fullest extent and not able to lift the right shoulder equal to the level of the left one).
Aggravating factor- movement of abduction; flexion & lateral rotation
Relieving factor – sleeping on the affected portion of the shoulder (i.e right side)
Provisional Dx- APABAHUKAM / Frozen shoulder (Adhesive capsulitis of shoulder)
Plan of treatment –
internal medication and
external application of oil.
Marma chiktsa – Marmas manipulated krukatika; amsa sandhi; Kaxadhara & Xipra. It is the Amsa & Kaxadhara played a pivotal role in relieving the stiffness around the affected joint on manipulation.
Abhyantarat :- Prasar... kashayam + Gulg.... kashayam + yogaraj
Bahyat:- Parinatakeri... thel + karpoor thel
Observation : The patient showed some improvement in flexion of shoulder after 4 days of Marma chikitsa and abduction lateral rotation responded after 7th day. The stiffness has reduced considerably up to 75% and the pain around 90%. H was adviced to follow exercises to the shoulder along with medications until the next follow up after 15 days. The patient was totally asymptomatic and was happily attending his daily routines, without any hindrance caused by his erstwhile affected shoulder. God’s grace bestowed up on him.