Ayurvedic medicine, treatment and remedies for Shoulder Pain

The term amsa sandhi shula is used to describe pain in the shoulder joint. Ayurvedic treatment targets and treats the root cause of shoulder pain, providing providig long term relief. Following are the major causes of shoulder pain as mentioned in Ayurvedic texts:

• Avabahuka: In this condition, vitiation of vata in the shoulder joint leads to pain accompanied by restricted shoulder movement and atrophy of shoulder muscles.
• Amavata: Poor digestion leads to formation of  ama (toxins) in the body, which accumulates at different locations. Amavata occurs when this accumulated ama in shoulder joints is vitiated by vata.
• Dislocated shoulder: Dislocation of the shoulder leads to derangement of vata, which causes pain and dryness of kapha located in shouder joint, resulting in instability of this joint.

A variety of anti-inflammatory and analgesic herbs and vata shamana (pacification) procedures are used in the ayurvedic treatment of shoulder pain to restore the deranged vata.

• Nasya karma
  • In this procedure, herbal medicines in the form of medicated oil, paste, powder or the smoke of errhine drugs are instilled into nostrils.
  • This therapy is indicated for relieving conditions of the head, eyes, throat, shoulders, neck, ears, nose and scapula.
  • Successful nasya karma brings about lightness in the body and head along with sensorial comfort.
  • After nasya karma, mild sudation is given over the face, throat, cheeks, and forehead along with massage of the feet, palms, and back of the neck.
  • Hot water gargles and inhalation of medicated smoke is encouraged in order to clear kapha dosha from mouth and throat.
  • Nasya karma is indicated in the treatment of frozen shoulder as well as dislocated shoulder and alleviates pain associated with these conditions.
• Pachana
  • It involves the administration of digestants that stimulate the agni (digestive fire) and allow for undigested food to be processed quickly and effectively.
  • This therapy improves digestion at both cellular and gastrointestinal levels.
  • Ghee (clarified butter) is a potent agni stimulant that aids in improving digestion and removing accumulated ama from the body in persons with arthritis or frozen shoulder. It is generally administered along with digestive juices or digestive stimulants.
  • The process of pachana lasts for 3 to 7 days.
  • Improved digestion, feeling of lightness, improved thirst, and well-formed stool without mucus are indicative of successful pachana therapy.

• Snehana
  • It involves the application of large amounts of warm medicinal oils over the body.
  • Oleation may be done internally by administering agents such as ghee or oil by mouth, as an enema or through the nasal route.
  • Snehana produces lubrication to the body, both externally and internally.
  • It is indicated for the treatment of vata disorders like frozen shoulder and arthritis. Therefore, it aids in relieving shoulder pain associated with these disorders.
  • This procedure balances vata and, therefore, allows for adequate flow of wastes and toxins to their removal sites.
  • Snehana process usually lasts for 7 days in persons with vata disorders.

• Swedana
  • This procedure uses steam or sweating therapy to dislodge and liquefy toxins and improve digestion.
  • The toxins accumulate in the gut can then be easily eliminated.
  • It relieves stiffness, coldness and heaviness.
  • Swedana is the primary treatment procedure for vata-dominant disorders like arthritis and frozen shoulder. It is, therefore, useful for relieving shoulder pain associated with these conditions.

• Lepa
  • Lepas like murivenna oil are external applications used for the management of shoulder pain and inflammation.
  • Murivenna oil is prepared from karanja (Indian beech), nagavalli (betel vine), shigru shaka (drumstick), coconut oil, palandu (onion) and shatavari (hundred roots).
  • It is applied on a pad and bandaged around the shoulder joint for treating a dislocated shoulder.
  • Lepas are also used for the treatment of fractures, wounds, injuries, sprains and muscular pain.

Ayurvedic herbs for shoulder pain

• Haridra
  • Both the rhizome and tubers of this herb are used for their medicinal properties.
  • This bitter, pungent herb is grown extensively throughout India.
  • It is an active anti-inflammatory agent as well as a pain reliever.
  • Curcumin and curcuminoids extracted from turmeric are recommended for the treatment of arthritis because of its anti-inflammatory properties. It is, therefore, useful in relieving shoulder pain associated with arthritis.
  • It also acts as an antibacterial and tonic agent, useful in the treatment of a number of conditions.
• Adraka
  • Adraka is an anti-inflammatory herb that is widely used for the treatment of arthritis.
  • As an analgesic, it is indicated for relieving shoulder pain.
  • The rhizome of this herb has analgesic, digestive, emetic and aromatic properties.
  • Adraka is considered to be a wonder drug because of its multiple healing properties. It is used along with rock salt for treating vata disorders.
  • It helps in restoring deranged vata in case of dislocated shoulder and, therefore, relieving shoulder pain associated with this condition.
• Rasonam
  • Cultivated all over India, bulbs and oil of this herb have been used extensively in Ayurveda for the treatment for various diseases.
  • Rasonam has anti-helminthic, expectorant and antispasmodic properties.
  • It also acts as an analgesic and provides relief from pain associated with a dislocated shoulder.
  • Garlic normalises deranged vata, aids in the recovery process of a dislocated shoulder and prevents the recurrence of dislocation.
  • It is, therefore, recommended in persons with shoulder pain associated with a dislocated shoulder.
• Vidanga
  • Vidanga acts as an anti-inflammatory and anti-emetic agent.
  • The anti-inflammatory properties of this herb make it useful in the treatment of arthritis, thereby relieving the associated shoulder pain.
  • It is also used in nasya karma procedure.
• Chakramarda
  • Leaves, seeds and roots of this herb are used for preparing Ayurvedic medicines.
  • Chakramarda is a natural anti-inflammatory herb.
  • Leaves of this plant, are boiled in castor oil and applied over inflamed parts of the body to provide respite from swelling and redness.
  • It also aids in reducing joint pain.
• Eranda
  • Almost the whole of this herb has medicinal properties.
  • Its anti-inflammatory and analgesic properties aid in the treatment of arthritis and relieves arthritic pain in shoulder joint.
  • Eranda leaves are warmed to be applied on painful joints for reducing shoulder pain.
  • It is incredibly useful in the treatment of vata disorders.
• Ashwagandha
  • Ashwagandha is commonly used in the form of churna (powder) administered with ghee, water or honey in persons with frozen shoulder and is useful in relieving shoulder pain associated with frozen shoulder.
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• Bala
  • Bala has anti-inflammatory and anti-oxidant properties.
  • It increases a person’s tolerance for pain.
  • Administered in the form of churna, bala is effective in the treatment of frozen shoulder, thereby providing relief from the associated shoulder pain.

Ayurvedic medicines for shoulder pain

• Yogaraja guggulu
  • This medication contains herbs such as guggulu (Indian bdellium-tree), chitraka (leadwort), rasna (Indian camphorweed), gokshura (small caltrops), pippalimoola (long pepper roots), guduchi (heart-leaved moonseed), and shatavari.
  • Yogaraja guggulu pacifies vata and removes ama, thereby relieving inflammation and pain in shoulders caused due to vata conditions.
• Dashamoola kashaya
  • Dashamoola kashaya is a decoction prepared from the roots of 10 herbs including brihati (bari katheri), bilwa (golden apple), prishniparni (kalshi), shyonaka (Indian caper), agnimantha (headache tree), gambhari (beechwood), kantakari (chhoti katheri), and gokshura.
  • It is effective in relieving pain caused by aggravated vata such as shoulder pain.
  • Other conditions that can be managed with dashamoola kashaya are diseases of bones associated with fever as well as degenerative diseases of bones.

As treatments vary according to numerous factors and an individual's prakriti (constitution), it is necessary to consult a qualified Ayurvedic doctor for the appropriate medications and treatments for your specific complaints.

Do’s

• Add nutritious food items such as milk, porridge, sali (a type of old rice), shigru, kulattha (horse gram), udada (black gram) and brinjal in your diet.
• Persons with a dislocated shoulder are expected to move their fingers and clench their fists to improve range of motion. This aids in reducing stiffness and maintaining blood circulation while the shoulder is immobilised.
• Perform shoulder exercises as per the guidance of the doctor.

Don’ts

• Kalaya (yellow pea) and cold water should be avoided.
• Sitting up late at night, exposure to easterly winds and suppressing natural urges such as urination is harmful to those with arthritis.
• Persons with arthritis should avoid eating food that is difficult to digest,
• Do not consume incompatible food items, fish, jaggery and curd.

A clinical study involving the noninvasive management of recurrent dislocated shoulder reports effective treatment with murivenna pichu along with a few other Ayurvedic therapeutic measures. The vatahara (vata-destroying) property of murivenna is known to be useful in persons with a dislocated shoulder. The study reports of the analgesic and anti-inflammatory effects of murivenna, which provide relief from shoulder pain.

Another clinical study reports the effectiveness of turmeric in the treatment of rheumatoid arthritis. The study was conducted to compare the efficacy of turmeric over ginger and indomethacin in the treatment of arthritis. The anti-oxidant and anti-inflammatory activities of turmeric were reported to be better as compared to those of ginger and indomethacin. It is, therefore, effective in alleviating shoulder pain associated with arthritis.

Although Ayurvedic treatment procedures and herbal medicines do not have any specific side effects, one needs to be mindful of the necessary precautions while undergoing treatment. Depending on individual prakriti, a particular remedy may show side effects in certain individuals. For eg.

• Nasya should be avoided in persons with a history of indigestion, after fasting, purgation or enema. It should not be performed in persons with acute fever.
• Snehana is contraindicated in those with very weak or very strong digestion, throat diseases. Obese persons should not undergo snehana.
• During sudation therapy, heavy application of oils should be avoided as it can lead to disorders of digestive system.
• Haridra should be consumed with caution by pregnant women or in cases of dehydration or severe exhaustion.
• Adraka should be taken in moderation as it aggravates pitta and may cause fever or ulcers.
• Bala should never be consumed in excess.

Shoulder joint, being a complex array of bones, tendons and muscles, has a great degree of motion that enables one to perform a number of tasks. An affected shoulder can have a significant impact on every day activties. Ayurvedic treatment of joint pain aims at the identification and alleviation of the underlying cause of shoulder pain. Various Ayurvedic therapies help restore the deranged vata associated with disorders of the shoulder and also cleanses ama to provides relief from pain. Anti-inflammatory and analgesic herbs play a significant role in relieving shoulder pain associated with conditions like frozen shoulder, arthritis and a dislocated shoulder. Though ayurvedic medicines are considered to be safe and devoid of side effects, it is always best to refer to a doctor before taking these remedies. This not only avoids unnecessary complications but also ensures a timely and quick recovery.