Abstract

A ROLE OF MAJJA BASTI (DASHMOOLA SIDDHA) IN THE MANAGEMENT OF AVASCULAR NECROSIS (AVN) OF FEMORAL HEAD: A CASE STUDY

Priya Pantel* and Swati Nagpal

Abstract

Avascular necrosis (AVN) is a condition that happens when there’s loss of blood supply to the bone, a disruption to the blood supply causes bone to die. It is also known as aseptic necrosis, ischemic bone necrosis or osteonecrosis. If not stopped this process ultimately cause the bone to collapse. It is the thought-provoking condition of the present era in orthopedics. Avascular Necrosis (AVN) is a progressive degenerative condition of bone, caused by lack of blood supply. While it can affect any bone, Avascular necrosis is expressly common in the hip joint. Disease has very poor prognosis in modern orthopaedic practice. Treatment of AVN in contemporary science revolves around the pain relieving medicine to total hip replacement surgery, which have drawbacks of long term recovery and short life span of hip. On conflicting Ayurvedic treatment provides long term relief and stops the progression of disease without any drawback and side effect. There is no direct co-relation of avascular necrosis and Asthi-Majja GataVata but on their clinical presentations it is Vata Pradhana Tridoshaja Vyadhi with main Vikruti of Asthi-Majja Dhatu. It is usually affect peoples between 30 to 50yrs of age. AVN is associated with long term use of high dose steroidal medication and excessive intake of alcohol.it will be asymptomatic in early stage, as the condition progress. The possible treatment in modern include NSALDs, core compression, bone transplant and total joint replancement surgery which have their own complications and adverse effect. Ayurvedic description of Asthimajjagata Vata closely resembles with AVN of modern medicine. Basti Chikitsa is considered to be the half the treatment for Vata dominated diseases by Acharayas.[1] Basti is considered as Param Aushadh for Vata.[1] Vata Dosha is predominantly existing in Asthi Dhatu and Sandhi (joints).[2] Asthimajjagata Vata is a vatavyadhi in which vitiated Vata get accumulate in Asthivaha and Majjavaha srotasa where already kha Vaigunya has been developed due to etiological factors. In brihattrayee symptoms of Asthigata Vata and Majjagata vata described together as they are closely related to each other. In Charak Samhita and Ashtang Hridaya, Aacharya stated that Asthimajjagata Vata can be cured by internal and external application of Sneha. Aim and objectives: To assess the efficacy of Dashmool Siddha Majjabasti in the management of AVN. Objective was to stop the further deterioration of the hip joint and to reduce the chances of surgical intervention in managing avascular necrosis. Materials and methods: already diagnosed and non-operated case of AVN of stage 3 with complaints of pain of bilateral hip joint, restricted movements and limping gait approached the out-patient division of the hospital and was managed by Shaman yoga and panchakarma therapy. Observation and Result: Significant improvement was noticed after the treatment. Pain was reduced significantly with marked improvement in range of motion. Patient was able to walk and climb stairs after the treatment without pain and stiffness. The Conservative management of AVN through Ayurvedic principles provides significant relief in sign and symptoms and improves quality of life.

Keywords: Asthimajjatagata Vaat, Dashmoola Sidha Majja Basti, Shaman yoga, Avascular necrosis.