“A CLINICAL CASE STUDY ON THE MANAGEMENT OF AVABAHUK THROUGH AYURVEDA W.S.R TO FROZEN SHOULDER.”

About Author

Correspondence Address

Department of kayachikitsa, shri Ayurvedic mahavidyalaya, Nagpur
Contact No. : 7020979192, Email : dilpreetkaurjuneja25@gmail.com

Date of Acceptance : 28 Dec 2025

Date of Publication : 31 Dec 2025

Article ID : SD-IJAY_155

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3409

Abstract

Avabahuk is a disorder described under Vatavyadhi in Ayurveda and can be clinically correlated with frozen shoulder due to the close similarity in signs and symptoms. Shoulder pain is commonly reported, accounting for approximately 16–26% of cases, and it is the third most common cause for musculoskeletal consultations in clinical practice. Frozen shoulder is characterised by severe pain, marked restriction of shoulder movements, and a progressive reduction in both active and passive range of motion.

In contemporary medical practice, treatment usually includes anti-inflammatory analgesics, specific shoulder exercises, and local application of pain-relieving ointments. However, these interventions often provide only limited or temporary relief, and satisfactory outcomes are not consistently achieved.

Case Report- A 50-year-old male patient presented with complaints of painful and restricted movements of the left shoulder joint, accompanied by neck pain and reduced strength in the right hand.

Conclusion- The patient was diagnosed with Avabahuk (frozen shoulder) and managed with Panchakarma therapies along with oral herbal medications. Following treatment, significant improvement was observed in both subjective symptoms and objective clinical parameters, indicating the effectiveness of the Ayurvedic approach in managing this condition.

KEY WORDS:-  Avabahuk , Anti- inflammatory, Panchakarma

Introduction

Vata is the dosha responsible for controlling all the neurological and neuromuscular activities in the body. It is responsible for all the movements in the body. Vata in its vitiated form gets filled in the Rikta Strotas (empty or susceptible channels) of the body, thereby producing various diseases that are called Vatavyadhi. 1 Under the term Nanatmaja Vyadhi of Vata, 80 diseases have been included. Charaka has stated that the causes of all these Vatavyadhi can be divided into two types, i.e., Dhatukshayajanya (caused by depletion of tissues) and Margavrodhjanya (caused by obstruction of Vata Dosha by others). 2

Avabahuka is considered to be a disease that affects the Amsa Sandhi (shoulder joint) and is caused by the Vata Dosha. Even though the term 'Avabahuka' is not mentioned in the Nanatmaja Vata Vyadhi, Acharya Sushruta and others have considered Avabahuka as a Vata Vyadhi. 3 Amsa Shosha can be considered as the preliminary stage of the disease where loss or dryness of the Shleshaka Kapha (one of the types of Kapha) within the shoulder joints occurs. The next stage, that is, Avabahuka, occurs due to the loss of Shleshaka Kapha, and symptoms like pain during movement and restricted movement are manifested. It is commented in the Madhukosha Teeka that Amsa Shosha is produced by Dhatukshaya, that is, Shuddha Vatajanya, and Avabahuka is Vata-Kaphajanya. 4

The symptoms of Avabahuka are often compared with the symptoms of adhesive capsulitis, which is commonly referred to as frozen shoulder. 5 Adhesive capsulitis refers to a mysterious fibrosis of the glenohumeral joint capsule, manifested by diffuse, dull, aching pain within the shoulder and progressive restriction of motion, but usually no localised tenderness. 6 In early stages, the pain is worst at the hours of darkness, and therefore the stiffness is limited to abduction and internal rotation of the shoulder. Later the pain is present most of the time with limited movements of the shoulder joint. 7

A number of treatment approaches are recommended for the management of frozen shoulder. These include pain management through analgesics, anti-inflammatories, steroid injections [8, 9] and various treatment modalities like physiotherapy, which commonly involves active and passive stretching and joint mobilisations. 10 In severe cases of restriction, orthographic distension, surgical capsular release, or manipulation under anaesthetics has been advocated. In spite of the variety of approaches, there is a lack of substantial evidence to prove that treatment speeds recovery. 14 In the present case, a patient with frozen shoulder was assessed and treated with a Panchakarma therapeutic regime that included Snehana (oleation), Sarvanga Bashpa Swedana (sudation), local Patrapinda Sweda, and Nasya along with Trayodashang Guggulu and Dashmul Kwatha to determine if therapeutic intervention resulted in a measurable improvement in shoulder pain and range of motion.

Discussion

In the present case, etiological factors (Hetu) such as Vatakaraka Ahara (Vata-aggravating diet), Atishrama (excessive physical exertion), vitiation of Vata Dosha—particularly Vyana Vayu—and accumulation of Ama due to Agnimandya led to pathological changes in the Amsa Sandhi. The aggravation of Vata resulted in depletion of joint lubrication, while Ama accumulation caused obstruction within the joint structures. These pathological processes produced restricted joint movements accompanied by Shoola (pain) and Stambha (stiffness), which are hallmark features of Avabahuka and are characteristic of Vata and Kapha involvement, respectively. Since Amsa Sandhi is also considered a primary seat of Kapha, the treatment strategy was designed to pacify Vata–Kapha Dosha Dushti both internally and externally, while simultaneously addressing Kha Vaigunya by strengthening the affected joint. The probable modes of action of the administered Shodhana and Shamana Chikitsa are discussed below.

Probable Mode of Action of Panchakarma Chikitsa

Snehana (Abhyanga)

Abhyanga possesses Snigdha (unctuous), Guru (heavy), and Mridu (soft) qualities, which counteract the dry and rough properties of aggravated Vata Dosha and help correct Dhatu Kshaya. Balataila, the medicated oil used in this therapy, contains Bala (Sida cordifolia), which is known for its Snigdha Guna and Vatahara properties. These attributes likely contributed to the pacification of vitiated Vata, resulting in pain reduction and improved mobility of the affected shoulder joint. Pharmacological studies indicate that Bala contains bioactive compounds such as vasicine, vasicinone, vasicol, and vasicinolone, which possess anti-inflammatory and analgesic effects.¹⁵–¹⁷

Swedana

Swedana is particularly indicated in conditions associated with Sankocha (contracture), Ayama (restricted extension), Shoola (pain), Stambha (stiffness), Gaurava (heaviness), and Supti (numbness).¹⁸ It alleviates stiffness and heaviness, reduces coldness (Sheeta Guna), and induces sweating, thereby enhancing joint flexibility. Additionally, Swedana facilitates clearance of channel obstruction (Srotorodha), contributing to symptomatic relief.¹⁹

Patra Pinda Sweda

Nirgundi (Vitex negundo) used in Patra Pinda Sweda possesses Vedanasthapana (analgesic) and Shothahara (anti-inflammatory) properties.²⁰ Classical Nighantu texts describe its use in disorders characterized by Shotha (swelling) and Shoola (pain),²¹ and it is also documented for its Vataghna action.²² The application of heat during Nirgundi Patra Pinda Sweda enhances local circulation and facilitates deeper penetration and absorption of the medicinal constituents, thereby reducing pain and stiffness.

Nasya

Classical Ayurvedic texts emphasize that drugs administered through Nasya reach the Shringataka Marma and exert therapeutic effects on disorders of the Skandha, Amsa, and Greeva regions.²³,²⁴ Administration of Anu Taila Nasya in this case likely aided in balancing Doshas and achieving Vata Shamana, thereby improving shoulder joint function.

MODE OF ACTION OF SHAMAN CHIKITSA

1. TRAYODASHANG GUGGUL:  vatanulomana and Aampachana properties of the ingredients of Trayodashanga Guggulu²⁵ help in relieving Malabaddhata (Constipation). Due to Deepana and Pachana properties Tandra, Gauravta, and Aruchi are also reduced. Along with this, it has anti-inflammatory, anti-arthritis, anti-gout, analgesic, muscle relaxant, and antioxidant properties by energize the growth of bone forming cells by producing more osteoclasts and osteoblasts. It prevent the pro-inflammatory cytokines, activity of xanthine oxidase, hydrogen peroxide, and renal microsomal lipid peroxidation process and also blocks the action of histamine and enhances the level of dopamine.²⁶

2. DASHMOOL KWATH - The tridoshar merit of dashmool kwath relieves pain and swelling .²⁷

3.  AGNITUNDI VATI: As the name suggest Agni means digestive fire, hence the one which improves digestive fire. Agnitundi Vati induces Pachana at gastrointestinal as

well as Dhatauata level (cellular and tissue level) and corrects Jatharagni as well as Dhatvagni. It is indicated in Adhmana, Shula, pain related to Vata imbalance. ²⁸

4. CAP FROZHOLON: Ayurvedic soft gel capsules for frozen shoulder, joint pain and rotator cuff issues, containing herbs like Shallaki , guggulu , nirgundi , rasna , and haridra mixed in medicated sesame oil (Tila taila)  base to reduce inflammation , ease stifness and improve joint mobility .they work by supporting vata balance , reducing pain and promote healing of shoulder and soft tissues .

Conclusion

Ayurveda treatment therapy with Balataila Sneahan, Sarvanga Bashpa Swedana, Anutaila Nasya along with Trayodashang Guggulu and dashmoola Kwatha is effective in reducing pain and improving flexibility of the affected shoulder joint in Avabahuka (frozen

shoulder).

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