VALIDATION OF VARMA POINTS FOR THANDAGAVATHAM- A CASE SERIES

S.Ramya¹, Sujatha²

¹ First year, Department of Varma Maruthuvam, Government Siddha Medical College, Palayamkottai, Tamilnadu, India.

² Lecturer, Department of Varma Maruthuvam, Government Siddha Medical College, Palayamkottai, Tamilnadu, India.

ABSTRACT:

Lumbar spondylosis is a degenerative change in lumbar vertebrae. The present study deals with the diagnosed case of lumbar spondylosis. Patient arrived in OPD and IPD with complaints of painful lumbar movements, restricted range of movements, weakness. It is correlated with Thandagavatham in Siddha literature. Assessment was done with the help of Visual Analogue Scale (VAS Scale). Patient was improved in walking, flexible in bending forward, pain reduced in lumbar region and other associated symptoms. Visual Analogue Scale are employed in differentiating the result. As per literary evidences Varma points are 108 in number (12 paduvarman+96thoduvarmam). Depending upon the location affected points are given. The course of Varma therapy for the selected 20 patients with consent showed good progress. Thus Varma therapy is non-invasive and effective in treating cases like Thandagavatham in current scenario.

KEYWORDS:

Thandagavatham, VAS Scale, Varma therapy.

INTRODUCTION:

Ancient text Tholkapiam explains about the effectiveness of Varma therapy (5000 BC). Justified that the text describes the term varmam as Vazhi Aatral. Varmam references were found in Palm leaf manuscripts written by Siddhars. Varmam is one among the ancient old commonly used external therapies. It is one among the South Indian Marital Arts. In modern Varma therapy is called as Thanuology. Varma points are so called life centres where saram (a vital energy) traverses through it. By giving pressure as mentioned in literature Vata, Pitha, Kapha normalises the deranged humour. Classical literature explains about varma points and its therapeutic value medicines in texts like Agathiyar Varma beerangi, Varma odivu murivu gnanam, Varma vithi etc. Varmam also used in treating traumatological conditions mentioned in Varma kayaviyal text. It is a channelized pathway of transporting the energy to various parts of our body to maintain the homeostasis. Varmam fulfils the cultural, spiritual, medical needs of humanity. In case of orthopaedic disorder Varma therapy plays a major role in it. It is also involved in treating conditions like Saganavatham (Cervical spondylosis), Thandagavatham (Lumbar spondylosis), mulangal mootu kanu savvu murivu (Ligament injuries), Azhal keel vayu (Osteo Arthritis), Pakkavatham (Hemiplegia)etc. Yugi vaithya chindhamani explains about 80 types of vatham, thandagavatham is one among such types. In India prevalence of Thandagavatham are10 million case per year. Varmam is a comprehensive, low cost and effective therapy in treating orthopaedic cases. ^[1]

CLINICAL FEATURES : ^[2]

Pain

Stiffness

Numbness and weakness

Muscle spasm

Muscle wasting

Restricted movements.

CASE REPORT:

Patients having symptoms of pain in both lower limbs, severe pain in lumbar area, bilateral knee joint pain, difficult to stand for a long time, difficulty in bending forward, decreased range of walking and other movements, some of them are present with tenderness. Pain gets aggravated occupationally. Severe pain occurs on lifting heavy objects, on a brisk walk

MATERIAL AND METHODS:

The present study deals with the diagnosed case of Lumbar Spondylosis.

A Case series to evaluate the effectiveness of Varma treatment in case of Thandagavatham ( Lumbar Spondylosis) carried out in Department of Sirappu Maruthuvam, Government Siddha Medical College and Hospital, Palayamkottai, Tirunelveli, Tamil Nadu, India. Carried out in In-patient ward and Out-patient ward from January to March 2020.

INCLUSION CRITERIA:

Age: 25-65 yrs.

Sex: both male and female

VAS Scores more than 3,

Antero posterior and Lateral view of Radiographic image suggest that Lumbar Spondylosis.

MRI/CT Scan shows that degeneration of lumbar vertebras or disc herniation.

Patients present with pain in lumbar region, stiffness, restricted movements etc.

EXCLUSION CRITERIA:

Diabetes mellitus

Cardiac diseases

Kidney failure

Malignancy conditions

Pregnant or lactating women

Congenital spine anomaly

History of spine trauma/fracture

Neurological impairment

CRITERIA OF WITHDRAWL:

If any adverse effect were found on the course of treatment, therapy is withheld and will be treated symptomatically.

TRAIL DESIGN:

Open controlled clinical study.

SAMPLE SIZE:

20 cases treated with Varma points and Internal medicines at regular intervals.

TREATMENT:

INTERNAL MEDICINE:

I. Amukkra choornam – 2g

Sangu Parppam – 200mg

Silasathu parpam – 200mg (Tds with milk)

II. Nilavembu kudineer – 60ml (Bds)

VARMA POINT AND ITS FUNCTIONS: ^[3]

“minnentra shakthi nilayangal thannil sevvane thozhil arinthu iyakkuvaye”

(Varma Kaandam, verse 557 – Reference 1)

Our body is composed of vital energy channels to maintain Body functions. It is activated by stimulating the vital centres.

Table 1: Represent Varma points given for Thandagavatham ^[2]

DURATION OF TREATMENT: 7 Days

DIAGNOSIS AND ASSESMENT:

Severe pain in lumbar area, Pain in both lower limbs, difficult to stand for a long time, difficulty in bending forward, decreased range of walking and other movements hence diagnosed as Lumbar Spondylosis.

RESULT AND OBSERVATION:

The incidence of Thandagavatham in reported in GSMC&H, Palayamkottai justified that 60% males and 40% females. Degeneration, improper posture, disc herniation is the major cause for Thandagavatham. 20 patients all are treated with Varma therapy and Internal medicines. A psychometric Visual Analogue Scale or Visual Analog Scale (VAS) was helpful in ruling out the results. Out of 20 patients 12 patients showed good relief from pain, found brisk walk, flexibility in bending forward, reduced pain around lumbo sacral region, tenderness is reduced, 4 patients showed Mild relief, slight decrease in pain around lumbar region, tenderness is slightly reduced.

Table 2: Represents result of Varma therapy Before and After treatment ^[4]

CONCLUSION:

From the evidence of Varma literary texts treatment methods are justified to treat Thandagavatham (Lumbar spondylosis). By activating life centres, we can visually see the patients getting free from the illness. It is an effective method of treatment cost efficient. Patients are relieved from pain during forward bending, walking, mobility is regained. Being a non-invasive treatment it paves a future pathway in treatment aspect with effective external therapeutic measure. Similar like such studies will be carry forward in future to reduce number of surgeries with the help of Varma Treatment. Varma treatment improves the quality of life.

ACKNOWLEDGEMENT:

The authors are thankful to the Principal, Head of the Department, Lecturers, Department of Sirappu Maruthuvam, Government Siddha Medical College, Palayamkottai, Tirunelveli. I thank patients who cooperated to perform this study.

REFERENCE:

1. Karthik Nagarajan.S, Uthrapathi.S, Muthukumar.N. J, Mahalakshmi.V and Banumathi.V, Effectiveness of Varmam Therapy In Patchavatham (Hemiplegia) – A Case Report, World Journal of Pharmaceutical Research, 2018; 8(1): 937-942.

2. Protocol for varma provided by Government Siddha Medical College, Chennai, 2015.

3. Kanimozhi.M.A, Shunmugom.N, Mootu Kannisaivu Pisagal – Knee Joint ACL and MCL Tear Repair Through Varmam – A Single Case Study, World Journal of Pharmaceutical Research, 2019; 8(2): 1737-1742.

4. Wikipedia – Visual Analogue Scale – Wikipedia -16.4.2020 – URL : https://en.wikipedia.org/wiki/Visual_analogue_scale .