This case study has been created with input from Dr. Naresh Perumbuduri, a senior Ayurvedic physician, and physiotherapists Dr. Gaurav Joshi and Dr. Palak Jain.

Chronic pain is slowly becoming a more common phenomenon; it is suffered by people in many forms, from endometriosis to fibromyalgia and much in between. The definition of chronic pain recovery varies from person to person. While some would consider the ability to manage their pain as recovery, others consider a change in perspective and understanding an important part of the recovery process.

Our guest at Ananda was in his 30s, and his first visit was triggered by connecting pains that originated at certain spots and then spread everywhere across the body. “The starting point was a sharp pain on the nape of his neck, which radiated down to his right shoulder, elbow, and forearm. This culminated in excruciating spasmodic pain on the side of his leg. He was unable to sit, stand, or assume a comfortable position while sleeping, finally leading to a sleep disorder as well,” shares Dr. Perumbuduri.



Ayurvedic Therapies for Chronic Pain

Pain can make people feel weak, and many people attach shame to that, despite it being something out of their control. Education plays a vital role in chronic pain management. Understanding the body is a key step in regaining control of it. In Ayurveda, people with a Vata-Pitta constitution are prone to dry frictional conditions in the joints. Ayurveda helps in recognising the unique qualities of each individual and uses the three doshas of vata, pitta, and kapha to help make sense of independent needs. A vata-pitta type means that two doshas dominate your prakriti, or constitution.

In order to pacify the painful joint conditions, our client was kept on an extensive treatment plan. This involved external oleation therapy, an oil massage process in which medicated oils, ghee, and herbs are applied to the body for up to a week in order to prepare it for specialised Panchakarma treatment. Nasyam was also done— oil drops were poured through the nasal cavity. The preparation of the oil and its quantity are just as important as the time and season in which the therapy is used. Certain therapies, such as Pizhichil, Choornaswedana, Pristha Vamsha therapy, and Stanika pichu were particularly helpful.



Pristha vasti is an Ayurvedic therapy for the whole back involving heat and oil.


The Role of Physiotherapy

Physiotherapy is an integral part of Ananda's holistic wellness programme, coordinating closely with Ayurveda and yoga to combat the epidemic of chronic pain. Dr. Gaurav shares further details on the guest’s condition: “There was swelling in the neck, a lack of oxygen, and blood flow in the arm." An MRI that was done revealed more details- the degeneration of the joint on the top of his shoulder, bulging discs in the neck, and the fluid around the bicep tendons was drying up with inflammation in the brachial plexus. The brachial plexus is the network of nerves that sends movement and sensory signals from the spinal cord to the arms, shoulder, and hand. “These severities in musculoskeletal conditions created small, scattered pains that magnified into this giant problem.”

Dr. Palak adds, “He took steroids and intra-articular injections, while suggestions to undergo spinal decompression surgery started to float his way.” These served as a wake-up call, which prompted his first visit to Ananda in the winter of 2021 to begin the process of uprooting the symptoms of pain from their source.

Chronic pain is a mind-body issue. Emotional and mental responses shape the experience of physical pain. A combination of medication and therapy through Ayurveda provided relief to the internal systems, which allowed physiotherapy to then address the trigger points that existed deep within the fasciae of the muscles or in the network of nerves.



Other treatments included matrix rhythm therapy, ultrasound therapy for specific trigger points, bilateral shoulder and neck traction, interferential therapy for the neck and shoulder, and a series of integrative massage therapies with spinal and neck manipulation.

Within a year of their first visit, our guest returned to Ananda and noticed dramatic progress. His range of motion improved dramatically, his nerve irritability reduced significantly, and the pain across his shoulders as well as spasms across his lower limbs completely subsided.