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VOL 4

ISSUE 3 (2016) INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE eISSN-2348-0173 pISSN-2395-3985

Sawant S.U. et.al., Effective Ayurvedic Management for Calcaneal Spur –A Case Study, Int. J. Ayu. Alt. Med., 2016; 4(3):160-163

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CASE REPORT Scientific Journal Impact Factor 5.733 (2015) by InnoSpace Sci. Res., Morocco

EFFECTIVE AYURVEDIC MANAGEMENT FOR CALCANEAL SPUR –A CASE STUDY

Sawant Shreya Umesh1*, Jayant Subhash Hartalkar2, Sawant Umesh Vasant3

1. Associate Professor, Dept. of Rachana Sharir, D. Y. Patil School of Ayurved, Nerul, Contact No. +91 9833696119, Email- [email protected]

2. Associate Professor, Dept. of Rachana Sharir, D. Y. Patil School of Ayurved,Nerul, Contact No. +91

9920956434, Email- [email protected]

3. Professor, Dept. of Rachana Sharir, Mahila Ayurved Medical College, Yamuna Nagar, Haryana, Contact No. +91 9833821258, Email- [email protected]

Article Received on - 11th Aug 2016 Article Revised on - 23rd Aug 2016 Article Accepted on - 29th Aug 2016

All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below).

(Full Text Available @ www.ijaam.org)

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CASE REPORT *Corresponding Author Sawant Shreya Umesh Associate Professor, Dept. of Rachana Sharir, D. Y. Patil School of Ayurved, Nerul, Contact No. +91 9833696119, Email- [email protected]

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ABSTRACT: The most common form of heel pain is mainly due to calcaneal spur. It is one of the

most troublesome common health complaint usually affects badly peoples routine work, and once it is manifested very difficult for the body to heal. The pathophysiology of calcaneal spurs is poorly understood. The association between calcaneal spurs and heel pain has led to the development of several interventions directly targeted at the spur, including surgical excision, extracorporeal shockwave therapy and radiation therapy. In Ayurveda, it can cure successfully and can avoid injections, surgery and other proceeding complications. A patient of calcaneal spur successfully treated with Ayurvedic methods is presented in this case study.

Key Words: Calcaneal spurs Ayurvedic management

INTRODUCTION The most common form of heel pain is mainly due to calcaneal spur. It is one of the most troublesome common health complaint usually affects badly peoples routine work, and once it is manifested very difficult for the body to heal.[1] A large percentage of people suffer from this disease. This is most often seen in the patients. Although initially considered to be an abnormal finding inextricably linked to heel pain, more recent studies have reported that between 11 and 16% of the general population has radiographic evidence of calcaneal spurs. [2]

Calcaneal spur (or heel spur) is a small osteophyte (bone spur) located on the calcaneus (heel bone). Calcaneal spurs are typically detected by a radiological examination (X-ray).The pathophysiology of calcaneal spurs is poorly understood. When a foot bone is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to pile up on each other, causing a spur-shaped deformity, called a calcaneal (or heel) spur. Obese people, flatfooted people, and people who often wear high-heeled shoes are most susceptible to heel spurs.[3]

An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing spondylitis (typically in children). The association between calcaneal spurs and heel pain has led to the development of several

interventions directly targeted at the spur, including surgical excision, extracorporeal shockwave therapy and radiation therapy.[4]Possible complications of surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection and scarring. In addition with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis. In Ayurveda, it can cure successfully and can avoid injections, surgery and other proceeding complications.A patient of calcaneal spur successfully treated with Ayurvedic methods is presented in this case study. CASE REPORT A Female patient of Right Calcaneal spur Age: 38Yrs, Wt. – 58 kg, Occupation – Housewife Modern Medicines taken for 1 yr for the same. Due to temporary results and side effects such as Hyperacidity, patient came for Ayurvedic treatment in clinic.(Dadar, Mumbai) C/O: Right Heel pain, since 1 yr. Heel pain is more severe when waking up in the morning and also from rest and pain relieved after few steps. After a short step a dull pain persist. Sometimes knife sticking type of pain H/O: Hyper Acidity since 6 months. No H/O OF B.P., Diabetes Menstrual History: Regular O/E: tenderness over affected area when palpate. P/A: Soft, Tongue: Coated

EFFECTIVE AYURVEDIC MANAGEMENT FOR CALCANEAL SPUR –A CASE STUDY

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Pulse: 86/min, B.P.: 140/80 mm of Hg

INVESTIGATIONS –

Rx for 15 days 1. Padmakashta churna 250 mg TDS after food. 2. Yograj guggul 2 tab with worm water BD

after food. 3. Avipattikar churna 1 tsf at bed time with

warm water 4. Agnikarma by Mruttika shalaka on painful site

at Right heel. 5. Ishtika Sweda (Brick Fomentation) is advised

daily for 10-15 min. Following instructions were given to the patient: give proper rest Use proper fitted footwear with having heel

arch and support. Avoid bare foot walk especially in hard floor. Avoid high heeled foot wear. Avoid standing for long. Avoid excessive intake of hot and spicy foods.

etc Follow up after 15 days: O/E: Pain during standing for a long time Tenderness over affected area - Reduced

Pain during walking - Reduced Acidity – Reduced No Constipation From above symptoms Treatment is changed - for 30 days,

1. Yograj guggul 2 tab BD after food. 2. Gokshuradi guggul 2 tab BD Before food 3. Avipattikar churna 1 tsf at bed time with

warm water 4. Ishtika Sweda (Brick Fomentation) is advised

daily for 10-15 min. Follow up after 30 days: O/E: No pain during walking, standing for a long time No tenderness on affected area on Rt Heel No Acidity No Constipation Investigation: X ray shows absence of calcaneal spur. Same Treatment is continued for next 15 days RESULTS AND OBSERVATIONS

Table No.1: Results & Observations

Sr. No. Sign & Symptoms Before Treatment

After 15 days

treatment

After 30 days

treatment 1 Hyper acidity × ×

2 Rt Heel pain during walking × ×

3 Rt Heel pain during standing for a long time ×

4 Tenderness at affected area × ×

5 Spur on Rt calcaneum in X ray X ray Not

done ×

Fig. 1: X ray findings before and after treatment

DISCUSSION According to Ayurveda this condition may be due to Kapha dosha vitiation along with Vata dosha. As

a result Kapha dushti/vitiation bone formation in that area malfunctions and lead to inflammation etc. excess calcium deposition and spur formation

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occurs. This vitiated kapha block or alter the normal path of the Vata srotas/channels. Vata has the main dosha in three of them and has the main functions like movement, neurological and motor activities. The vitiated Vata also causes pain. Patient had acidity before treatment, so for Padmakashta churna is used in first 15 day as it is Vata and Pittahar.[5] Avipattikar churna is used for pitta shamak as it is mentioned in amlapitta rogadhikar.[6]As calcaneal pain is produced by vitiation of Vata Dosha, Yograj guggul is used as it is mentioned in Vataroga.[7] As per Panchabhautik chikitsa, Gokshuradi Guggul is used and also for Kleda vahan in Apana Kala.[8] Agnikarma is a type cauterization method, following internal medicines gives dramatic change to the patient. It gives instant pain relief. The easiest form of Swedana is Ishtika sweda. It can be performed by the patient itself at home, because it is simple and cost effective. All medicines are used which especially act on Vata Dosha. CONCLUSION There are very good medicines available for the calcaneal spur in Ayurved which gives better results than modern medicines. Also, modern medicines may develop some side effects which are hazardous. Ayurvedic treatment is the safest and successful treatment offered till date which is

result oriented and is side effect free. Ayurveda is considered such treatment as it’s an herb based treatment and known to be work on internal reasons to rectify the problem from roots. Calcaneal spur can be successfully treated by using Vata shamak, Raktaprasadak Dravyas and Agnikarma. In Ayurveda it can cure successfully and can avoid injections, surgery and other proceeding complications. ACKNOWLEDGEMENT Author acknowledges all parent and colleagues who helped a lot in making this Article very effective in very short time. Acknowledge co-author for his valuable Contribution. REFERENCES

1. https://www.vaidyaveekshana.blogspot.com [ Assessed date : 07 /08/ 2016]

2. https://jfootanklers.biomedcentral.com/article,[Assesseddate:07/08/2016]

3. https://en.wikipedia.org/wiki/Calanealspur,[Assesseddate:08/08/2016]

4. https://jfootanklers.biomedcentral.com/article, [ Assessed date :0 7 /08/ 2016]

5. Vaidya Ganesh Garde, Ashtang Hridaya, Anmol Prakashan, edition 2003, p.67

6. Vaidya Govind Das, Bhaishajya Ratnavali, Chaukhambha Prakashan, Varanasi, edition, 2010, p. 903

7. K. R. Shrikantha Murthy, Sharandhar Samhita, Chaukhambha Prakashan, Varanasi, edition, 2007, p.106

8. Ibid., p.109

CITE THIS ARTICLE AS –

Sawant S.U. et.al., Effective Ayurvedic Management for Calcaneal Spur –A Case Study, Int. J. Ayu. Alt. Med., 2016; 4(3):160-163 Source of Support – Nil Conflict of Interest – None Declared

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