VATAKANTAKA: A CASE STUDY *Guide & Physician: Dr. R. V. Shettar Asst. Professor P.G. Dept. of kayachikitsa D. G. M. A. M. C.

& H, Gadag *Author:Dr. Pragati A. Katariya P. G. Scholar II year kayachikitsa D. G. M. A. M. C. & H, Gadag

Abstract: - Vatakantaka is very common and affecting normal routine work. A case with
chronic Vatakantaka managed successfully by Ishtika sweda along with Agnikarma is reported here. It is the need of hour to focus such practises which yields good results without much expense.

Introduction:There are many forms of foot pain, but heel pain can be one of the most troubling. The most common form of heel pain in people is known as Heel Spurs or Calcaneum spur and it is one of the most troublesome because it can be very difficult for the body to heal itself. A Heel Spur is actually a type of bone growth that develops on the outside of the heel bone where the plantar fascia ligament attaches. Spurs may form when the plantar fascia becomes inflamed causing calcification or bone growth. They are often described as having a small hook shape to them, which causes pain by irritating the surrounding soft tissue. Middle aged, overweight, and athletic individuals are more prone to plantar problems, as are non-athletic people who spend a lot of time on their feet or suddenly become active after a long period of lethargy. A recent study found that over 50 per cent of people who suffer from Calcaneum spur are on their feet nearly all day. Heel spurs usually develop gradually. Heel pain may only occur when taking the first steps after getting out of bed or when taking the first steps after sitting for a long period of time. If the plantar fascia ligament is not rested, the inflammation and heel pain will get worse. Other conditions or aggravating factors, such as the repetitive stress of walking, standing, running, or jumping, will contribute to the inflammation and pain. Studies suggest that approximately 10%of individuals who see a doctor for heel spur have the problem for more than a year.

Heel spur can be correlated with Vatakantaka in Ayurveda ,as having similarities in laxanas.The line of treatment of Vatakantaka is followed here and has shown the encouraging result.

The case and course of illness:A 40 year old female from North Karnataka was presented on 31st August, diagnosed as calcaneum spur based on X ray report. Patient was having pain within the heel and behind the heel, of the left foot, since 5 years. Along with pain inflammation was there. Patient was unable to walk properly so was putting more stress on the right heel to avoid the pain of left heel. Pain was more in morning hours, along with pain stiffness was also there and patient was unable to walk for certain time after awaking. Initially she had undergone allopathic as well as Ayurvedic treatment but got only temporary relief. Later patient approached to D.G.M.A.M.C& Hospital, Gadag and admitted.

Material for Procedure:Materials used for procedure are Pinda Taila for Abhyanga,Two moderate size pieces of Ishtika (Brick) of dark brown colour,Superetant water (Ganji) of boiled rice1liter,Loha Shalaka,Jatyadi Taila,Mahamanjishtadi Ghanavati,Kanchanara Guggulu.

Method of Administration:Pinda Taila was used for sthanika Abhyanga (for Left foot concentrating more on heel) for 20 Minutes. After abhyanga Ishtika Sweda was done. Ishtika was heated on moderate flame till red hot, after that immediately it was kept in a vessel and prepared rice water poured over it. It yields hot fumes and affected foot held over it, till ishtika became cold. When Ishtika became cold it was replaced by another red hot ishtika and thereby temperature was maintained. The procedure was repeated till the appearance of Samyak Swinna Laxanas.

*Abhyanga and Ishtika Sweda were done for 7 days.

After 7days of Abhyanga and Ishtika Sweda, Agnikarma was followed on 8th day with Loha Shalaka and making the signs of Bindu, all over the heel of left foot. After Agnikarma application of Jatyadi Taila was done on the same area where Agnikarma was done, as Paschat karma of Agnikarma.

*During this procedure patient was taking Mahamanjishtadi Ghanavati (2tab. twice a day, after meal with Ushna Jala.) and Kanchanara Guggulu (2tab. twice a day, after meal with Ushna Jala.) as internal medicine.

Observation:After 7days treatment of Abhyanga and Ishtika Sweda patient got significant relief from inflammation, stiffness and pain and After Agni karma, patient got complete relief from pain. Patient was able to walk properly without much stress and also there was significant relief in pain of morning hours. X ray was repeated after the treatment but has not shown any significant changes but patient improved significantly on subjective parameters.

Discussion:Depending on the Vyadhi Laxanas, the dushti of Vata, along with kapha was considered here, and treatment was planned according to that. Pinda taila was selected here for Abhyanga; it is indicated for Vatavyadhi2 .Ruksha Sweda is specially indicated for Kaphaja and Vatakphaja disorders3. Here considering Kaphanubandha, along with Vata,Ruksha sweda i.e. Ishtika Sweda was selected. Also Ruksha sweda helps to improve the Kharatwa of Asthi dhatu and gives strength to it.Thereby snigdha(pinda taila abhyanga)-ruksha(ishtika sweda) chikitsa was followed keeping in mind, Vata as pradhana dosha along with anubandhi kapha.

Agnikarma has played an important role in giving instant relief from pain and it is directly indicated for Vatakantaka4.Internal medicines also have been selected, keeping in mind the dosha-dushya involvement and clinical manifestation.

References:1.
Bramhanand Tripathi ed. Ashtanga Hridaya nidana sthana , 15/53, Chaukhamba sanskrita pratishthana, Delhi, pp-544

2.

Bramhanand Tripathi ed. Charaka Samhita chikitsa sthana , 29/123, Chaukhamba surbharati prakashana, Delhi, pp-1003

3.

Bramhashankara Mishra ed. Bhaishajya Ratnavali 5/190, 18th edition, Chaukhamba sanskrita pratishthana, Delhi, pp-88

4.

Aacharya Priyavat Sharma ed. Chakradatta, 22/66, 2nd edition, Chaukhamba publishers, Varanasi, pp-191