Effectiveness of Thokkanam Therapy (Siddha Physical Manipulation Technique) in the management of Kumbavatham (Periarthritis of Shoulder joint)- A Case Report

Periarthritis shoulder is an inflammatory disorder characterised by pain, stiffness, restriction of shoulder movements and functional disability.  Though it is a common musculoskeletal condition, its management remains a huge challenge to the orthopaedic surgeons due to unsatisfactory effectiveness of the available treatment modalities. In Siddha system of medicine, this condition is referred to as Kumbavatham. It is one among the 80 types of Vatha diseases, caused due to vitiated Vatha humour. Various internal and external treatment modalities are indicated for the management of Vatha diseases. Thokkanam is a type of external therapy modality, in which physical manipulation procedures are done by hands of the physician on the body of the patient with or without application of medicated oil. Thokkanam as a standalone treatment modality is not yet subjected to scientific evaluation. Hence this study reports the successful management of a 61-year-old male patient. He reported with complaints of pain and restricted movements in the right shoulder joint for the past one year to Puramaruthuvam department of Ayothidoss Pandithar hospital (APH)- National Institute Siddha (NIS). He was diagnosed with Kumbavatham and the treatment was started. Thokkanam with Kunthriga thailam was carried out for 14 days. Following the treatment, pain and restriction of movements subsided. The prognosis was assessed using VAS score, goniometric measurements of range of movements and Shoulder pain and disability index (SPADI) score. VAS score improved from 10 points to 2 points, SPADI score improved from 96.76% to 6.9% and goniometric measurement improved from restricted movements to normal range of movements following treatment. These findings may encourage the use of Thokkanam therapy with Kunthriga thailam in the management of Kumbavatham.