AN INTEGRATIVE ANATOMICAL REVIEW OF PRISHTHA MARMA WITH SPECIAL REFERENCE TO AWABAHUKA AND KATISHOOLA

Ayurveda defines Marma as vital anatomical sites where the five principal body structures—Mamsa (muscle), Sira (vessels), Snayu (ligaments/tendons), Asthi (bone), and Sandhi (joints)—intersect, forming highly sensitive centers of Prana that maintain structural and functional integration of the human body. Among the 107 Marmas described in classical Ayurvedic texts, Prishtha Marma located on the posterior aspect of the body possess significant clinical importance due to their direct involvement in axial and appendicular locomotion. These Marmas maintain neurovascular regulation, biomechanical stability, and musculoskeletal mobility.Disorders such as Awabahuka (correlated with Adhesive Capsulitis/Frozen Shoulder) and Katishoola (correlated with Mechanical Low Back Pain) commonly arise due to Vata vitiation in Snayu-dominant Marma regions. Modern literature associates these conditions with capsular fibrosis, myofascial tightness, nerve compression, facet joint degeneration, and postural stress. Prishtha Marmas anatomically correspond to major neural pathways including the suprascapular nerve, axillary nerve, sciatic nerve, and lumbar plexus, as well as fascial components like the thoracolumbar fascia—structures known to influence pain perception, motor coordination, and proprioception. Marma Chikitsa, a therapeutic approach involving precise manual manipulation of selective Marmas, has been shown to improve pain threshold, reduce muscle spasm, enhance microcirculation, and restore joint range of motion through neuromodulation and myofascial release mechanisms. This integrative review aims to correlate Prishtha Marmas with modern neuro-musculoskeletal anatomy and analyze their therapeutic efficacy in Awabahuka and Katishoola. Establishing anatomical-clinical correlations may contribute to evidence-based validation and global acceptance of Ayurvedic Marma-based interventions in musculoskeletal pain management.