how pain management is done using clinical approach?

1. !! SHREE ATMARAJ !!CLINICAL APPROACH TO PAIN MANAGEMENT BY AYURVEDA VAIDYA ANIRUDDHA SHREEDHAR KULKARNI, B.A.M.S. SHREE ATMARAJ AYURVEDEEYA CHIKITSALAYA, GANESH MARG, SHANIWAR PETH, MIRAJ. 416410 PHONE – 0233 2222402 CELL – 9422407049 EMAIL – askulkarni2@gmail.com WEBSITE – www.ayusampada.co.in

2. INTRODUCTION Pain is a cardinal symptom attributed to Vata humor or dosha. Vata disorders are seen arising out of three main mechanisms – When the momentum of vata is obstructed, vata gets vitiated. When the body elements are depleted, vata fills the vacant space and gets vitiated. Momentum of vata is obstructed by its subtypes or dhatus or malas. Obstructed vata moves in reverse direction, but, obstructed again and gets enveloped. This process is known as ‘avarana’ and is also responsible for vitiation of vata.

3. PAIN – DEFINITION AND SCOPE Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” Intellectual Pain, Emotional Pain, Interpersonal Pain, Financial Pain, Spiritual Pain, Bureaucratic Pain, and Physical Pain. Pain is what the patient says it is, and exists whenever the patient says it does.

4. ASSESSMENT OF PAIN HISTORY 1. When the pain started? 2. What events or illness coincided with the onset? 3. Where does it hurt? (Location) 4. How does it feel? (Character) 5. What are the aggravating and relieving influences? (Upashaya-Anupashaya) 6. What investigations have been done? 7. What treatments have been tried? 8. Past medical and surgical history is important to identify existing disease and previous experience with pain and analgesic use.

5. PHYSICAL ASSESSMENT PRAKRUTI (CONSTITUTION) DARSHAN (INSPECTION) SPARSHAN (PALPATION)

6. CLASSIFICATION OF PAIN ASHUKARI (visarp, anta vidradhi) – CHIRAKARI (sandhishoola, vatarakta) EKANGA(affecting a single site or organ)- SARVANGA(affecting entire body or multiple organs/systems) UTTANA (superficial) - GAMBHIRA(deep) ACCORDING TO DOSHA DOMINANACE – vataj, pittaj, kaphaj, vatakaphaj, vatapittaj and sannipatik ACCORDING TO ORGAN- skin, stomach, bones, joints etc.

7. MODREN ASPECT Nociceptive pain is due to the stimulation of nerve fibers that transmit signals in a normal way from nerve endings to brain centers. Somatic pain Visceral pain Neuropathic pain is the abnormal sustained stimulation of the nerve fibers that transmit signals from the nerve ending to brain center and/or from a dysfunction in the central nervous system. dysesthetic pain lancinatingpain

8. PRINCIPLES OF MANAGEMENT OF PAIN HETU NISCHITI (DETERMINATION OF CAUSATIVE FACTOR) SAMPRAPTI (PATHOGENESIS) SHODHANA CHIKITSA (PURIFICATION METHODS) SHAMAN CHIKITSA (PACIFICATION METHODS) VIHARA CHIKITSA (NON PHARMACOLOGICAL MANAGEMENT)

9. PAIN DOMINANT DISEASE CONDITIONS AND THEIR TREATMENT AJIRNA (INDIGESTION) – HARALU, LAGHUSUTASHEKHAR, SHANKH BHASMA, VARANGAK KSHAR, VIDANGA POWDER KUKSHISHOOLA (PAIN IN FLANKS) – HINGWASHTAKA CHURNA, KUSHTH POWDER, NAGARADI DECOCTION UDAVARTA (INVERTED VATA) – HARALU, GOKSHURADI GUGGUL, PHALATRIKADI GUGGUL, VARANGAK KSHAR, CHINCHALAVAN OIL KRUMI (WORM INFESTATION) – CHATURTHAKA YOGA, ARGAVDHAKAPILA TABLET, VIDANGA POWDER, VIDANGARISHTA GULMA (ABDOMINAL LUMP) – PHALATRIKADI GUGGUL, AROGYAVARDHINI, CHATURTHAKA YOGA, VARANGAK KSHAR, TALISADI POWDER, PANCHASAKAR POWDER, CHINCHALAVAN OIL

10. PAIN DOMINANT DISEASE CONDITIONS AND THEIR TREATMENT STREE ROGA (GYNECOLOGICAL DISORDERS) – CHANDRAPRABHA, GOKSHURADI GUGGUL, DASHAMULARISHTA, VARANGAK KSHAR, JINGI SHARADI, KALINGAKADI YOGA BALA ROGA (PEDIATRIC DISORDERS) – CHATURTHAK YOGA, VIDANGA POWDER, TAMRA BHASMA, PARIPATHADI DECOCTION, KUMARIA ASAV NO-3, VIDANGARISHTA, SHANKHA BHASMA VIDRADHI (INTERNAL AND EXTERNAL ABSCESSES) – SHOBHANJAN, TRIPHALA GUGGUL, PATOLADI GUGGUL, GANDHAKA RASAYAN, RAJANI YOGA, JINGI SHARADI VRANASHOTHA (INFLAMMATION) – PATOLADI GUGGUL, SOOTASHEKHAR, TRIPHALA GUGGUL, RAJANI YOGA

11. VATARAKTA (GOUT) PATOLADI YOGA, VARANGAK KSHAR, TRIPHALA GUGGUL, YOGARAJ GUGGUL, EKANGAVEER, VATVIDHWANSA, SHOBHANJAN, CHATURTHAK YOGA

12. DUSHTARBUDA (MALIGNANT CONDITIONS) KUNAKHI GUGGUL, CHOPCHINYADI POWDER, SUVARNA BHASMA, HIRAK BHASMA, GOKSHURADI GUGGUL, AROGYAVARDHINI

13. ANTRAPUCHHA DAHA (APPENDICITIS) SHOBHANJAN, TRIPHALA GUGGUL, PATOLADI YOGA, RAJANI YOGA, JINGI SHARADI, GANDHAK RASAYAN

14. VISARP (ERYSIPELAS-HERPES) RAJANI YOGA, JINGI SHARADI, SITOPALADI POWDER, PUNARNAVADI GUGGUL, SOOTASHEKHAR, PRAWAL BHASMA, GIRIJ

15. SANDHIGAT VATA (ARTHRITIS) GOKSHURADI GUGGUL, CHANDRAPRABHA, TRIPHALA GUGGUL, CHATURTHAK YOGA, PANCHAKASHYA YOGA, KUSHTH POWDER, PADMAK KITTA YOGA, KINAHI, SHOBHANJAN, VATAGAJANKUSH

16. ASHMARI (RENAL AND BILIARY CALCULI) ELADI YOGA, CHANDRAPRABHA, GOKSHURADI GUGGUL, HARALU, VARANGAK KSHAR, VARUNADI DECOCTION

17. GUDAGAT VYADHI (ANORECTAL DISEASES) TRIPHALA GUGGUL, SHATATAL YOGA, PHALATRIKADI GUGGUL, LAGHUSOOTSHEKHAR, VIDANGA POWDER, AVIPATTIKAR POWDER

18. SHIROROGA (HEADACHE) PATHYADI YOGA, LAXMINARAYAN RASA, TRIBHUVANKIRTI, MAHASUDARSHAN POWDER, SOOTASHEKHARA, PANCHAKASHAY YOGA

19. HRITSHOOLA (ANGINA – CHEST PAIN) MRIGASHRINGA BHASMA, VARANGAK KSHAR, GOKSHURADI GUGGUL, ARJUNARISHTA, PRABHAKAR TABLET

20. THANK YOU