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Evaluation of the Effect of Jambira Pinda Sweda in Cervical Spondylosis w.r.t.

Clinical Symptomatology

Article  in  Journal of Research in Ayurvedic Sciences · August 2020

DOI: 10.5005/jras-10064-0103

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ORIGINAL RESEARCH ARTICLE

Evaluation of the Effect of Jambira Pinda Sweda

in Cervical Spondylosis w.r.t. Clinical Symptomatology
Sakshi Sharma1, Renu Makhija2, Mridula Dua3, Valiparambil Chandran Deep4, Paravazhi Radhakrishnan5, Amit Madan6,
Bharti Gupta7, Richa Singhal8, Rakesh Rana9, Vinod Kumar Lavaniya10, Madan Mohan Sharma11, Narayanam Srikanth12,
Kartar Singh Dhiman13

A b s t r ac t​
Introduction: Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies, intervertebral
discs of the neck, and the contents of the spinal canal. Spondylosis progresses with age and often develops at multiple interspaces. Though
many conventional treatments are available but in view of their side effects and dependency, it is important to search for safe and effective
Ayurvedic treatment.
Objective: To evaluate the effect of Jambira Pinda Sweda in cervical spondylosis w.r.t. clinical symptomatology.
Materials and methods: A single-arm, open, prospective interventional clinical study was conducted at two peripheral institutes of Central
Council for Research in Ayurvedic Sciences. Total 60 patients of either sex aged between 30 years and 65 years, with clinical and radiological
evidence of cervical spondylosis, were selected for the study. The treatment procedure Jambira Pinda Sweda was done daily for the period of
14 days. The patients were assessed at baseline, 7th day, 14th day, and 21st day (after 1 week without intervention) on the basis of relief in sign
and symptoms of cervical spondylosis by reduction in the VAS score, Northwick Park Neck Pain Questionnaire, and SF-36 Health Survey Score
for Quality of life.
Results: Mean value of VAS on baseline was 6.90, on 7th day it was 3.37, and decreased up to 2.57 on 14th day and 2.08 on 21st day showing
statistically significant improvement (p < 0.001). The mean value of Northwick Park Neck Pain Questionnaire on baseline was 45.79, on 7th day
it was 23.57, which further decreased to 17.32 on 14th day showing statistically significant decrease (p < 0.001). The significant improvement
was revealed in all the parameters of the SF-36 health survey (p < 0.001).
Conclusion: Jambira Pinda Sweda have been shown to be an effective local Ayurvedic treatment for cervical spondylosis. During the study, no
adverse effect was noticed; hence, it proved to be a safe treatment.
Keywords: Cervical spondylosis, Jambira Pinda Sweda, Radiculopathy.
Journal of Research in Ayurvedic Sciences (2020): 10.5005/jras-10064-0103

I n t r o d u c t i o n​ 1–3,6,7
Central Ayurveda Research Institute for Cardiovascular Diseases,
Punjabi Bagh, New Delhi, India
Cervical spondylosis is a chronic and progressive degenerative 4
condition that affects the neck. The cervical spine refers to the seven Regional Ayurveda Research Institute for Urinary Disorders, Jammu,
small vertebrae that form the neck in which soft discs between the Jammu and Kashmir, India
5
vertebrae provide cushioning. During the initial phase of cervical National Ayurveda Research Institute for Panchakarma,
spondylosis, changes such as disc desiccation, reduction in disc Cheruthuruthy, Kerala, India
8–13
height and progressive reduction in the ability to bear axial loads, Central Council for Research in Ayurvedic Sciences, Janakpuri, New
is seen. Following this, laxity of soft-tissues within and around the Delhi, India
disc occurs resulting in disharmony of structural and mechanical Corresponding Author: Sakshi Sharma, Central Ayurveda Research
integrity of cervical spine. Eventually, a cascade of events are Institute for Cardiovascular Diseases, Punjabi Bagh, New Delhi, India,
set into motion that fluctuates along further degeneration and Phone: +91 9654165662, e-mail: drsakshi.sharma87@[Link]
compensatory tissue adaptation. As a compensatory mechanism, How to cite this article: Sharma S, Makhija R, Dua M, et al. Evaluation of
development of osteophytes also occurs. Cervical spondylosis is the Effect of Jambira Pinda Sweda in Cervical Spondylosis w.r.t. Clinical
also known as arthritis or degenerative osteoarthritis of the neck Symptomatology. J Res Ayurvedic Sci. 2020;4(1):18–25.
and cervical osteoarthritis. This condition progresses with age and Source of support: Nil
other causative factors include neck injuries, work-related activities Conflict of interest: None
that put extra strain on the cervical region, holding the neck in an
uncomfortable position for prolonged periods or repetitive stress,
genetic factors, smoking, being overweight, and physical inactivity. and trouble in keeping body balance. In later stages, spondylotic
With these factors, over a period of time, the discs get thinner, and changes may result in stenosis of the spinal canal, lateral recess, and
their ability to absorb shock is lost, because intervertebral discs lose foramina. Spinal canal stenosis can lead to myelopathy, whereas the
hydration and elasticity with age and these losses lead to cracks stenosis of lateral recess and foramina may cause radiculopathy1
and fissures. Symptoms of cervical spondylosis include pain in the with the symptoms of sensation of “pins and needles” in the
neck that may radiate to arms or shoulders, headaches, weakness in extremities, pain in the limbs, stiff neck, and headaches (mostly
limbs, numbness in shoulders, arms, or hands, stiffness in the neck, on back of the head).

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org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to
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 Effect of Jambira Pinda Sweda in Cervical Spondylosis

In Ayurveda, cervical spondylosis can be correlated with O b j e c t i v e​

Sandhigata Vata. Sandhigata Vata is mentioned under Vata Vyadhi.
To evaluate the effect of Jambira Pinda Sweda in cervical spondylosis
As per classics, Nidana Sevana (etiological factors) aggravates
(Grivagraha) with special reference to symptomatology.
Vata and this Prakupita (vitiated) Vata accumulates in Rikta Strotas
(∼empty channels) to give rise to various generalized and localized
diseases. In case Vata Dosha is vitiated in Griva Asthi Sandhi (cervical M at e r ia l s and M e t h o d s​
joint), it leads to Griva Asthi Sandhigata Vata and can be diagnosed Study Design
as a Grivagraha. Some of the Lakshanas (symptoms) of Kupita It was an interventional, open-label, prospective study executed
Anila (vitiated Vata) are similar to the signs and symptoms of in 2017 at two peripheral institutes of the Central Council for
Grivastambha (neck stiffness). These are Pani-Prishtha-Shirograha Research in Ayurvedic Sciences (CCRAS), namely the Central
(spasticity in leg, back, and head), Gatrasuptata (numbness), Ayurveda Research Institute for Cardiovascular Diseases (CARICD),
Grivayahundanam (cervical dystonia), Bheda (breaking pain), Toda Punjabi Bagh, New Delhi, and the National Ayurveda Institute
(pricking pain), and Arti. for Panchakarma (NARIP), Cheruthuruthy, Kerala. After obtaining
The pathogenesis of Sandhigata Vata as described in Ayurvedic necessary clearance from the institute ethical committee (IEC) (F.
classics is as follows: No. 6-21/2012-ACRI/Tech./IEC/217; dt. 23.05.15 and F. No. 3/1/2014-
• Nidana​(etiology): According to Acharya Charaka, Vata get NRIP/Tech.; dt. 08.06.15) of both participating centers, the study
aggravated by improper food habits, untimely eating, fasting, was registered prospectively under Clinical Trials Registry—India
and undisciplined lifestyle; stress and worries, sleep disturbances; (CTRI/2015/10/006300).
excessive indulgence in physical exercises, workout, and sexual
act; excessive emaciation because of worry, grief, and affliction Study Participants
by disease; forcible suppression of or expulsion of natural urges; In present study, total 60 participants (30 at each center) of either sex
and injuries to marmas, uncomfortable rides, and movements.2 aged between 30 years and 65 years were recruited after obtaining
• Purvaroopa​(premonitory sign): There are no Purvaroopa for the informed written consent. Total study period was of 6 months
Sandhigatavata mentioned in Samhita. with recruitment period of 5 months.
• Roopa​ (symptoms): Shotha (swelling), Shoola (pain), Vata Purna
Inclusion Criteria
Druti Sparsha (palpable as air-filled bag), Prasarane Akunchane
Vedana (pain during flexion and extension),2 Hanti Sandhigata Participants of either sex aged between 30 years and 65 years,
Pravritti (abolish/restrict activities of joint)3 diagnosed as cervical spondylosis with clinical and radiological
• Samprapti​(pathogenesis): Various etiological factors that vitiate evidence with or without cervical radiculopathy.
Vata cause increase in Rukshata (dryness), Kharata (hardness/
Exclusion Criteria
roughness) in Srotasa, and undergo Sthanasamsraya in Greeva
Sandhi Pradesha, where it gradually result in Griva Sandhigata • Age below 30 years and above 65 years.
Vata resulting in the manifestation of symptoms as mentioned • Cases of cervical spondylosis with intractable pain, neurological
above.4 deficit, severe deltoid, or wrist extensor weakness.
• Patients with acute cervical pathology apart from cervical
The conventional managements for cervical spondylosis
spondylosis excluding any clinical evidence of cervical
are physical therapy/physiotherapy, ice or heat, collar, etc.
spondylotic myelopathy.
In contemporary science, muscle relaxants, narcotics (like
• Patients with poorly controlled hypertension (>140/90 mm
hydrocodone), steroid injections, and NSAIDs. If the condition is
Hg), patients with poorly controlled diabetes mellitus having
severe and does not respond to other forms of treatment, it may need
HBA1c >7.0%.
surgery but it is most often associated with various and sometimes
• Patients who have a past history of any type of cardiovascular
severe complications.
disease, patients with any hepatic or renal disorder, with liver
In Ayurveda, various modes of treatment are mentioned for
enzymes twice the normal or serum creatinine >1.4 mg.
improvement in the signs and symptoms of cervical spondylosis,
specially the local treatments such as various types of Snehana
(oleation) and Swedana (sudation) are advocated for Vatavyadhis. Study Interventions
Jambira Pinda Sweda5 is also a modified form of Swedana, which Study intervention is the procedure, Jambira Pinda Sweda for 14
refers to the sudation performed by specially prepared bundles days daily in the morning time. Procedure compliance was assessed
packed with Jambira (Citrus limon (L.) Osbeck) fruit pieces. The word on 7th and 14th days and one follow-up without treatment was
Jambira Pinda is derived from two words: Jambira means lemon and done on 21st day.
Pinda means bolus. It is a modified type of Sankar Sweda (one type
of sudation) having Mridu (soft) and Snigdha Guna (unctous). With Preparations for Jambira Pinda Sweda
Snehana and Swedana, Vakra (cross) and Stabdha (stiff) body parts Ingredients for preparing the Potali (poultice) for Jambira Pinda
can be Namayita (flexed easily). The results of Snehana and Swedana Sweda are Jambira (C. limon chopped into pieces) 750 g along
are nourishment of Dhatus, increase in Agni-Bala, and increase in with Shatapushpa Choorna (powder of Anethum sowa Kurz fruits)
strength of the body. In light of above, the present clinical study has 250 g, Saindhava (rock salt) 30 g, and Haridra Choorna (powder of
been conducted to evaluate the role of Jambira Pinda Sweda for its Curcuma longa L. rhizome) 60 g fried in 100 mL of Mahanarayana
efficacy as well as safety in patients with clinical and radiological Taila6 for making Potali and it was also used for reheating the Potali
evidence of cervical spondylosis. in sufficient quantity.

Journal of Research in Ayurvedic Sciences, Volume 4 Issue 1 (January–March 2020) 19

 Effect of Jambira Pinda Sweda in Cervical Spondylosis

Preparation of Potali examination; Visual Analogue Scale (VAS); Northwick Park Neck
Sliced lemon and other ingredients are fried in 100 mL Mahanarayana Pain Questionnaire; and SF36 Questionnaire were recorded into the
Taila till brown color appears, and then divided into four equal parts predesigned case report forms (CRFs). During the treatment on the
and made into Potalis accordingly. 7th day, progress of the treatment was assessed and similarly at the
end of the treatment, i.e., 14th day. A follow-up without treatment
Preoperative Procedure was done on the 21st day where physical examination and clinical
The participants selected for the study were seated with legs assessment, VAS, Northwick Park Neck Pain Questionnaire, and SF36
extended in a Droni (a specific table) and Abhyanga (external Questionnaire were assessed (Flowchart 1).
oleation) was performed with Mahanarayana Taila all over the body At the study site, data of all the patients were recorded in
for about 10 minutes and then Talam is applied on center of the predesigned CRFs and were also entered in electronic formats
head with 10 mL Ksheerabala Taila.7 Talam is a procedure of retaining (e-formats) designed in MS-Excel with many data validation checks
medicines over the center of the head, which is done before doing to ensure correct data entry. The e-formats and xerox of the CRFs
almost all Ayurvedic procedures to protect body from temperature along with the laboratory investigations reports of the patients
variations during the main treatment. were sent by the participating centers to the council’s headquarters
timely for the purpose of clinical trial monitoring.
Procedure
Out of the four prepared Potalis, two Potalis were heated up to Outcomes
40–45°C by keeping on the hot pan containing Mahanarayana The primary outcome measures were analyzed as mean change in
Taila. These Potalis are applied to the patients as per the general VAS and Northwick Park Neck Pain Questionnaire.9 The secondary
procedure for about 30–45 minutes. Care was taken to maintain the outcome measure was change in quality of life (QoL) that was
temperature throughout the procedure by reheating the Potalis. assessed by the SF-36 Health Survey Questionnaire.10

Postoperative Procedure Statistical Analysis

After the procedure, the body was wiped with clean towel, Primary outcome and secondary outcome measures, i.e., VAS Score,
Talam was removed, and Rasnadi Choorna8 (5 g) was applied. The Northwick Park Neck Pain Questionnaire, and SF-36 health survey,
participants were advised to take complete rest for half an hour were analyzed as mean change in the response from baseline to
to one hour. 14th day and follow-up at the end of 21st day by using paired t-test.
A p value of less than 0.05 was considered significant. Symptomatic
Study Procedure relief was assessed as percentage change in terms of presence of
On the baseline day (0 day), general information—(personal any symptom from baseline to end of the treatment. The statistical
identification and demographic profile); physical and systemic analysis was done using SPSS version 15.0.

Flowchart 1: Study schedule

20 Journal of Research in Ayurvedic Sciences, Volume 4 Issue 1 (January–March 2020)

 Effect of Jambira Pinda Sweda in Cervical Spondylosis

Flowchart 2: Outflow of the patients in the study Table 1: Demographic profile (n = 59)
Age group
 30–40 18 (30.5)
 41–50 26 (44.1)
 51–60 12 (20.3)
 61–65 3 (5.1)
Sex
 Male 18 (30.5)
 Female 41 (69.5)
Marital status
 Married 56 (94.9)
O b s e r vat i o n s  Unmarried 2 (3.4)
Out of the total 60 patients enrolled in the study, one dropped out  Widow(er) 1 (1.7)
during the course of the study. Hence, data of a total 59 patients Educational status
were used for statistical analysis (Flowchart 2).  Illiterate 4 (6.8)
It was observed that majority of the patients were in the age
  Read and write 55 (93.2)
group of 41–50 years (44.1%) followed by age group 30–40 years
Present occupation
(30.5%). Maximum patients were female (69.5%) and 30.5% were
  Desk work 11 (18.6)
male. About 94.9% of the patients were married. About 93.2%
  Field work with physical work 14 (23.7)
of the patients were literate and 6.8% were illiterate. Present
  Field work 7 (11.9)
occupationwise, 18.6% were engaged in desk work followed by
 Housewife 27 (45.8)
23.7% field work with physical labor, 11.9% field work, and 45.8%
housewives. Socioeconomically, 61.0% patients were above Nature of occupation
poverty line followed by 39% below poverty line. About 54.2% of   Heavy labor 3 (5.1)
the patients were living in urban area followed by 40.7% in rural   Moderate labor 41 (69.5)
area. Hindu religion dominated the sample size 84.7% followed by   Office job 6 (10.2)
Muslim (11.9%) and 1.7% each of Sikh and Christian. About 66.1% of  Sedentary 9 (15.3)
the patients were nonvegetarian and 33.9% vegetarian. About 6.8% Socioeconomic status
of the patients were addicted to smoking, 5.1% to alcohol, and 88.1%   Above poverty line 36 (61)
had no such addiction. About 57.6% of the patients had normal   Below poverty line 23 (39)
sleep pattern while 42.4% had abnormal. About 81.4% patients Habitat
had regular bowel habits and 18.6% had irregular. About 69.5%  Urban 32 (54.2)
patients were doing moderate labor followed by 10.2% of office job  Semiurban 3 (5.1)
and 5.1% patients doing heavy labor. About 74.6% patients showed  Rural 24 (40.7)
average emotional stress while 25.4% moderate (Table 1). By general Religion
physical examination at the baseline, it was observed that 59.3%  Hindu 50 (84.7)
patients were average built, 37.3% were well-built, and 3.4% were  Muslim 7 (11.9)
emaciated and 54.2% patients were moderately nourished, 44.1%  Sikh 1 (1.7)
were well nourished, and 1.7% were malnourished (Table 2). The  Christian 1 (1.7)
average weight of the patient was 65.32 kg where maximum weight History of present illness
being 111 kg. The mean body mass index (BMI) was 26.17 kg/m,2  No 49 (83.1)
mean respiratory rate was 18.27, and mean pulse rate was 74.83.  Yes 10 (16.9)
The mean systolic blood pressure was recorded as 121.08 mm Hg Dietary habits
and mean diastolic blood pressure was 80.78 mm Hg (Table 3). On  Vegetarian 20 (33.9)
examination, 69.50% patients were not having any problem in other  Nonvegetarian 39 (66.1)
joints than vertebral column while 30.50% patients were having
Addiction
problem in other joints also.
 Smoking 4 (6.8)
R e s u lts​  Alcohol 3 (5.1)
 None 52 (88.1)
Mean value of VAS on baseline was 6.90, on 7th day it was 3.37 and Sleep pattern
decreased up to 2.57 on 14th day and 2.08 on 21st day showing  Normal 34 (57.6)
significant improvement while paired difference was 3.525, 4.373,
 Abnormal 25 (42.4)
and 4.814 on 7th, 14th, and 21st day, respectively, which is also
Bowel habits
statistically significant (p < 0.001) (Table 4).
 Regular 48 (81.4)
Mean value of the Northwick Park Neck Pain Questionnaire on
 Irregular 11 (18.6)
baseline was 45.79; on 7th day it was 23.57, which further decreased
Status of emotional stress
to 17.32 on 14th day and 15.42 on 21st day showing improvement
 Average 44 (74.6)
while paired difference was 22.22 on 7th day, 28.47 on 14th day
of the treatment, and 30.37 on 21st day, which was statistically  Moderate 15 (25.4)
significant (p < 0.001) (Table 5). Values as expressed as n (%)

Journal of Research in Ayurvedic Sciences, Volume 4 Issue 1 (January–March 2020) 21

 Effect of Jambira Pinda Sweda in Cervical Spondylosis

Table 2: Physical examination (n = 59) Table 6: Effect of treatment on SF36 questionnaire (n = 59)
Parameter Mean (SD) Paired
Status of built Domain Mean value difference t value p value
 Average 35 (59.3) Physical functioning
 Emaciated   2 (3.4)  Baseline 58.05 (22.457) – – –
 Well-built 22 (37.3)   14th day 76.61 (18.252) −18.559 10.494 <0.001
(13.584)
Status of nutrition
  21st day 80.71 (17.979) −22.119 9.323 <0.001
  Moderately nourished 32 (54.2)
(18.223)
 Malnourished   1 (1.7) Role limitations due to physical health
  Well nourished 26 (44.1)  Baseline 8.47 (22.257) – – –
  14th day 64.41 (39.720) −55.932 10.881 <0.001
Table 3: General examination (n = 59) (39.485)
Parameter Mean (SD)   21st day 72.88 (37.797) −64.407 12.371 <0.001
Weight (kg)   65.32 (12.883) (39.99)
BMI (kg/m2) 26.171 (4.9556) Limitations due to emotional problems
Respiratory rate (per minute)   18.27 (0.762)  Baseline 31.64 (45.242) – – –
Pulse rate (per minute)   74.83 (10.277)   14th day 78.53 (37.533) −46.89 7.568 <0.001
Systolic blood pressure (mm Hg) 121.08 (16.992) (47.594)
Diastolic blood pressure (mm Hg)   80.78 (5.079)   21st day 83.04 (34.677) −51.402 8.426 <0.001
(46.86)
Energy/fatigue
Table 4: Effect of treatment on VAS (n = 59)
 Baseline 48.47 (16.822) – – –
VAS Mean value Paired difference t value p value   14th day 63.22 (17.139) −14.746 7.146 <0.001
Baseline 6.90 (1.517) – – – (15.85)
7th day 3.37 (1.541) 3.525 (2.062) 13.13 <0.001   21st day 68.22 (17.733) −19.746 8.353 <0.001
14th day 2.53 (1.356) 4.373 (1.77) 18.972 <0.001 (18.157)
21st day 2.08 (1.725) 4.814 (2.004) 18.449 <0.001 Emotional well-being
Values as expressed as mean (SD)  Baseline 58.24 (15.970) – – –
  14th day 69.97 (14.600) −11.729 7.237 <0.001
Table 5: Effect of treatment on northwick park neck pain (12.448)
questionnaire (n = 59)   21st day 63.83 (16.109) −15.593 7.537 <0.001
Northwick (15.891)
park neck pain Paired Social functioning
questionnaire Mean value difference t value p value  Baseline 59.75 (22.513) – – –
Baseline 45.7972 – – –   14th day 76.48 (16.752) −16.7373 7.564 <0.001
(15.44889) (16.995)
7th day 23.5719 22.22525 13.025 <0.001   21st day 81.14 (16.144) −21.398 8.229 <0.001
(14.63754) (13.10678) (19.975)
14th day 17.3208 28.47644 17.266 <0.001 Pain
(10.93011) (12.66831)  Baseline 51.36 (15.045) – – –
21st day 15.4252 30.37203 13.631 <0.001   14th day 73.90 (14.2211) −22.5458 9.656 <0.001
(12.34109) (17.11513) (17.9348)
Values as expressed as mean (SD)   21st day 77.80 (14.3450) −26.5254 −10.5 <0.001
(19.4981)
The quality of life was assessed by the SF-36 Health Survey General health
Questionnaire, which showed significant improvement in its every  Baseline 40.08 (15.100) – – –
domain, i.e., physical functioning (18.559), role limitation due to   14th day 60.68 (15.438) −20.593 10.464 <0.001
physical health (55.93), limitations due to emotion problem (46.890), (15.117)
energy fatigue (14.746), emotional well-being (11.729), social   21st day 65.93 (15.770) −25.847 12.122 <0.001
functioning (16.73), pain (22.54), and general health (20.59). The (16.378)
improvement in each domain of SF36 was statistically significant
Values as expressed as mean (SD)
(p < 0.0001) (Table 6).

Safety Profile
The procedure has proven to be harmless, safe, and effective. No D i s c u s s i o n​
adverse effects or allergic outbursts were observed during the Cervical spondylosis is a chronic progressive degenerative
treatment. condition; its symptoms increase with advancing age. Analgesics,

22 Journal of Research in Ayurvedic Sciences, Volume 4 Issue 1 (January–March 2020)

 Effect of Jambira Pinda Sweda in Cervical Spondylosis

anti-inflammatory agents, antidepressants, strategies to improve also decreases the Stambha and releases the pain. Saindhava
posture, and stress management are widely used conventional Lavana is Tridoshaghana and well known for Sadhyasnehana
methods of providing symptomatic relief. The Cochrane review due to its Sukshma and Snigdha Guna.19 It helps to dissolve and
group advocates that a combination of exercise, mobilization expel the Doshas and relieve joint stiffness. Rasandi Choorna is
physiotherapy, and manipulation are more effective treatment also a Vata-kaphahara drug. Throughout, the procedure Talam
modalities. Other modalities like acupuncture, traction, with Ksheerabala Taila was done as maintains the normal body
electrotherapy, and psychotherapy are also conventionally used temperature during the procedure.
but are of uncertain value.11 During the procedure, the heat produced by the medicated
In Ayurveda, various indigenous drugs and procedure bolus increases the temperature by 2–3° in specific areas of the
are used including Snehapana, Upanaha, Agnikarma, Taila body, which significantly helps in vasodilatation and improves local
Abhyanga, Virechana Karma (therapeutic purgation), Basti Karma blood supply. Thereby significantly reducing the inflammation,
(therapeutic enema), and classical drugs like Simhanada Guggulu, pain, and stiffness in the neck region and associated symptoms,
Mahavatavidhwamsa Rasa, Ashwagandha Choorna (powder of which are evident by VAS and Northwick Park Neck Pain
Withania somnifera (L.) Dunal roots), Shunthi Choorna (powder Questionnaire (Tables 3 and 4). The improvement was also seen in
of Zingiber officinale Roscoe rhizome), etc., for management each domain of SF36 Questionnaire, such as physical functioning,
of Sandhigata Vata. The effect of Ayurvedic local treatment pain, energy fatigue, general health, etc. (Table 5), which overall
procedures like Snehana, Swedana, Griva Basti, Patra Potali Sweda, proves that Jambira Pinda Sweda is an effective local remedy in the
Pinda Swedana, etc., has shown significant results in reducing management of clinical symptoms of cervical spondylosis.
symptomatology of Sandhigata Vata, which has been proved by
various clinical researches.12
A clinical study to assess effect of Grivabasti with Karpasasthyadi
C o n c lu s i o n​
Taila in cervical spondylosis revealed statistically significant The present study was intended to explore the role of Ayurvedic local
results.13 Conclusive results from a study of year 2013 shows that the treatment Jambira Pinda Sweda in relieving the symptomatology in
combined effect of Griva Basti, Patra Potali Sweda, and Nasya (nasal cervical spondylosis. It has been observed that the local treatment
instillation) can offer benefits to reducing symptoms of cervical in the form of Jambira Pinda Sweda has shown considerable
spondylosis.14 Another clinical study states that Tikta Kshira Basti improvement in the scoring of VAS, Northwick Park Neck Pain
can offer good benefit in neurological manifestations of cervical Questionnaire, and SF36 Questionnaire after treatment. It has
spondylosis like tingling sensation, numbness, diminished muscle proven that Jambira Pinda Sweda considerably reduces pain,
power, and diminished reflexes whereas Patrapinda Sweda can do stiffness, and associated symptoms of cervical spondylosis. Hence,
better to relieve pain, tenderness, stiffness, vertigo, and restricted this study concludes that Jambira Pinda Sweda can be considered as
movements.15 a safe and effective line of treatment for management of the disease.
Jambira Pinda Swedana was used in a clinical study with oral
medication, i.e., Yogaraja Guggulu, Mahavatavidhwansa Rasa,
Ashwagandha Choorna, Shunthi Choorna, Maharasnadi Kwatha, References
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the main ingredient of the Potali is Amla Rasatmaka (sour in taste)
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performing Jambira Pinda Potali Swedana, local Abhyanga with of AYUSH, Ministry of H & FW, Govt. of India; 2000. p. 132.
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that are demulcent, anodyne, and have strengthening effect on 9. Leak AM, Cooper J, Dyer S, et al. The northwick park neck pain
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