Management of Grade II osteoarthritis (Azhal kilvayu) utilizing Siddha internal and external treatment modalities (Varmam and Thokkanam): A case report

Abstract

A 59-year-old female patient visited the clinic with complaints of pain in both knee joints, along with mild swelling that had persisted for three months. Radiographic examination revealed Grade II knee osteoarthritis (OA). Her treatment plan included Siddha therapeutic purgation (Agathiyar kulambu), Siddha internal medications (Parangipattai maathirai, Sangu Parpam maathirai), and Siddha external therapies (Varmam and Thokkanam). Vata Kesari tailam was specifically selected for Thokkanam therapy. Remarkably, the Knee Injury and Osteoarthritis Outcome score significantly improved from 19 before treatment to 85 by day 60. The visual analogue scale score also revealed a substantial reduction in pain throughout the treatment period, dropping from eight to two points after the intervention. This notable improvement reflects not only a decrease in pain but also a significant increase in the patient's overall quality of life. Specific metrics indicate considerable progress in critical areas, including activities of daily living (ADL) and participation in sports and recreational activities. The findings of this case report elucidate a noteworthy therapeutic approach for managing osteoarthritis (Azhal kilvayu). The case illustrates a comprehensive approach that combines conventional diagnostic assessments with Siddha therapeutic interventions.