Nirgundi Lashunam Shigru Kashaya in the management of Avabahuka (frozen shoulder): A single case study

Abstract

Avabahuka is a type of Vatavyadhi caused by vitiated Vata Dosha and associated with Kapha Dosha. It closely resembles frozen shoulder and significantly affects the quality of life of the patient. This case study focuses on the management of Avabhahuka using Nirgundi Lashunam Shigru Kashaya, as mentioned in traditional text Sarasamkshepaya. A 59-year-old female presented to the National Ayurveda Hospital, Sri Lanka, with right shoulder pain (Shoola), stiffness (Sthabdhata), and restricted movements (Bahupraspanditahara) for one month. This clinical condition was diagnosed as Avabahuka. The treatment duration was 14 days, during which she was administered Nirgundi Lashunam Shigru Kashaya, 120 mL twice daily before meals. Assessment included both subjective and objective parameters. The range of movement was assessed by using a goniometer, whereas functional ability was assessed using the Shoulder Pain and Disability Index (SPADI). Initial investigations revealed an ESR of 68/mmh and mild degeneration of the acromioclavicular (AC) joint on X -ray. Following the treatment, the patient experienced complete pain relief, significant reduction in stiffness, improved shoulder function without support. The range of motion improved, with flexion increasing 100° to 180°, extension 15° to 50°, abduction 100° to 180° and both internal and external rotation 15° to 90°. SPADI score showed marked improvement, with pain reduced from 76% to 16%, disability from 87.5% to 16.25%, and the total score from 83% to 15.38%. ESR was reduced to 37/mmh, indicating a decrease in inflammatory activity and no change was observed in the X-ray findings. This case suggests that Nirgundi Lashunam Shigru Kashaya is effective in the management of Avabhahuka. Further clinical studies with larger samples are recommended to validate these findings.