Patra Pinda Sweda: Ela Kizhi massage Preparation, Procedure, Benefits

Article by Dr Raghuram Y.S. MD (Ay)
We all represent a miniature nature. All elements in the nature are represented within us in a micro-form. Example – According to Ayurveda the wind is represented in the body in the form of Vata or Vayu, the fire is represented in the form of Pitta and water is represented in the form of Kapha. There are many such comparisons done between the macro-nature and micro-nature within us. When these micro-elements are imbalanced, we replace them or balance them by using the elements of macro-elements of nature. This forms the secret of Ayurvedic treatment. We bring about a balance in the micro-nature of our body by making skillful use of macro-elements of the nature. The key is ‘best utilization of nature in psycho-somatic healing’

Almost all medicines used in Ayurveda are derived and procured from the nature. It includes medicines used for oral consumption and also those used for treatments (Panchakarma detoxification treatments) and external therapies.

Patra Pinda Sweda or Ela Kizhi is one of the best example wherein we use the herbal drugs or leaves of medicinal plants obtained from nature for external treatments, to heal pains and related conditions and strengthen & rejuvenate joints, muscles and soft tissues.

Patra Pinda Sweda or Ela Kizhi is a form of sweat inducing therapies (fomentation, sudation, steaming treatment).

Swedana or fomentation (sudation, sweat inducing treatments, steaming treatment) is a specialized treatment of Ayurveda which helps in providing unparalleled relief in pain, swelling and stiffness associated with diseases like Amavata vis-à-vis Rheumatoid arthritis, Sandhigata Vata (Osteoarthritis), Kati Shula (Low back pain) etc.

Patra Pinda Sweda (Elakizhi) is a form of swedana which is included under the category of Pinda Sweda (bolus fomentation). In this procedure we use heated or oil fried leaves of medicinal plants tied in a bolus to provide heat to the pain afflicted joints or body parts, especially in diseases like Osteoarthritis, Rheumatoid Arthritis, Lumbar spondylosis, Cervical spondylosis, Musculoskeletal pains, Myalgia etc.

Before going into details of about Valuka Sweda and the method of doing it, I would like to give a brief introduction of Swedana in a few paragraphs

Swedana

Swedana –
स्तंभ गौरव शीतघ्नं स्वेदनं स्वेद कारकम्। (च.सू.२२/१२)
Stambha gaurava sheetaghnam swedanam sweda kaarakam (Ref-Charaka sutra sthana 22/12)

Swedana is a treatment procedure in which sweat is induced by application of heat and warmth in the form of steam or by bringing the body / body parts in contact with heated medicaments (powders, leaves, processed rice, sand etc) made into a bolus(potalli). Swedana provides relief from Stambha (stiffness and catches), Gaurava (heaviness) and Sheeta (coldness) in the body or body parts.

Swedana is said to be the best form of treatment in expelling morbid Vata and Kapha and also destroying the diseases manifested due to morbid Vata and Kapha.

Swedana is usually done after Abhyanga and or Snehana (administration of medicated oils and ghee for oral consumption in metered doses, as a pre-treatment procedure for cleansing treatments like Vamana – Therapeutic vomiting and Virechana – Therapeutic purgation.

After Swedana, the body starts sweating, we feel lighter and energetic, the cells get activated and flush the toxins away. The cellular metabolism improves and we feel light and at ease.

There are many types of Swedana as explained in Ayurvedic texts. There are about 13 types of Sagni Sweda’s (sweat inducing treatments administered by procedures involving utilization of fire or heated materials) and 10 types of Niragni Sweda (sweat inducing treatments where in the fire or heated materials are not utilized ex. sleeping by covering the body with thick blankets until we sweat etc).

Again, Swedana can be done in 2 ways – Ruksha Sweda (dry fomentation) and Snigdha Sweda (wet fomentation or sweat inducing treatment done after giving oil massage or by using the medicinal drugs which are processed or fried in herbal oils). In some pathological conditions both forms can be skillfully combined as and when required. In conditions where pain and associated symptoms are due to ama (metabolic toxins having a sticky nature, tending to block the transport systems of the body and cause painful conditions), meda (contaminated or accumulated fat) and or kapha (morbid kapha) we generally prefer doing Ruksha Sweda or dry fomentation. In conditions where the pain and related symptoms are due to vitiation of only morbid Vayu, we generally prefer Snigdha Sweda (wet or unctuous fomentation)

Every form of Sweda can provide relief from pain, stiffness and swelling. But their area of utilization and the diseases and pathological conditions in which they are administered or preferred will differ. In this context I would limit my discussion to Valuka Sweda (sand bag fomentation or sand bolus fomentation)

Note –
Ama means metabolic wastes created by low metabolism and indigestion which have a sticky nature and has a tendency to produce pain and stiffness.
Meda means fat.
Patra Pinda Sweda falls into the category of Snigdha Sweda and Pinda Sweda.

Pinda Sweda

Pinda Sweda (Bolus Fomentation) –
Pinda means bolus, Sweda means inducing sweating. Thus in Pinda sweda, the medicaments, generally hot or boiled to tolerable temperature are tied in a cloth so as to make a bolus. The bolus is gently rubbed over the painful area. Heat is provided until sweating occurs.

Pinda sweda is generally done as a local fomentation, applied on the pain afflicted body parts. It can be expanded so as to cover the entire body also. There are many variants of Pinda sweda, the name is given on the basis of the material / medicaments tied within the bolus.

Example – Patra Pinda Sweda (leaves of medicinal plants which can relieve pain, stiffness and swelling are used in the bolus), Churna Pinda Sweda (herbal powders prepared by pounding the medicinal drugs which can relieve pain and associated conditions are tied in the bolus), Valuka Sweda (heated sand is tied in the bolus) etc.

Patra Pinda Sweda

What is Patra Pinda Sweda?
Patra means leaves, Pinda means bolus, Sweda is sweat, Swedana is sweat inducing treatment.

Patra Pinda Sweda is a treatment in which leaves of medicinal plants having analgesic, anti-degenerative and anti-inflammatory properties are used for fomentation (sweat inducing) of painful parts

In this treatment, the leaves of medicinal plants having analgesic and anti-inflammatory properties are heated or fried in herbal oils to tolerable temperature and tied in a bolus. The bolus is heated in a pan or dipped in herbal oils being heated at a constant temperature in pans. The heated bolus is continuously rubbed over the pain afflicted areas. This treatment is generally preferred in the absence of ama (intermediate products of digestion and cell metabolism, circulating or tissue toxins which get adhered in the cells due to their sticky nature, block the channels and transport systems of the body and cause pain and stiffness) or done after getting rid of ama through treatment procedures like Valuka Sweda (sand bolus fomentation) or Udwarthana (massage in an upward direction usually done with herbal powders).

Patra Pinda Sweda is an unparalleled treatment in Vata morbidity or any disease or painful conditions caused by morbid Vayu, usually degenerative diseases. Leaves which can pacify morbid Pitta are used in the bolus for tackling inflammatory diseases of joints and soft tissues. Morbid Kapha and its symptoms like catches, heaviness, coldness etc can be got rid of by using Kapha destroying leaves in the bolus.

Indications

In which conditions is Patra Pinda Sweda used?
Patra Pinda Sweda is used mainly to provide relief from pain, inflammation, swelling and stiffness (catch) associated with bone, joint and or musculoskeletal pains. Many times it also acts as a disease-modifier wherein it provides a substantial relief of more than 90% and a long standing one too. It is more effective when combined skillfully with Abhyanga (massage with herbal oils), Kati Vasti (oil pooling for low back pains), Greeva Vasti (oil pooling for neck pains) etc treatments.

Patra Pinda Sweda is used in the treatment of –

Osteoarthritis (Sandhigata Vata) – Osteo means bones and Arthritis means painful inflammation and stiffness of the joints. Osteoarthritis is the common form of arthritis. It afflicts millions of people throughout the world. Osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over a period of time i.e. it results from the breakdown of joint cartilage and underlying bone. OA can affect and damage any joint in the body.

Joints of the hands, Joints near the finger ends, base of the thumb, neck, lower back, hips, knees and spine are commonly afflicted by osteoarthritis. Joints on one side of the body are often more affected than those on the other. Unlike other types of arthritis, only joints are typically involved in OA.

The most common symptoms are joint pain and stiffness. Joint swelling and decreased range of movements are also present in many cases.

Rheumatoid Arthritis (Amavata) – It is a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet and ankles. It has an autoimmune component also. Initially Valuka Sweda (sand bolus fomentation) is done to get rid of ama and morbid kapha. Patra Pinda Sweda is administered in the next stage of the disease to rejuvenate and strengthen the joints and soft tissues.

Chronic stages of RA (Jeerna or pravruddha Amavata) – where the inflammation has subsided but pain has been left over

Musculo-skeletal pains as in myalgia and or fibromyalgia (Mamsagata Vata)

Low back pain or Lumbago (Lumbar spondylosis)

Sciatica (Gridhrasi) – Pain affecting the back, hip and outer side of the leg caused by compression of a spinal nerve root in the lower back is called Sciatica. It happens due to the effect of degeneration of intervertebral disc or discs causing compression on the Sciatic nerve.

Intervertebral disc protrusion or prolapse (IVDP) – is impinging or compressing on the nerves supplying the lower limbs. It presents with pain, numbness, pain extending down the limbs, pain worsening at night, muscle weakness, tingling, aching or burning sensations in the neck, back, legs and arm etc depending on the site of prolapse.

Sacroiliac Joint Syndrome or Sacroiliac Joint Dysfunction

Spondylolisthesis – is a forward displacement of a vertebra, especially a 5^th lumbar vertebra. Generally it occurs following a fracture. It presents with back stiffness, tight hamstrings, leaning forward posture, waddling gait and generalized lower back pain with intermittent shooting pain from buttocks to the posterior thigh and or lower leg via sciatic nerve.

Internal derangements (ex. meniscal tears) – The onset meniscal tears is usually acute and debilitating, with preceding trauma can be minor. Patients may describe true locking (normal flexion, but an inability to extend the affected knee).

Bursitis – Greater trochanteric bursitis in the hip and pes anserine bursitis in the knee present with pain over the lateral aspect of the hip and over the medial aspect of the knee respectively. There is also local tenderness in these areas that is usually absent in simple OA.

Cervical spondylosis – Neck pain due to damage of neck bones and joints or osteoarthritis of neck bones

Whiplash – neck pain caused when a person’s head moves backward and then suddenly forward with great force.  Whiplash presents with neck pain and stiffness, headaches, dizziness, blurred vision, ringing in ears etc.

Wry neck (Torticollis) – It is a painfully twisted and tilted neck. The top of the head in this condition generally tilts to one side and the chin tilts to the other side. Symptoms include, an inability to move your head normally, neck pain or stiffness, headache, having one shoulder higher than the other, swollen neck muscles, a tilting of your chin to one side.

Ankylosing Spondylitis – It is a form of arthritis which primarily affects the spine. It causes severe inflammation of the vertebrae that might eventually lead to chronic pain and disability. The disease will cause pain and stiffness in other parts of your body. Other large joints such as the shoulders, hips and knees can be involved as well.

Polymyalgia Rheumatica – It is an inflammatory disorder that causes pain and stiffness in various parts of the body. It commonly affects neck, shoulders, arms, thighs and hips.

Spinal stenosis – It is a condition in which the spinal column (backbone or spine) narrows and starts compressing the spinal cord. It is a gradual process. If the narrowing is minimal, no symptoms will occur. Too much narrowing can compress the nerves and cause problems. The symptoms include leg or arm weakness, lower back pain while standing or walking, numbness in legs or buttocks and balance problems.

Spina bifida (occulta) – It is a birth defect where there is an incomplete closing of the backbone and membranes around the spinal cord. It presents with leg weakness and paralysis, club foot, hip dislocation, bladder and bowel control problems etc

Coccydynia – Tail bone pain

Frozen Shoulder – Chronic pain and stiffness of the shoulder joint with limitation of range of movements, also known as adhesive capsulitis

Elbow pain due to various conditions like Tendinitis, Olecranon bursitis, elbow sprain, cellulitis, arthritis, nerve entrapment etc

Other conditions –
Iliotibial band syndrome – The ilio-tibial band is a band of rough tissue that runs from your hip down to the outer part of your knee. If it is irritated by overuse or other problems, it becomes inflamed and cause pain on the outer side of the knee.

Patello-femoral pain syndrome (Chondromalacia patellae) – This often results from issues associated with muscle imbalance, tightness and alignment of the legs, rather than an injury. Pain is present between the patella and the underlying thighbone (femur).

Loose bodies in the joints – Sometimes injury can break loose cartilages. These pieces can get stuck in the joint, causing it to freeze and producing pain and swelling.

Knee injuries: like ACL (Anterior cruciate ligament) injury, Torn Meniscus, Knee Bursitis, Patellar tendonitis etc
Old (chronic) joint injuries which was not properly treated
Sprained ligaments
Cartilage tears
Sports injuries
Sprains and strains
Pains and catches in the joints and spine (especially neck and low back) due to bad postures
Pain due to repeated trauma of bones, joints, muscles, soft tissues
Neuromuscular diseases and various musculoskeletal disorders

Note – In all the above said conditions, Patra Pinda Sweda should be carried out after doing Abhyanga (massage with medicated oils). Abhyanga and Patra Pinda Sweda forms a superb combo in relieving pain, stiffness and swelling caused due to many conditions. Patra Pinda Sweda is highly effective both in musculoskeletal and neuro-muscular diseases.

Procedure

How is Patra Pinda Sweda done?
Patra Pinda Sweda is done in the below said method –

Purvakarma

Purvakarma (Pre-treatment procedures): This includes –
Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined. After careful assessment, it is decided if Patra Pinda Sweda is suitable to the disease and diseased or not. The treatment line-up, materials and medicines which need to be used are enlisted.
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Preparation for the treatment:
Materials needed for the treatment are collected beforehand. They are:

Patra or leaves of medicinal plants having analgesic and anti-inflammatory properties – Since leaves with medicinal properties are the most important materials used in this treatment; we need to select the leaves which are suitable for the condition and patient we are handling. We need to collect leaves beforehand and have a stock of them.

The leaves should be taken from the plants or trees which have been grown in clean and fertile land and available in abundance. The leaves or the trees from which we procure the leaves should not be diseased or contaminated or infested with germs or worms. The leaves should be fresh. The whole leaves should be collected and not those which are torn or mutilated. The leaves shall be taken fresh from the plant directly and those which have shed down shall not be collected. The leaves needed for the treatment shall be collected on the previous evening of the treatment or on the day of the treatment itself. They shall not be collected and refrigerated. Every day, the leaves should be collected fresh and replaced with the used ones or the bolus itself shall be prepared fresh with fresh leaves on the day of treatment on a daily basis.

The leaves which are generally used in Patra Pinda Sweda are – Fresh leaves of pain killing and vata alleviating drugs like Eranda (Ricinus communis – castor plant), Nigundi (Vitex negundo), Arka (Calotropis gigantean), Chincha (tamarind), etc

Other ingredients – Lemon, coconut gratings, Rasnadi Churna, Haridra (Turmeric powder), Methika (fenugreek), Saindhava Lavana (rock salt), Eranda Taila (castor oil) etc for patra pinda sweda

Sterile clothes to tie the bolus
Thicker threads to tie the cloth into bolus after placing leaves in it
Pans for heating / frying the sand
Spoons for frying the leaves
Stove for heating
Sterile napkins or tissue papers for wiping
For Abhyanga (massage) – Taila (medicated oil), Ghee (medicated ghee) or both suitable to the disease and diseased are collected and stored beforehand. The same oils shall be used for frying or processing the leaves. Some effective oils used for Abhyanga are

Vishagarbha Taila,
Kottamchukkadi Taila
Murivenna
Mahanarayana Taila
Ksheerabala Tailam
Mahamasha tailam
Balashwagandhadi Tailam
Ashwagandhabalalakshadi Tailam
Sahacharadi taila
Pinda tailam
Tiktaka ghritam
Guggulutiktaka ghritam
Tila taila (sesame oil) etc

Materials needed to conduct local treatments like oil pooling (sthanika vasti’s like Kati Vasti for low back pain, Greeva Vasti for neck pain etc) like black gram flour etc

Medicines needed to conduct Virechana (therapeutic purgation) or Vasti (therapeutic enemas), enema cans and syringes, sterile cotton etc

Treatment procedures which are done in Purvakarma and also form effective combo’s with Patra Pinda Sweda –
Abhyanga or Samvahana – Good herbal oil massage
Kati Vasti – Oil pooling in the low back region for low back pain. Read more about Kati Basti
Greeva Vasti – Oil pooling in the cervical region (nape of the neck) for neck pain. Read more about Griva Basti
Prishta Vasti – Oil pooling to the whole spine
Janu Vasti – Oil pooling around the knee joints for knee joint pain and arthritis. Read more about Janu Basti
Valuka Sweda – Sand bolus fomentation in the initial or acute conditions of RA and stiffness of the thigh. Read more about Valuka Sweda

Pradhana Karma

Pradhana Karma (Treatment proper):
Patra Pinda Sweda (Leaf bolus fomentation) – Patra means leaves of medicinal plants, Pinda means bolus, Sweda means fomentation. As the name indicates sliced (chopped) leaves of medicinal plants having anti-inflammatory, anti-degenerative and analgesic properties are filled and tied in a sterile cloth so as to form a bolus.

The fresh leaves of the Vata alleviating / pain relieving herbs are collected and sliced into small pieces. Ex. Leaves of Eranda (Ricinus communis – castor plant),Nirgundi (Vitex nigundo), Arka (Calotropis gigantean), etc are sliced. The leaves are selected as per the disease and dosha involved in causing the disease or disorder.

The sliced leaves are put into non-stick pan.
Herbal oils (oils used for Abhyanga mentioned above) selected so as to suit (antagonistic) the disease and dosha involved in causing the pathology are taken in required quantities and put over the leaves (chopped) present in the pan

The leaves are thoroughly fried in herbal oils
Grated coconut, sliced lemon pieces, Rasnadi Churna (Kottamchukkadi, Grihadhumadi, Ellumnishadi etc), Haridra (Turmeric powder), Methika (fenugreek), Saindhava Lavana (rock salt), Eranda Taila (castor oil) are also added and fried.

The sliced leaves and the other ingredients which are fried and processed in the herbal oils are tied in a sterile cloth. The upper free ends of the clothes are tied with strong thick threads so as to form a bolus or Patra Pinda (Leaf bolus).

A couple of boluses are prepared for changing purposes (back up)
A pan is kept on the stove. The stove is ignited and kept in a mild flame. Medicated oils are poured in the pan and allowed to get hot.

The leaf bolus is dipped in warm oil; temperature of the bolus is tested and used for giving fomentation. Before rubbing the bolus over the afflicted painful body part of the patient, the bolus is wiped along the rim of the pan to rip off the excessive oil sticking to the bolus. If not, the excessive oil dripping from the bolus will spill all around and create inconvenience to the treatment procedure.

The bolus is rubbed on the affected part gently (as good as massaging with bolus).
Once the bolus gets cooled (as felt by touching the bolus with the hand), it is changed with another bolus which has been kept in the pan containing the oil. The bolus is repeatedly interchanged with the backup bolus throughout the treatment duration. The key is to maintain the temperature of the bolus.

The procedure is repeated many times for a period of 30-40 minutes.
Caution – Everyday the bolus is replaced or the leaves are replaced with fresh ones (including all the other ingredients like lemon slices etc.

The procedure is done till sweating occurs and the patient feels light and healthy or until the signs of proper fomentation have been achieved (Samyak Swinna or Swedana Lakshanas)

Samyak Swinna Lakshana

Signs of proper fomentation (Samyak Swinna or Samyak Swedana Lakshanas) –
शीत शूल व्यूपरमे स्तंभ गौरव निग्रहे।
संजाते मार्दवे च एव स्वेदनात् विरतिर्मता॥(सु.चि.१४/१३)
स्वेद स्रावो व्याधि हानिः लघुत्वं शीतार्थित्वं मार्दवः च आतुरस्य।
सम्यक् स्विन्ने लक्षणं प्राहुः एतान् मिथ्या स्विन्ने व्यत्यनेने एतदेव॥(सु.चि.३२/२३)
Sheeta shula vyooparame stambha gaurava nigrahe
Sanjaate maardave cha eva svedanaat viratirmataa (Ref – Sushruta Chikitsa 14/23)
Sveda sraavo vyaadhi haanihi laghutvam sheetaarthitvam maardavaha cha aaturasya
Samyak svinnae lakshanam praahuhu etaan mithyaa svinne vyatyyane etadeva (Ref – Sushruta Chikitsa 32/23)

Properly done sweating therapy brings about the below said signs –
Sheetoparama – The feeling of coldness pacifies
Shuloparama – Pacification of pain
Stambha nigraha – reduction of stiffness
Gaurava nigraha – reduction of the feeling of heaviness
Maardava – smoothness of the body or body parts
Sweda praadurbhaava – sweating of body or body parts subjected to fomentation
Roga lakshana prashamanam – Pacification or reduction of the symptoms of the disease
Sheetaartitvam – Liking towards cold foods and comforts

Care should also be taken so as to see that the patient is not subjected to excessive or deficit sweating

Aswinna Lakshana

Parameters for improper / less sweating (Asamyak / Heena Swinna / Aswinna Lakshana) – In this the symptoms opposite to those explained in the Ati Swinna Lakshana are manifested i.e.

Sheeto anuparama – no relief from the feeling of cold
Shula anuparamam – non-pacification of pain
Stambha anigraha – no relief from stiffness
Gaurava anigraha – no relief from heaviness
Amaardavam – lack of smoothness of the part
Aswedam – absence of manifestation of sweat
Alaghutvam – no feeling of lightness
Vyadhi anupashama – no relief from disease

Ati Swinna Lakshana

Parameters of excessive / over sweating (Ati Swinna Lakshana) –
Pitta prakopa – aggravation of pitta
Asra prakopa – aggravation of rakta
Trushna – thirst
Murcha – loss of consciousness
Svara sadana – weakness of voice
Anga sadana – weakness of the body
Bhrama – giddiness
Sandhi peeda – joint pains
Jwara – fever
Shyava-rakta mandala – brownish-red eruptions
Chardi – vomiting

Paschat Karma

Paschat Karma (Post-treatment procedures):
The body parts of the patient subjected to Patra Pinda Sweda is wiped with sterile cloth dipped and squeezed in warm salt water or wiped with tissue papers. The couch is also cleaned of leaf pieces.

The patient is asked to relax for a while

Snana – Patient is advised to take a refreshing hot water bath after going home or after a few hours if the patient is being handled as in-patient

Nitya Virechana – Daily metered dose of purgation with purgative decoctions or oils like Gandharvahastadi Kashayam, Gandharvahastadi Eranda tailam, Nimbamritadi Eranda Tailam etc can be administered if a small amount of detoxification is essential on a daily basis or if morbid Dosha’s need to be tackled (optional and strictly based on the decision of the doctor)

Vasti – Medicated enema’s can be combined with Patra Pinda Sweda especially in chronic conditions of OA etc diseases. A combination of Sneha Vasti (enemas with medicated oils and ghee) with Brihat Saindhavadi Taila or Guggulutiktakam Ghritam, Mahanarayana Tailam or Dhanwantaram tailam / mezhupakam / Sahacharadi tailam etc and Kashaya Vasti (Decoction enemas) with Erandamuladi Vasti or Dashamula Vasti or Mustadi Yapana Vasti is highly effective in Amavata and other musculoskeletal diseases. Lekhana Vasti’s (fat and kapha depleting enemas) can be done while managing obesity and diseases caused due to errors of fat metabolism which are causing stress on the bones, joints, soft tissues and muscles. These therapies can also be planned after finishing the course of Patra Pinda  Sweda. They can also be carried out in line with Patra Pinda Sweda

External and internal therapies / treatments can be planned individually or in combination depending on the severity of the disease,strength and tolerance of the patient.

Matra Vasti – daily metered doses of oil enema is given alongside Patra Pinda Sweda. Matra Vasti controls morbid Vata and Pitta, strengthens the bones, joints, muscles, soft tissues and soothes nerves.

Discharge – The patient is discharged on daily basis (out-patient) or after the course has been completed (in-patient) after giving proper lifestyle and diet advises along with suitable medicines (oral). The patient is also advised to undergo the treatment twice or thrice in a year.

Duration, benefits

Duration of Elakizhi massage course –
The number of days of treatment varies from 7-14 days depending on the nature and intensity of the disease

Benefits of Patra Pinda Sweda –
Relieves pain, stiffness and swelling associated with arthritis and other painful conditions mentioned above
Pacifies the morbidity of Vata, Pitta and Kapha in the afflicted joints, muscles and soft tissues
Causes sweating and brings about lightness and a feeling of health in the afflicted joints, muscles and soft tissues
Forms an effective combination with local treatments like Kati Vasti, Greeva Vasti, Abhyanga etc and fortifies the results w.r.t providing relief from pain and related conditions
When combined with Nitya Virechana and or Vasti, Patra Pinda Sweda eliminates the body toxins, establishes health and tones up the joints and soft tissues
Improves the movements of the joints
Removes water retention in the tissues and effusion of joints
Soothes the nerves and improves blood circulation

Contraindications

Contra-indications of Patra Pinda Sweda –
Diabetes mellitus (can be done for a short period with caution, giving proper medicines to treat diabetes or in controlled and uncomplicated diabetes)
High blood pressure (Hypertension)
Severe varicosity of veins
Deep vein thrombosis
Fractures
Fever
Severe inflammation

Patra Pinda Sweda can be done with caution and under supervision in case of Diabetes and Hypertension if doing it is mandatory and no other better options are available. Care should be taken to see that there is no excessive sweating and resulting dehydration.

Limitations of  Patrapinda Pottali Sweda –
Patra Pinda Sweda is one of the best Ayurvedic treatments which is used in providing relief from pain and associated conditions related with Osteoarthritis, Rheumatoid arthritis, Low back pain, Sciatica etc conditions. But on the other hand it is not a sole remedy in these conditions. Parallel to it we might have to add some disease modifying drugs and or compounds and effective treatments for better relief.

Parallel Ayurvedic medicines

Parallel Medications to expel morbid Doshas, strengthen and rejuvenate the joints and soft tissues (Diseases modifying medications) 

Kashaya’s (Herbal decoctions):
Amruthottaram Kashayam
Rasnadi Kashayam or Rasnaerandadi Kashayam
Maharasnadi Kashayam
Amavatari Kashayam
Varanadi Kashayam
Varadi Kashayam
Punarnavadi Kashayam
Guggulutiktakam Kashayam
Sahacharadi Kashayam
Sahacharabaladi Kashayam
Kokilaksham Kashayam
Rasnasaptakam Kashayam
Rasnapanchakam Kashayam
Guluchyadi Kashayam
Gandharvahastadi Kashayam

Asava / Arishtam (herbal fermented liquids):
Ashwagandharishtam
Balarishtam
Dashamuraishtam
Punarnavasavam
Devadarvarishtam etc

Lehas and Rasayana’s (rejuvenators, herbal confections, anti-ageing medicines, immune-modulators) –
Ashwagandha Rasayanam
Ajashwagandhadi Rasayanam / Leham
Kushmandam Rasayanam
Chyavanaprasham
Brahma Rasayanam etc

Ghritam and Tailam (medicated ghee and oils):
Guggulutiktakam Ghritam
Varanadi Ghritam
Rasnadi Ghritam
Dhanwantaram Ghritam
Shunti Ghritam
Ksheerabala tailam 101
Dhanwantaram tailam 101
Maharajaprasarini Tailam

Vati and Gulika (Tablets):
Simhanada Guggulu
Kanchanara Guggulu
Kaishora Guggulu
Yogaraja Guggulu
Navaka Guggulu
Trayodashanga Guggulu
Mahavata vidhwamsini Ras
Vatagajankusha Ras
Amavatari Ras
Vadavagni Ras
Trimurti Ras
Medohara Vidangadi Lauha
Shallaki

Churna (powders) –
Shaddharana Churna
Ajamodadi Churna
Vaishwanara Churna
Vardhamana Pippali
Triphala Churna

Just before finish,
Patra Pinda Sweda is the best treatment which Ayurveda provides to tackle pain, swelling and catches related to Arthritis, Neuromuscular and Musculoskeletal disorders. All you need to do is to meet an experienced Ayurvedic doctor and put forth your problems. The doctor will help you to get fit and healthy. A proper diagnosis should be made before the treatment is planned. The best way of taking the treatment is to have it done under the supervision of the doctor.
Click to Consult Dr Raghuram Y.S. MD (Ayu)