The causes (hetu) of Apabahuka may be classified into two groups. (i) Bahya Hetu — Causing injury to the vital parts of the body (marma) or the region surrounding the amsa sandhi, which is also known as bahya abhigataja that manifests the vyadhi or disease first; (ii) Abhyantara hetu — Indulging in the etiological factors that aggravate Vata leading to the vitiation of Vata in that region and is also known as dosha prokopajanya (Samshraya), which in turn leads to karmahani of bahu.
Causative Factors for Frozen Shoulder
- Overuse or repetitive movement, office jobs, physical labor, etc.
- Diabetes or stroke
- A secondary condition caused by rheumatoid arthritis or degenerative disorders
- Excess bitter and astringent foods
- Exposure to wind and cold
- Incorrect sitting or sleeping positionDukkha Shayya
The improper posture that creates a significant amount of pressure on the amsasandhi will disturb the muscular integrity, and provoke Vata. This manifests the disease. Other viharaja nidanas as reported in the Vatavyadhi context may influence the condition by provocating Vata dosha. Even though a specific bahya hetu (external cause) has not been mentioned for Apabahuka, the general factors reported for Vata prakopa must be analyzed and elicited.
Line Of Management in Ayurveda
1. Treatment of Kevala Vata
2. Treatment of Samsrusta Vata
3. Treatment of Avruta Vata
Ayurvedic classics explain the chikitsa of Apabahuka as follows.
1. Nasya and uttarabhaktika Snehapana are useful in the management of Apabahuka.
2. Astanga Sangraha mentions Navana Nasya and sneha pana for Apabahuka.
3. Sushrutacharya advises Vatavyadhi chikitsa for Apabahuka, except siravyadha.
4. Chikitsa sara sangraha advises Nasya, Uttara bhaktika Snehapana, and Sweda for the treatment of Apabahuka.
5. Brumhana nasya is indicated in Apabahuka by Vagbhata.
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