Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Torticollis, also called wryneck is a painful situation of the neck marked by painfully twisted neck. On this situation the neck is twisted. This additional causes the top to rotate and tilt at an odd angle. The highest of the top is usually tilted to 1 facet whereas the chin is tilted in direction of the opposite facet.
Generalized Signs of Torticollis
Signs typically start slowly however would worsen over time, because the illness progresses. Completely different signs could also be skilled by completely different individuals. The most typical signs of torticollis embrace –
– lack of ability to maneuver the top usually
– lack of ability to show the top, often holding it twisted to 1 facet
– ache in neck and muscular tissues therein
– neck stiffness
– spasm of neck muscular tissues
– ache alongside the backbone
– swelling of neck muscular tissues
– headache
– chin tilted to 1 facet / awkward place of the chin
– one shoulder is increased than the opposite
Associated Studying – Torticollis
Ayurveda understanding of Torticollis
Vata dysfunction
Ache, stiffness, lack of ability to maneuver or flip the top, spasm, mal-positioning of shoulder and chin and related headache – all these signs in torticollis level out in direction of involvement of aggravated vata in causation and worsening of torticollis over a time period. Torticollis is clearly a vata dysfunction. Manyastambha and Grivastambha defined within the context of vata nanatmaja rogas embrace the reason of torticollis.
Manyastambha
Manya, in Sanskrit means ‘again of the neck’ Stambha means stiffness. The which means of the phrase stambha shall not be restricted to ‘solely stiffness’. It additionally consists of the opposite signs coexisting with stiffness or attributable to it, like ache and limitation of actions. We don’t discover a detailed description of Manyastambha.
Manyastambha has been defined within the context of ‘vata nanatmaja vyadhi’ i.e. eighty particular circumstances attributable to ‘aggravation of solely vata’. However we will additionally see a kapha element in Manyastambha. So, it’s predominantly a vata dysfunction, with kapha affiliation in some circumstances.
Torticollis might be carefully correlated to manyastambha.
Kapha involvement in Torticollis, Kaphavruta Vata
Stambha, which interprets to stiffness or catch or rigidity (limiting the actions) is a symptom attributed to kapha, although vata can also trigger stambha. Grasp Sushruta has particularly talked about kapha together with vata within the pathogenesis of manyastambha.
Because the aggravated kapha blocks the vata and interferes in its regular functioning, torticollis can be thought of as kaphavruta vata situation.
Understanding Torticollis from the attitude of causative elements, Greeva Hundanam
Among the many causes of acquired torticollis sleeping in awkward or bizarre place has been talked about.
The opposite causes of acquired torticollis like spasm or damage of neck muscular tissues, damage, vigorous motion and damage leading to muscle shrinkage will trigger aggravation of solely vata. On this case they might trigger greeva hundana which is alike torticollis. The causes of secondary torticollis like slipped sides or disc herniation can even trigger aggravation of vata resulting in greeva hundana.
Harm to muscle or nervous system will trigger torticollis. This too would possibly happen on account of vata aggravation following damage and trigger greeva hundana.
Associated Studying – Hundanam
Understanding Torticollis from ‘forms of torticollis’ perspective
Fastened and muscular torticollis might be thought of within the class of asthi and mamsagata vata.
Congenital torticollis as in Klippel Feil Syndrome could also be thought of because the affliction of muscular tissues and bones of the fetus by aggravated vata. Vata is liable for differentiation of physique components. The fusion of neck vertebrae could happen on account of failure of this perform of vata.
Spasmodic contractions of neck muscular tissues are additionally attributable to vata aggravation. When vata will get aggravated spasmodic contractions can happen anyplace within the physique. Similar is the case with tilt of the top. Irregular twists, turns and tilts within the physique components are attributable to aggravated vata.
Among the many forms of torticollis on the idea of place of head and neck – laterocollis, rotational torticollis, anterocollis and retrocollis – all are attributable to aggravated vata.
Understanding Torticollis from ‘signs and issues of torticollis’ perspective
1. Signs and dosha relation in torticollis
Sl No | Symptom of torticollis | Dosha relation with the symptom |
1 | Incapacity to maneuver the top usually or flip the top, often holding it twisted to 1 facet | Vata |
2 | Neck ache / ache in neck muscular tissues | Vata |
3 | Neck stiffness / spasm of neck muscular tissues | Kapha, vata, kaphavrita vata |
4 | Ache down the backbone | Vata |
5 | Headache | Vata |
6 | Swelling of neck muscular tissues | Kapha, vata, kaphavrita vata |
7 | Chin tilted to 1 facet / awkward place of the chin | Vata, kaphavrita vata |
8 | One shoulder increased than the opposite | Vata |
9 | Delayed motor expertise in kids | Vata |
10 | Difficulties with imaginative and prescient and listening to in kids | Vata |
2. Dosha affiliation in different signs of torticollis
Sl No | Symptom of torticollis | Dosha affiliation |
1 | Neck ache | Vata |
2 | Mass formation | Kaphavrita Vata |
3 | Thickening or tightness of sternocleidomastoid muscle | Kapha-Vata, Kaphavrita Vata |
4 | Cervical backbone tenderness | Vata |
5 | Tremor within the head | Vata |
6 | Decreased neck motion | Kaphavrita Vata |
7 | Uncommon shoulder heights | Vata |
3. Dosha affiliation with issues of torticollis
Sl No | Complication of torticollis | Dosha Relation |
1 | Swelling of neck muscular tissues | Vata, Vata-Kapha, Kaphavrita Vata |
2 | Continual ache | Vata |
3 | Compressed nerves | Vata |
4 | Neurological signs | Vata |
5 | Despair | Vata |
6 | Issue in socializing | Vata, Kapha |
7 | Isolation | Kapha, Vata |
8 | Incapacity to drive | Kapha-Vata, Kaphavrita Vata |
Stiff Neck, Greeva Hundanam
It’s a self-limiting type of torticollis which happens spontaneously and consists of a number of painful neck muscular tissues. This situation will spontaneously go away in about 1-4 weeks’ time. The muscular tissues that are usually concerned on this situation are trapezius or sternocleidomastoid. In lots of circumstances no particular or clear causes are discovered however in some circumstances colds or uncommon postures are contributory. This situation can be correlated with the reason of Greeva hundanam.
Spasmodic Torticollis, Greeva Hundanam
It’s a situation in which there’s recurrent and transient contraction of neck muscular tissues, primarily sternocleidomastoid muscle. It is usually known as by the under talked about names –
– Intermittent torticollis
– Cervical dystonia
– Idiopathic cervical dystonia
This situation can even correlate with the outline of greeva hundanam.
Ayurveda Remedy of Torticollis
Remedy ideas
Nidana Parivarjana – One shall keep away from / maintain away the causative elements because the initially a part of intervention. Primarily extreme day sleep, sleeping on uneven floor (odd, untoward place) and extreme wanting in upward gaze shall be averted as a lot as potential.
Vata Vyadhi Chikitsa – Since Manyastambha typically in contrast with torticollis is without doubt one of the vata vyadhis, a basic line of therapy of vata vyadhi must be adopted in treating torticollis.
– When solely vata is concerned – interventions like abhyanga – oil therapeutic massage, lepa – anointment of medicinal pastes, pichu – conserving a gauze or swab dipped in vata assuaging oil over the posterior a part of the neck, swedana – sudation, primarily nadi sweda or pinda sweda, nasya – errhines and vasti – medicated enemas are extraordinarily useful.
– When kapha is related – ruksha sweda – dry sudation / fomentation, mrudu vamana – gentle emesis, nasya – errhines and lepa might be useful.
You will need to establish the dosha involvement and affiliation on this situation in order to offer good outcomes.
Greeva Basti – oil pooling therapies finished on the again of the neck is extraordinarily useful in relieving the signs of torticollis. It may be skillfully mixed with nasya and churna or patra pinda sweda for higher outcomes.
Helpful formulations
For Abhyanga and Greeva Basti – Mahanarayana Taila, Ksheerabala Taila, Prasarinyadi Taila and Mahamasha Taila / Kottamchukkadi Tailam (kapha involvement)
For Nasya – Ksheerabala Taila 101 and Mahamasha Taila for vata predominant circumstances / Anu taila for kapha predominant situation
For Vasti – Ksheerabala Taila, Mahamasha Taila, Guggulutiktaka Ghrta
For oral use –
– Prasarinyadi Kashayam
– Maharasnadi Kashayam
– Varanadi Kashayam
– Rasonadi Kashayam
– Dashamula Kashayam
– Mahayogaraja Guggulu
– Rasnadi Guggulu
– Ashwagandharishta
– Balarishta
– Mahavata Vidhwamsini Ras
Helpful Yoga Postures
– Ushtrasana – Camel Pose
– Shavasana – Corpse Pose
– Navasana – Boat Pose
– Uttana Shishosana – Prolonged Pet Pose
– Balasana – Youngster’s Pose
– Vashishthasana – Facet Plank Pose
– Setu Bandhasana / Setu Bandha Sarvangasana – Bridge Pose
– Utthitha Trikonasana – Prolonged Triangle Pose
– Adho Mukha Shvanasana – Downward Dealing with Canine Pose
– Paschimottanasana – Seated Ahead Bend Pose
– Uttanasana – Standing Ahead Bend Pose
– Virabhadrasana II – Warrior II Pose
– Urdhwa Mukha Pasasana – Thread the Needle Pose
– Viparita Karani – Legs up the wall Pose
– Gomukhasana – Cow Face Pose
– Ardha Matsyendrasana – Half Lord of the Fishes Pose
– Dwi Pada Viparita Dandasana – Two Footed Pose
– Chakravakasana / Marjaryasana / Bitalasana – Cat / Cow Stretch Pose
– Anahataasana – Melting Coronary heart Pose
– Salamba Bhujangasana – Sphinx Pose