Article by Dr Raghuram Y.S. MD (Ay) & Manasa S, B.A.M.S
Myalgia is the name given for muscle pain. Muscle pain occurs due to different causes, overuse of muscles and injury are the most common causes. It may also occur secondary to many systemic diseases. The pain may vary in range, mild to moderate to severe and also from person to person. Some cases of muscle pain are acute, temporary and respond well to simple home remedies or treatments. On the other hand, many times muscle pain may run a chronic course, be widespread, presenting with severe and persistent ache and may demand medical attention, especially if they are due to some serious and chronic underlying medical conditions.
Related Reading – Muscle Pain, Myalgia – causes, symptoms, prevention and treatment
In this article we shall try to understand myalgia or muscle pain from the Ayurveda Perspective and also touch upon the possible Ayurveda interventions for the same.
The ‘Vata’ factor
Vata aggravating causes – Pain in muscle or any structure of the body cannot be caused without the involvement of aggravated vata. Myalgia is also caused by aggravated vata affecting and damaging the muscles and interfering with its normal functions, apart from causing pain and other related symptoms therein.
Below mentioned causative factors shall be considered from Ayurveda perspective –
– causative factors for aggravation of vata
– causes of ‘Vata Vyadhi’
The causes include the foods, activities, seasons, habits and therapies which aggravate vata.
Treatment includes –
– Nidana Parivarjana – avoiding the causative factors responsible for aggravation of vata
– Vata calming therapies, medicines, diet and lifestyle changes
– Principles of treating Vata Vyadhi
– Principles of treating Mamsagata Vata
– External therapies – Abhyanga, Swedana, Sarvanga Dhara (widespread muscle involvement), Ekanga Dhara (small groups of muscles involved), Lepa, Upanaha, Patrapinda Sweda, Shashtika Shali Pinda Sweda,
– Brimhana – bulk enhancing or strengthening therapies, medicines and foods
– Snehana – intake of fats / medicated fats – oils, ghee, bone marrow, muscle fat
– Mamsarasa – use of meat soup or juice for those who are accustomed to consume meat
– Internal therapies – Vasti – Asthapana and Anuvasana, Matra Vasti, Ksheera Vasti, Virechana
Mamsagata Vata & Medogata Vata
- Mamsagata Vata
In the context of Vata Vyadhi, a condition called ‘Mamsagata Vata’ has been explained, the explanation of which matches with myalgia or muscle pain.
Mamsagata Vata is marked by presence of –
– Heaviness of the body parts,
– Pricking or throbbing pain in the body parts,
– Pain as if someone has beaten with sticks or fist
– Severe pain in body parts
– Severe tiredness / fatigue
This is a condition caused by aggravated vata getting localized in the muscles, gradually damaging it and causing pain and other symptoms.
Related Reading – Mamsagata Vata
- Medogata Vata
The same symptoms of Mamsagata Vata are also found in Medogata Vata wherein the aggravated vata is localized in the fat tissue instead of mamsa – muscles as in Mamsagata Vata.
Treatment – Treatment for both Mamsagata and Medogata Vata is the same. Acharya Charaka mentions the below mentioned treatments for these two conditions –
– Virechana – purgation
– Niruha Vasti – Decoction enemas
– Shamana – palliative treatments or administration of vata alleviating medicines and measures
Asthi Majjagata Vata
Mamsa Bala Kshaya i.e. deterioration in strength of muscles and Satata Ruk – severe pain in bones and bone marrow (and also in muscles) have been mentioned amongst the symptoms of Asthi Majjagata Vata i.e. aggravated vata localized in the bones and bone marrow.
Often, we see that the muscle pain and weakness will be evident in joint related or bone related diseases. Here, muscle pain and its loss of strength will be secondary to the diseases of bones and joints and bone marrow.
Treatment – of Asthi Majjagata Vata too shall be considered for treating Myalgia, especially so, if the pain and weakness is secondary to bone or marrow disorders. Treatment principles include –
– Bahya Abhyantara Sneha – administration of internal and external oleation therapies as and when needed.
Also,
In all the above said conditions – Mamsa, Medo, Asthi and Majjagata Vata conditions – the general line of treatment of Vata Disorders can be readily administered along with specific line of treatment.
Especially in this context, speaking about Mamsagata Vata, – in my clinical experience – Abhyanga, Patrapinda Sweda and Shashtika Shali Pinda Sweda / Navarakizhi are highly effective in relieving pain and other symptoms of Mamsagata vata vis-à-vis myalgia or painful muscular conditions.
Mamsavruta Vata
Mamsavruta Vata is a condition wherein the muscle tissue envelopes and blocks the vata and interferes in its functions. Though pain is not mentioned amongst the symptoms of this condition, the treatment principles of the same can be considered in treating muscle pains.
Treatment principles of Mamsavruta Vata includes
– Swedana – sudation
– Abhyanga – herbal oil massage,
– Mamsarasa – consumption of meat soup and
– Sneha – consumption of medicated fats
Sandhigata Vata
This is a condition in which aggravated vata gets localized in the joints of the body and causes pain and swelling. The person finds it difficult to make movements, especially to flex and extend the limbs. Muscles are responsible for all movements along with joints, so muscle pain is a part and parcel of symptoms of sandhigata vata also.
Treatment principles include – vata vyadhi treatment in general and sandhigata vata treatment in specific.
Muscle Pain caused by Pitta
Muscle pains caused by pitta will be inflammatory in nature and will have signs of inflammation like rise in temperature, burning sensation, redness, tenderness, fever etc. When there is severe pain and mild signs of inflammation, it can be a case of Vata-Pitta type of muscle pain. These types of pain can be caused by injury, infection or inflammation.
Treatment in these conditions include –
– Pitta mitigating measures
– Coolant therapies – like lepa – anointment or application of pastes made of coolant ingredients like Chandana (sandal wood), Ushira (vetiver) etc, Dhara with cooling oils or ghee or combination of both or milk processed with Dashamula or coolant herbs
– Virechana
Muscle Pain with Kapha involvement
Aggravation of only Kapha will not cause pain in the muscles. It might cause heaviness or swelling in the involved muscles. Usually, Kapha may get involved as an associated dosha along with aggravated vata or pitta.
Treatment comprises kapha alleviating measures including diet and medicines.
When kapha builds up in the body and also in kapha related disorders, wherein there will be swelling or oedema due to collection of fluids, the pain and other symptoms are due to pressure. In these conditions, shotha chikitsa should also be considered.
Rakta involvement in muscle pain
Muscle pains may be caused due to conditions like Vatarakta caused by aggravated Rakta. Treatment principles of Vatarakta shall be considered in this context. Uttana Vatarakta is a type of Vatarakta wherein skin and muscles are involved. Pain has been mentioned as part of symptoms in this context. This is applicable for muscles too.
Ama involvement in myalgia
Ama is one causative factor for causation of pain, anywhere in the body. Pain is a specific and predominant feature in conditions like Samavata and Amavata. If muscle pain is secondary to such conditions, treatment should be focussed towards ‘ama’.
Line of treatment of amavata or samavata shall be adopted.
Important formulations in Myalgia
For internal use –
– Maharasnadi Kashayam
– Sahacharadi Kashayam
– Guggulutiktakam Kashayam / Ghrtam
– Gandharvahastadi Kashayam
– Rasnaerandadi Kashayam
– Balarishtam
– Ashwagandharishtam
– Ashwagandha Churna
– Ashwagandha Ksheerapaka
– Mahasneha
For external use –
– Ksheerabala Taila
– Bala Taila
– Balashwagandha Lakshadi Taila
– Sahacharadi Taila
– Prasarini Taila
Myalgia vs Mamsagata Vata / Vata Vyadhi
Physical stress, overuse of muscles, repetitive strain, blunt injuries, chronic pain and painful syndromes, neuromuscular disorders and ischemia have been counted amongst the important causes for muscle aches / myalgia. All these causes lead to aggravation of vata looking from Ayurveda perspective. Most of them have been mentioned in the nidana – etiological factors for vata aggravation or causation of vata vyadhis.
Pitta association with vata can be considered wherein inflammatory conditions are causing myalgia.
Localized myalgia can be mamsagata vata restricted to limited area of muscle groups. It can be considered and treated on the lines of ekanga vata – vata aggravation in a small portion of body. Diffuse Myalgia can be counted as mamsagata vata occurring in the entire body, involving many muscle groups. It can be considered as variant of Sarvanga Vata – vata aggravation taking place in the complete body.
