Ayurvedic Approach in the Management of Brachial Plexopathy: A Clinical Case Report

Abstract

Brachial plexopathy is a peripheral nerve injury that leads to significant functional impairment of the upper limb. Common causes include trauma, inflammation, compression or ischemia affecting brachial plexus. In Ayurvedic terms, this can be correlated with Amsa Marma Abhighatha, primarily a Vata predominant condition. This case presents the role of Ayurvedic therapies in improving upper limb function in post-traumatic brachial plexopathy. A 34 years old male presented with weakness and pain in the right arm for one year following a road traffic accident. He had a history of unconsciousness and multiple head injuries with diagnosis of post-ganglionic brachial plexus injury. On examination, there was muscle wasting in the right upper limb, severe motor and sensory deficits, and impaired range of motion. MRI revealed discontinuity in nerve fibers from the level of C5 to C8 with neuroma formation. The patient was treated with panchakarma procedures like Udwarthanam(therapeutic powder massage), Upanaham(sudation by application of medicated herbal paste or powders), Snehapanam(therapeutic oleation ), Abhyanga ushma sweda(therapeutic massage and sudation), Virechana(therapeutic purgation), Sandhana kizhi(sudation by application of poultice), Pizhinju thadaval(local oil application),Nasya(medication through nasal route) and ksheera dhooma(therapeutic smoking), Kayasekam(therapeutic streaming over body), Shashtika pinda swedam(sudation by application of poultice),Rajayapana vasthi (enema which prolongs life span),internal medications and physiotherapy for a period of 3 months.  After the treatment and during the follow up period significant improvement was noted in motor functions such as shoulder abduction, thumb extension, and grip strength. Sensory responses also improved in affected dermatomes. The patient experienced relief in pain and enhancement in range of motion and limb strength, prominent venous return, and the regained ability to hold objects with the right hand. This case demonstrates that Ayurvedic management can offer promising results in chronic brachial plexus injury.