Therapeutic Values of Abhyanga, Shirodhara, Basti Treatment, and Udvartanam
Ayurvedic Treatments
The ancient art of healing has been practiced for thousands of years, drawing upon a wealth of knowledge and traditions passed down through generations. This time-honored approach encompasses various techniques and philosophies that aim to restore balance and harmony within the body and mind.
A) Abhyanga (Ayurvedic Massage)
Oil plays an essential role in Ayurvedic treatments, as the therapeutic substance in the oil can move into the body's channels and influence dosha activity. External oil massage is known as Abhyanga in Ayurveda (Bagali & Barag, 2018). The type of oil used is individually specific, based on body constitution, doshas, imbalances, or therapeutic purposes. It can also vary according to the season. In an Abhyanga (Ayurvedic Massage) treatment, warm, medicated, or non-medicated oil is used over the entire body. The oil is applied at room temperature for Pitta conditions and warmer for Vata and Kapha. Early hours are ideal for Abhyanga, and the patient should have an empty stomach.
Various Abhyanga (Ayurvedic Massage) therapies include Sarvanga Abhyanga (full body), Shiro Abhyanga (head), Mukha Abhyanga (face), Hasta Abhyanga, and Pada Abhyanga (foot). Applying oil to the skin followed by massage in a specific direction improves blood circulation, digestion, and intestinal function; facilitates the removal of toxins from joints and tissues - lymphatic drainage; relieves physical and mental fatigue; improves musculoskeletal system function; and clears stiffness and heaviness, providing a sense of lightness. Additionally, Abhyanga (Ayurvedic Massage) assists in developing a healthy body, improving sleep patterns, strengthening body tolerance, and decreasing the effects of aging and weight gain (Madhukar et al., 2018). However, Abhyanga (Ayurvedic Massage) is not ideal for the following conditions: high fever; severe renal or cardiac disease; menstruation; deep X-ray therapy; osteoporosis; severe spasticity; very hairy skin; acute inflammation; skin diseases; recent fractures; severe varicose veins; atherosclerosis; thrombosis; myositis ossificans; malignancy; or immediately after chemotherapy or radiotherapy (Sangwan, 2018).
B) Shirodhara
Shiro means head, and dhara means flow. This involves a gentle and continuous stream of thin, medicated warm oil (or other liquid) poured over the forehead along the hairline and eyebrows, focusing on the ajna marma or ajna chakra, an area where nerves are highly concentrated. The oil's pressure on the forehead creates a vibration. This slow, stream-like dripping stimulates the pineal, pituitary, and hypothalamus glands in the brain, which organize and regulate hormonal secretions (Dhuri et al., 2013; Swathika et al., 2019). These hormonal secretions control autonomic responses that govern breathing, digestion, elimination, and emotional state. It is traditionally used to treat various conditions related to cognition, sleep, and anxiety, positively affecting the parasympathetic system. These effects are observed through the oil as a medium. Shirodhara is equated with a meditative state and a reduction in catecholamines and an increased serotonin reuptake (Dhuri et al., 2013; Rastogi et al., 2016; Sanwariya et al., 2016). Shirodhara is a great treatment for a compromised nervous system, positively stimulating the parasympathetic nervous system to promote "rest and digest" responses for relaxation and slowing down of high-energy functions. Benefits include:
Relief of symptoms of anxiety, stress, fatigue, hypertension, tension, worry, fear, insomnia, and headaches, as well as depression.
Mood regulation and feelings of pleasure and relaxation (Dhuri et al., 2013; Sanwariya et al., 2016).
Shirodhara should not be performed during the third trimester of pregnancy, menstruation, lactation, after a recent neck injury, with abrasions or cuts on the head, rashes on the scalp or forehead, under the influence of drugs or alcohol, or if diagnosed with a tumor (as it may stimulate tumor growth).
Shiro means head and dhara means flow, which involves a gentle and continuous stream of thin, medicated warm oil poured over the forehead along the hairline and eyebrow, focusing on the ajna marma or ajna chakra, an area where nerves are highly concentrated, connecting to the three major glands: the hypothalamus, pituitary, and pineal glands. The hypothalamus is also known as the "master gland" because its most important function is to link the nervous system to the endocrine system (hormonal) by controlling the pituitary gland. This is where emotions, stress, sleep, circadian cycles, appetite, and other bodily functions are controlled. The pineal gland is often referred to as the "third eye." The third eye is the connecting link between the physical and spiritual worlds, and it's considered the sacred place of extrasensory perception in the brain. The pineal gland produces melatonin, which regulates circadian cycles and induces sleep. It needs darkness to secrete melatonin.
The rhythmic flow of oil in Shirodhara creates a subtle vibration, stimulating these glands and helping to better manage stress, sleep, emotions, and circadian cycles. It promotes feel-good hormones (dopamine, serotonin, endorphins, and oxytocin). The pressure of the oil on the forehead creates a vibration, and this stimulation creates positive energy around the heart chakra. Shirodhara is equated with a meditative state and relieves symptoms of anxiety, stress, fatigue, hypertension, tension, worry, fear, insomnia, and headaches, as well as depression.
Ayurvedic Herbal Oil
Herbal oil is an essential and integral part of various Ayurvedic treatments, playing a crucial role in promoting overall health and wellness.
C) Basti Treatment
Basti treatment is a procedure in which warm, medicated oil is kept over the lumbosacral area or any adjacent part for a certain period using a specially formed frame ring made from black gram flour. Kati refers to the lower part of the spine, and Basti means to hold (a compartment that holds) or retain something inside (in this case, medicated oil). This is a form of localized fomentation. The oil is generally heated and pooled over the affected or inflamed area. Various types of local Basti are performed, such as Kati (upper or lower back) Basti , Griva (neck) Basti, Janu (knee) Basti, Shiro (head) Basti, and Uro (chest) Basti (Prakash et al., 2017). Therapeutic heat causes vasodilation, improving blood circulation and removing catabolic waste (such as lactic acid), increasing anabolism as tissues receive nutrients and oxygen. Heat improves local cell metabolism and tissue elasticity. Connective tissue (tendons and ligaments) becomes more elastic. This technique relieves pain, stiffness, swelling, and inflammation. Oils nourish and strengthen affected joints and reduce pain or discomfort by soothing nerves (Chaudhary et al., 2018; Prakash et al., 2017; Chaudhary et al., 2019). Basti treatment should not be performed during acute fever, the acute stage of rheumatoid arthritis, inflammatory or infective conditions, hemorrhagic disease, kidney disease, fractures, dislocations, infections, or loss of sensation (Chaudhary et al., 2018; Prakash et al., 2017).
D) Udvartana/Udvartanam
Udvartana means rubbing herbal powder or paste (sometimes oil) in the direction opposite to the hair follicles over the body. Deep stroking is applied. This enhances venous circulation and lymphatic drainage and reduces fluid retention. This technique stretches the superficial fascia, reducing congestion and nodular formation (Kar, 2015). Massage friction increases local temperature, leading to the absorption and digestion of herbal formulations and liquification of subcutaneous fat (adipose tissue). There are two types: Snigdha Udvartana (Ayurvedic paste massage) and Ruksha Udvartana (Ayurvedic powder massage), which vary according to one's condition. In Snigdha Udvartana, warm, herbalized oil is massaged into the body, and then heated herbal paste is applied with upward massage strokes. In Ruksha Udvartana, only heated dry herbal powder is applied. Udvartanam is best done early in the morning on an empty stomach, after emptying the bladder. Benefits include: improved blood circulation; reduced appearance of subcutaneous fat tissue and cellulite; elimination of body odor; skin rejuvenation; and improved lymphatic system function and joint mobility (Nanaso & Bapusaheb, 2015). Udvartanam should not be performed on those with dry skin, abrasions, cuts, wounds, pregnancy, infancy, or oozing skin conditions (such as eczema), or conditions with severe pain and high Pitta.
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Sanwariya, R. K., Mishra, P. K., & Tyagi, A. (2016). Shirodhara in Management of Hypertension—A Review Article. International Ayurvedic Medical Journal, 4(2), 79–81.
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