Abstract

EVALUATION OF THE EFFECT OF MARMA CHIKITSA IN THE PAIN MANAGEMENT OF PLANTAR FASCIITIS: A CASE STUDY

Dr. Aishwarya Rathore*, Dr. Rita Marwaha, Dr. Nisha Bhalerao, Dr. Pankaj Gupta

Abstract

Plantar fasciitis is defined as when the plantar fascia gets irritated, torn, or inflamed at its attachment point on the heel bone (medial calcaneal tuberosity). This often results from friction in the calcified posterior insertion of the plantar fascia. It commonly affects people who stand or walk for long periods. The condition also involves irritation in nearby tissues around the fascia. Plantar fasciitis causes sharp, stabbing heel pain like stepping on a thorn, worst with first morning steps. It eases after walking but returns after long rest. A 2021 study found that plantar fasciitis impacts about 4-9% of people overall, ranking it among the top reasons for doctor visits due to foot pain. Vatakantaka causes intense heel pain. Aggravated Vata localizes in the ankle region (Khudapradesha) when walking on uneven or irregular surfaces. This case study explores Marma Chikitsa's effect as a drug-free treatment for plantar fasciitis. A 38-year-old woman presented with persistent right sole and heel pain lasting four months. The pain worsened with prolonged standing and was most severe during the first steps in the morning after rising from bed. Faulty footwear was identified as the probable cause, and the Windlass test, producing pain upon passive dorsiflexion of the toes on the affected foot was positive. Despite conservative treatments failing to provide full relief, the patient's prior therapy was discontinued. Marma Chikitsa was then administered only at the Kshipra, Talhridaya, Kurchshir, Gulpha, and Indrabasti Marma points. Each point received 0.8 second stimulations, 15-18 times per session, over a 15-day course. This regimen lead to marked symptom improvement. In this single case study of plantar fasciitis treated with Marma Chikitsa, sequential assessments over 15 days demonstrated significant clinical improvement. Pain intensity (VAS) reduced steadily from 7/10 at baseline to 2/10 by Day 15. Stiffness improved from moderate to mild, while tenderness decreased progressively from severe to complete resolution. Additionally, the Windlass test converted from positive to negative by Day 10, indicating restoration of plantar fascia function. These findings suggest the effect of Marma Chikitsa in reducing pain and improving functional outcomes in plantar fasciitis. This non-invasive approach could serve as a valuable alternative to conventional treatments for plantar fasciitis, such as foot orthoses, night splinting, non-steroidal anti-inflammatory drugs, corticosteroid injections, and surgical intervention.

Keywords: Plantar Fasciitis, Marma Chikitsa, Marma Sthanas, Pain management, VAS score, Vatkantaka.