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Establishing the Pain Management Effect of Marma Tantra in Janu Sandhigatavata vis-a-vis Knee Osteoarthritis: An Observational Study

Shashidhar V. Emmi, Maheshkumar n.a

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Journal of Global Medical Education and Research 9(1):p 7-21, Jan -June 2026. | DOI: n.a

How Cite This Article:

Maheshkumar, Shashidhar V. Emmi. Establishing the Pain Management Effect of Marma Tantra in Janu Sandhigatavata vis-a-vis Knee Osteoarthritis: An Observational Study. Jr of Glob Med Edu and Res. 2026;9(1): 07-21.

Timeline

Received : April 09, 2026         Accepted : May 15, 2026          Published : June 30, 2026

Abstract

Background: Janu Sandhigatavata, a Vata-predominant degenerative disorder of the knee joint described in Ayurvedic classical texts, corresponds closely to knee Osteoarthritis (OA) in contemporary medicine. Knee OA is the second commonest musculoskeletal problem worldwide, with a prevalence of 22–39% in India, predominantly affecting the elderly female population.16 Objective: To evaluate the efficacy of Marma Tantra — an ancient Ayurvedic therapeutic technique targeting vital energy points — in pain management and functional improvement in patients with Janu andhigatavata/Knee Osteoarthritis. Materials and Methods: An observational pre-test, post-test study was conducted on 20 patients (mean age 53.3 ± 6.95 years) fulfilling the diagnostic criteria for Janu Sandhigatavata at DGM Ayurvedic Hospital, Gadag. Marmatantra was administered over 7 sessions (1 week), combining Snehan with Ashwagandha taila, Mardan karma, Peedana karma, and Janu Marma stimulation. Outcome measures included Janu Sandhi Shoola (pain grading), Sandhi Shotha (swelling), Sandhi Atopa (crepitation), Sparsha Asahatva (tenderness), Walking Time, Visual Analogue Scale (VAS), WOMAC Scale, and Kellgren-Lawrence radiographic grading. Results: All parameters showed statistically highly significant improvement (p < 0.00001) after one week of Marma Tantra. Mean VAS score reduced from 2.7 ± 1.1 to 0.5 ± 1.4 (p < 0.00001). Mean WOMAC score reduced from 3.9 ± 10.8 to 2.1 ± 9.3 (p < 0.00001). Mean knee flexion improved from 100.5° ± 15.4° to 120.3° ± 10.1° (p < 0.01). Sandhi Shotha showed significance at p = 0.0075.

References

  • 1.   Mishra JN. Marma and Its Management. Reprint 2014 ed. Varanasi: Chaukhambha Orientalia; 2014. p. 88. Available from: http:// www.vedicbooks.net.
  • 2.   Sharma RK, Chandra DC. Concept of Marma Massage in Ayurveda. Int J Creat Res Thoughts. 2020;ISSN:2320-2882. Available from: https://ijcrt.org.
  • 3.   Trikamji JA, editor. Charaka Samhita of Agnivesha with Ayurveda Deepika commentary by Chakrapanidatta. 2nd ed. Chikitsasthana; Vatavyadhi Chikitsa Adhyaya: Chapter 28, verse 11. Varanasi: Chaukhamba Orientalia; 2015. p. 29.
  • 4.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Vatavyadhi Chikitsa Adhyaya: Chapter 28, verse 11. Varanasi: Chaukhamba Orientalia; 2015. p. 29.
  • 5.   Chaurasia BD. Human Anatomy: Regional and Applied Dissection and Clinical. 5th ed. Vol. 2. Chapter 12. New Delhi: CBS Publishers and Distributors; 2010. pp. 150-156.
  • 6.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Sutrasthana; Chapter 12, verse 8. Varanasi: Chaukhamba Orientalia; 2015. p. 79.
  • 7.   Trikamji JA, editor. Sushruta Samhita of Sushruta with Nibandhasangraha commentary by Dalhanacharya. Sharira Sthana; Sharira Sankhya: Chapter 5, verse 16. Varanasi: Chaukhamba Orientalia; 2014. p. 365.
  • 8.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 56. Varanasi: Chaukhamba Orientalia; 2015. p. 619.
  • 9.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 15. Varanasi: Chaukhamba Orientalia; 2015. p. 693.
  • 10.   Trikamji JA, editor. Sushruta Samhita. Sutrasthana; Vranaprasna Adhyaya: Chapter 21, verse 19. Varanasi: Chaukhamba Orientalia; 2014. p. 103.
  • 11.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 16. Varanasi: Chaukhamba Orientalia; 2015. p. 616.
  • 12.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 56 [Ch.28/1]. Varanasi: Chaukhamba Orientalia; 2015. p. 158.
  • 13.   Upadhyaya Y, editor. Madavanidana of Sri Madhavakara with Madhukosha Sanskrit commentary. Vol. 1. Chapter 22. Varanasi: Chaukhamba Prakashan; Reprint 2016. p. 617.
  • 14.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 56. Varanasi: Chaukhamba Orientalia; 2015. p. 158.
  • 15.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 56. Varanasi: Chaukhamba Orientalia; 2015. p. 628.
  • 16.   Sharma S, editor. Ashtanga Sangraha of Vriddha Vagbhata with Sashilekha commentary. 3rd ed. Nidanasthana; Vatavyadhi Nidana: Chapter 15, verse 36. Varanasi: Chaukhamba Sanskrit Series Office; 2012. p. 416.
  • 17.   Agnivesha. Charaka Samhita. Part 2. 8th ed. Chikitsasthana; Chapter 28, shloka 38. Varanasi: Chaukhamba Sanskrit Sansthan; 2004. p. 697.
  • 18.   Trikamji JA, editor. Charaka Samhita. Chikitsasthana; Chapter 28, shlokas 72- 74. Reprint 2008. Varanasi: Chaukhamba Sanskrit Sansthan; 2008.
  • 19.   Agnivesha. Charaka Samhita. Chikitsasthana; Chapter 28, shloka 19. 4th ed. Varanasi: Chaukhamba Sanskrit Sansthan; 1994. p. 617.
  • 20.   Trikamji JA, editor. Charaka Samhita of Agnivesha. Chikitsasthana; Chapter 28, verse 11. Varanasi: Chaukhamba Orientalia; 2015. p. 29.
  • 21.   Davidson S. Davidson’s Principles and Practice of Medicine. 20th ed. Musculoskeletal Disorders. Edinburgh: Elsevier Churchill Livingstone; 2006. p. 1098.
  • 22.   Davidson S. Davidson’s Principles and Practice of Medicine. 20th ed. Musculoskeletal Disorders. Edinburgh: Elsevier Churchill21 JGMER/Volume 9, Number 1/January–June 2026 Livingstone; 2006. pp. 1100-1101.
  • 23.   Shah S, editor. API Textbook of Medicine. 8th ed. Vol. 1. Mumbai: The Association of Physicians of India; 2008. pp. 282-283.
  • 24.   Shah S, editor. API Textbook of Medicine. 8th ed. Vol. 1. Mumbai: The Association of Physicians of India; 2008. pp. 282-283.
  • 25.   Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 15. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 107.
  • 26.   Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 4. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 104.
  • 27.   Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 24. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 110. 28. Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 28. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 116
  • 28.   Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 28. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 116
  • 29.   Gupta LP. Rachana Sharira: A Comprehensive Anatomical Approach (English). Vol. II. Varanasi: Chaukhambha Surbharati Prakashan; First edition 2015. p. 1213.
  • 30.   Murthy KRS, translator. Sushruta Samhita (English). Vol. I. Sharira Sthana: Chapter 6, verse 33. Reprint ed. Varanasi: Chaukhambha Orientalia; 2014. p. 117.
  • 31.   Lele A, Ranade S, Frawley D. Secrets of Marma (English). Reprint 2005 ed. Varanasi: Chaukhambha Sanskrit Pratishthan; 2005. p. 56.
  • 32.   Mishra JN. Marma and Its Management (English). Reprint 2014 ed. Varanasi: Chaukhambha Orientalia; 2014. p. 88
  • 33.   Thatte DG. Acupuncture, Marma and Other Asian Therapeutic Techniques (English). Chapter 1. Reprint 2006 ed. Varanasi: Chaukhambha Orientalia; 2006. p. 5.
  • 34.   Joshi SK. Marma Science and Principles of Marma Therapy. Delhi: Vani Publications; 2010.

Data Sharing Statement

"There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

Whether all authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Maheshkumar, Shashidhar V. Emmi. Establishing the Pain Management Effect of Marma Tantra in Janu Sandhigatavata vis-a-vis Knee Osteoarthritis: An Observational Study. Jr of Glob Med Edu and Res. 2026;9(1): 07-21.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
April 09, 2026 May 15, 2026 June 30, 2026
DOI: n.a

Keywords

Marma TantraMarma VignanaJanu SandhiJanu Sandhigatavata •Vata • SandhishoolaSandhishothaOsteoarthritisVASWOMACPeedanaJanu Marma

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Timeline

Received April 09, 2026
Accepted May 15, 2026
Published June 30, 2026

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.



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