In ayurveda its mentioned in classics as MAMSASHOSHA (reduction in muscle bulk), according to ayurveda this condition occurs due to doshic imbalance and changes in saptha dhathus which are the basic elements maintaining the body structure

In ayurveda there is the concept of agni (digestive fire) which maintains the cellurar metabolism which inturn nourishes the dhathus which are rasa, raktha, mamsa, medha, asthi, majja and shukla which builds the body and each dhathu is having its digestive fire, any imbalance or vitiation in this fire will be leading to improper absorbtion of nutrients leading to the condition of weakness.

In this case there is an increase in mamsa dhathu agni, which will be leading to muscle destruction and in turn reduction in muscle bulk and increase in medas (fat) which is the next dhathu after mamsa

If we closely look into the pathogenisis of this disease it’s the increase in fat tissue and decrease in the muscle bulk will be there in most of the condition leading to a reduction in muscle power.

Muscular dystrophy can be defined as a group of muscular diseases that weaken the muscles which move the human body. Muscular dystrophies are characterised by progressive muscle weakness, the death of muscle cells and tissue…

MAIN SYMPTOMS INCLUDE:

1. Progressive muscular wasting

2. Difficulty in walking

3. Change in walking pattern

4. Limited range of movement

5. Difficulty in breathing

6. Scoliosis

7. Poor balance

8. Difficulty in climbing and getting up

There are different types of muscular dystrophies named in different manners but the basic cause behind the condition is the breaking of muscle fibres due to different factors

Muscular dystrophy is a group of muscular ailments which are characterized by the progressive weakness and loss of muscle mass. It effects people of all the age group. There are different types of muscular dystrophy and most common symptoms can be seen in boys during childhood. In muscular dystrophy abnormal genes hinder the production of proteins which are needed in the formation of healthy muscles.

In Ayurveda, Acharyas carefully consider this condition as Adibala-pravrit (disease that occurs by defects in shukra i.e. spermatozoa and shonita i.e. ova or we can say hereditary) with Mamsagata Vata (Vata dosha vitiation in Mamsa dhatu) due to Srotorodha (obstruction in tissue microchannels). There is depletion of Dhatvagni (metabolism) paving the way of ama (toxins) formation, followed by vitiation of Kaphadosha. While Srotorodha produces hypertrophy in particular region, Vata is manifested first as Prakopa(vitiation) and then depletion occurs. This complex pathogenesis may be responsible for progressive wasting and necrosis of the affected muscle fibers.

For a healthy body there are three doshas – vata, pitta and kapha that are required in a balanced state. Muscular dystrophy is described as the “mamsashosha” in ayurveda. According to Ayurveda, muscular dystrophy is due to imbalance of vata dosha and sapta dhatus (basic elements to maintain body structure). Sapta dhatus involve rasa, rakta, mamsa, meda, asthi, majja and shukra which builds our body, each sapta dhatu has its own digestive fire (Dhatwagni). Vitiation in digestive fire of any of these dhatu leads to improper absorption of nutrients which result in weakness.

In Ayurveda for the management of this disorder, concept of the paraspar dhatu paka is of prime importance whereas Acharyas have mentioned specific chikitsa sootra for the condition by considering its severity which can easily be understood by the physicians.

Acharyas while explaining the dhatupaka avastha clearly signifies the importance of Agni which is responsible for the formation of the next dhatus. Thus correction of agni should be done by administration of deepana and pachana dravyas in order to strengthen the process. Doshas must be balanced and metabolic toxins must be eliminated from dhatus through panchakarma.

The pre-operative process quoted by Acharyas has the concept of “Brhmanyastu mrudu langyet “that signifies the usage of Rukshana for better brihmana treatment modalities. For example, udvartana which helps in the removal of srotorodha and does Sthiri karana of angas. Pachana medicines are also explained as a mode of Rukshana chikitsa and it is also must in the treatment of muscular dystrophy initially with deepana, like parisheka with Dhanyamla.

Panchakarma, the penta bio purifactory methods of Ayurveda i.e. Vamana, Virechana , Niruha, Anuvasan and Nasya are of prime importance. After the purification, rasyana therapy can be adopted. Not only these invasive therapies like virechana, vasti etc. but upkarma, i.e, Para panchakarma procedures are very much essential for the same. It is very well understood in the treatment principle of Vataroga by Charaka and Yogaratnakar that upakarmas like Abhyanga, Svedana are having prime treatment modalities. Snehana both bahya and abhyantra helps to pacify the vata dosha.

In contrast Abhyanga a variety of bahya sneha with medicated oils helps in subsiding the vata dosha, improves muscle tone and makes the body compact. Whereas swedana like Shastikashaali pinda swedana also improves the tone of the body.

Swedana karma increases the metabolic activity which in turn increases the oxygen demand and blood flow. This vasodilatation stimulates the superficial nerve ending causing a reflex dilatation of the arterioles. Due to the effect of heat on the sensory nerve endings, there will be a reflex stimulation of sweat glands in the areas exposed to heat. This rise in temperature induces muscle relaxation and increases the efficacy of muscle action as the increased blood supply ensures the optimum condition for muscle contraction. Swedana also acts by the mechanism of thermo regulation regulated by skin and coordinated with the functions of the other excretory organs. It is supplied with many groups of nerves, which conduct various stimuli. The secretion of sweat is under nervous system control especially autonomous. Thus swedana can bring about changes indirectly on the autonomic nervous system and the heat can bring about changes in conduction of nerve stimuli by changing sodium ion concentration.

Types Of Muscular Dystrophy-

There are several types of muscular dystrophy, few are explained below with symptoms:-

1. DUCHENNE MUSCULAR DYSTROPHY

This is the most common type of muscular dystrophy which affects boys mostly at the age of 2 and 3 years.

Symptoms-

·         Difficulty in running and jumping

·         Learning disabilities

·         Problems in getting up from a lying and sitting position

·         Walking on toes

·         Quick falls

·         Stiffness

·         Pain in muscles

2. BECKER MUSCULAR DYSTROPHY

This type of dystrophy is also similar to Duchenne muscular dystrophy but it is less severe. It also occurs in the boys at the age of 11 and 25 years.

Symptom-

·         Weakness in legs and arms

·         Muscle cramps

·         Difficulty in getting up from floor

3. CONGENITAL MUSCULAR DYSTROPHY

It occurs between birth and age of 2 years.

Symptoms-

·         Difficulty to sit and stand without support

·         Vision problems

·         Scoliosis

4. MYOTONIC DYSTROPHY

It is also called as Steinert’s disease or dystrophia myotonic. Myotonic dystrophy is characterized by the inability in the muscle relaxation after they contract. It may affect the various parts of body like adrenal glands, heart, eyes, facial muscles and central nervous system. Usual onset is between the age group of 20 and 30.

Symptoms-

·         Poor vision

·         Difficulty in swallowing

·         Early baldness

·         Problem in lifting neck due to muscle weakness

·         Weight loss

CAUSES OF MUSCULAR DYSTROPHY-

Certain genes are involved in making proteins that protect muscle fibers. Muscular dystrophy occurs when one of these genes is defective. Each form of muscular dystrophy is caused by a genetic mutation particular to that type of disease. Most of these mutations are inherited.

RISK FACTORS OF MUSCULAR DYSTROPHY-

Muscular dystrophy occurs in both sexes and in all ages and races. However, the most common variety Duchenne usually occurs in young boys. People with a family history of muscular dystrophy are at higher risk of developing the disease or passing it on to their children.

The complications of progressive muscle weakness include:

·         Trouble walking – Some people with muscular dystrophy eventually need to use a wheelchair.

·         Trouble using arms – Daily activities can become more difficult if the muscles of the arms and shoulders are affected.

·         Shortening of muscles or tendons around joints (contractures) – Contractures can further limit mobility.

·         Breathing problems – Progressive weakness can affect the muscles associated with breathing. People with muscular dystrophy might eventually need to use a breathing assistance device (ventilator), initially at night but possibly also during the day.

·         Curved spine (scoliosis) – Weakened muscles might be unable to hold the spine straight.

·         Heart problems – Muscular dystrophy can reduce the efficiency of the heart muscle.

·         Swallowing problems – If the muscles involved with swallowing are affected, nutritional problems and aspiration pneumonia can develop.

IMPORTANCE OF YOGA IN MUSCULAR DYSTROPHY

Yoga has also shown to improve a muscular dystrophy patient’s digestion and aid the elimination of toxins. In muscular dystrophy, yoga can help to cope up with symptoms and improve the quality of life. Regular practice of yoga can improve blood circulation and strengthens the weakening muscles.

YOGASANAS

·         Surya Namaskar

·         Bhujangasana

·         Gomukhasana

·         Padhastasana

·         Pawanmuktasana

·         Parvatasana

·         Paschimottanasana

·         Padmasana

·         Virbhadrasana

·         Virasana

PRANAYAMA

·         Nadi Shodhana Pranayama

·         Bhramari Pranayama

·         Anuloma – Vilom Pranayama

MEDITATION

·         Nada Anusadhana

·         OM meditation

LINE OF TREATMENT-

1.       BAHYA ABHYANGA- Ashvagandha bala taila, Mahamamsa taila

2.       Udhvartan- Amalaki, Ashvagandha

3.       Sarvangdhara- Picchil

4.       Shashtik shali sveda

5.       Tila Ammsa panda sveda

6.       Matra basti

SANSAMAN CHIKITSA PATRA

1.  Yaga (2-3 times with Brahmi rasayan /Chyavanprash)

A. a. Kumar kalian rasa 30mg + Praval panchamrut 125mg + Yogendra rasa 30mg (for below 10 year age)

A. b. Kumar kalian rasa 60mg + Praval panchamrut 250mg + Yogendra rasa 60mg (for below 10 year age)

B. Balrogantak rasa 60mg + Vatakulantak rasa 30ml + Giloy sattva 125mg

2.  Atisar/Apach-  Balchaturbhuj curna

3. Bhimseni kapoor 125mg two times chatan with suddha ghruta

4.  Suddha shilajeet 125-500mg with milk

5.  Arvindasava ½ tsp two times with water

Samshodhan

1.  Svedan

A. Shashtik shali sveda-

Balamula kadha-300ml + dugdha-300ml

-          Cook rice in 500ml dravya and make 4 pottali

-          Rest 100ml dravya cooked in slow flame

 Make gental massage with help of pottali and dravya

B. Udad-25gm + Tila-25gm + Rice-25gm +Choker (west part of aata)-25gm add with

Ashvagandha/satavari kvatha 300ml + 300ml milk

Use as shashtik shali sveda

(use 20days A formula then 20 days B formula)

2.  Matra basti (continuous-20 to 30ml)

A. Taila basti

a.       Bala taila

b.      Nirgundi taila

c.       Ashvagandhadhi bala taila

B. Mamsa rasa basti-

- aja mamasa rasa (1part) + water (14part)à cook à100ml basti

C.Mustadi yapan basti

D.Siddha basti

- Yava+ Kol+ Kulatha+Pippali+Mulethi+Ashvagandha+Kivach beej(each 20gm) add with 8 times waterà cool until 200ml remainingàadd 50ml madhu + 50ml PanchTikta Ghrita+10gm sindhavà basti

(3 course of 11 days—may give anuvasana basti with-balamula/ Nirgundi taila/Ashvagandhabaladi taila after meal)

E.Brihad Panchmula Niruha basti

- Brihad panchmula-100gm+Pippali-20gm +Mulethi-20gmà make 300ml kvatha and add panch siddha ghruta-50ml +50ml madhu+10gm Saindhavà basti

3. Ashvagandha, Balamula siddhit dugdha pana

4. Indriyavardhak taila nasya

-in children 2drops BD

-less then 1year 1drroup BD