Ishtika Sweda for Calcaneal Spur Treatment



Calcaneal Spur or Heel Spur is one of the chief causes of heel pain.

Calcaneus bone or Calcaneum: It is the largest bone forming the foot and also the largest tarsal(Tarsals are the bones of the foot and are 7 in number). It forms the heel and is also called the heel bone.

Calcaneal spur is an abnormal growth of bone in the form of a hook either underneath the foot(inferior aspect of calcaneus) in relation to the attachment of the plantar fascia or behind the heel(posterior aspect of the calcaneum) at the insertion of the Achilles tendon.

Other conditions which produce heel pain:

*Another condition called Plantar Fascitis is often confused with Calcaneal spur but infact it is a different diagnosis. Plantar fascia is a ligamentaneous tissue which extends from the calcaneum to the ball of the foot. It helps in maintaining the arch of the foot and substantially bears the weight of the body while walking or running. It is thus prone to wear and tears and is thus subjected to trauma. This condition also produces similar type of foot pain. They are often interrelated but not as a rule.

*Retrocalcaneal bursitis: Inflammation of the bursae related to calcaneal bone

*Achilles tendonitis: Inflammation of the Achilles tendon at its insertion over the calcaneum causing posterior heel pain

*Tarsal Tunnel Syndrome: Compression of the posterior tibial nerve in the bony passages amidst the tarsal bones.

Causes: Constant pressure on the heel due to long standing jobs requiring standing or walking for long periods, Ill fitting foot wears..

Symptoms: Pain in the heel either below or behind. Pain aggravates in the morning after waking up from the sleep or after standing or walking for long periods.

Treatment:

*Rest

*Cold or ice packs

*Analgesics

Ayurvedic approach in healing heel pain:

*Shodana: Virechana with Gandharvahastadi oil is definitely beneficial in this condition.

Matra Vasti with Gulgulutiktaka gritham either singly or in combination with Narayana tailam or Dhanwantara tailam/Mezhupakam provides a long standing relief and also prevents recurrence.

*Shamana: The below mentioned medicaments are prescribed for an effective relief-

Tablet Kaishora Guggulu or Kaishora Guggulu(DS)
Tablet Yogaraja Gulgulu
Gulgulu Tiktakam Kashayam or Gulgulu Tiktakam Kashayam tablets
Sahacharadi Kashayam or Sahacharadi Kashayam Tablets
Dashanga Lepam
*Sthanika(Local): Abhyanga and Ishtika Sweda work out wonders in the treatment of calcaneal spurs.

Raktavasechana(Blood letting) and Suchi Daha(hot needle cauterization) are also advised.



Ishtika Sweda(Brick Fomentation):



CS can be compared to Vata Kantaka in Ayurveda.The easiest form of treatment of CS is Ishtika Sweda. It can be performed by the patient itself at home since it is simple and cost effective.



Method of preparation:



*First of all the painful area of the spur should be given an Abhyangam(massage without force) using any vata hara tailas viz Mahanarayana taila or Ksheerabala taila or Dhanwantara taila. Bricks should be taken and broken into small pieces. They should be heated red hot and dipped in rice washed water i.e tandulodaka or Dashamoola kashaya and immediately tied in a cloth in the form of a bolus. The hot bolus should be placed on the massaged part removing intermittently. Before fomenting the affected part the heat of the bolus should be tested by putting it on the palm by the person doing it to avoid burns. This is not advised in diabetic patients or in conditions where the sensation is disturbed.

*Alternately the brick pieces are heated to tolerable heat and tied in the cloth and sudation is given to the painful part without dipping it in the decoction or rice wash. But abhyanga should be done before the procedure as a rule. Once the bricks lose the heat they are removed from the bolus and heated again. The procedure is repeated.

*In Plantar fascitis without spur, abhyangam with any one of the above said tailas is given and later the patient is advised to keep his foot in the hot decoction of Dashamoola (when it is tolerable) or just in hot water or salted hot water.