Effectiveness of Siddha Varmam Therapy in Improving Pain, Flexibility and Quality of Life in Osteoarthritis Adults: A Randomized Controlled Study

Introduction

Osteoarthritis (OA) is a prevalent joint disorder caused by the degradation of joint cartilage and underlying bone, most commonly affecting the knees and hips. Osteoarthritis impacts about 3.8% of the global population, with a higher prevalence among the elderly in India—affects 22% to 39% of the Indian population, and is a leading cause of locomotor disability in the elderly in which 10% of men and 18% of women over 60 years [1]. It accounts for around 2% of years lived with disability, with bone deformities heightening the risk of knee OA due to pre-existing malformations and cartilage defects. The condition progress as cartilage deteriorates, leading to bone friction, pain, reduced mobility, and deformity [2]. Repetitive stress on the knees, common in certain occupations, increases OA risk. Symptoms, including “pain, tenderness, stiffness, loss of flexibility, grating sensations, and bone spurs, tend to worsen over time. Modern medicine, offers symptomatic relief through analgesics and anti-inflammatory drugs are often accompanied by side effects like gastritis and ulcers, Siddha Varmam Therapy stands out as a holistic treatment for OA, aiming to alleviate pain, enhance flexibility, and improve overall quality of life, bypassing the adverse effects typical of standard medical treatments [3]. Siddha targets the root causes of OA, akin to Azhal keel vaayu in traditional terms, without adverse effects [4].

The therapy, deeply embedded in Siddha medicine, effectively manages osteoarthritis (OA) symptoms, enhancing pain relief, flexibility, and overall quality of life. It emphasizes a drug-free, non-invasive, and cost-effective treatment that stands out for its efficiency in managing OA. It focuses on stimulating specific points to improve energy flow, reduce inflammation, and alleviate pain, offering a sustainable alternative to NSAIDs, which may pose gastrointestinal and cardiovascular risks over long-term use [5]. Additionally, Siddha therapy surpasses NSAIDs in enhancing joint mobility and flexibility through holistic practices, including physical manipulations and traditional remedies, contributing to better daily functioning and physical activity [6, 7]. Beyond physical benefits, Siddha’s comprehensive approach significantly boosts patients’ mental well-being, stress levels, and vitality, marking a stark contrast to the limited scope of NSAIDs that focus solely on pain management without addressing the broader spectrum of health and well-being. The randomized control study examines the effects of Siddha therapy on the OA patients in comparison to patients who are on NSAID’s with respect to to pain reduction, joint flexibility and enhanced quality of life.

Results

Participants undergoing Siddha Varmam therapy

exhibited notable enhancements in their overall WOMAC global scores, with a significant mean improvement of -21.15 (SD 22.46) mm (P<.001). This improvement was consistent across all evaluated domains, including pain, stiffness, and physical functional disability. In contrast, the control group, despite being on medication, did not show any significant changes from baseline across these domains, with the exception of pain.

As shown in Table 1, the intervention group shows substantial improvement in comparison to baseline was noted in the domain of pain, with a decrease of -23.19 (SD 24.30) mm (P<.001), followed by stiffness, which improved by -21.60 (SD 26.99) mm (P<.001), and physical function, which saw an enhancement of -20.50 (SD 22.50) mm (P<.001) . The differential effects amid the groups were statistically significant across all measured parameters, indicating the distinct advantage of the intervention in alleviating the symptoms of osteoarthritis.

Furthermore, the changes in the Visual Analog Scale (VAS) and clinical assessments of range of motion paralleled those seen in the WOMAC global score, with a strong correlation (r = 0.84, P<.001) between VAS changes and WOMAC score improvements. This correlation underscores the consistent and significant impact of Siddha Varmam therapy on outcome measures of pain, stiffness and functionality.

Table 2 presents the reliability statistics for two groups, Control and Experimental or (Siddha with Yoga), based on Cronbach’s Alpha coefficients. Each group was assessed using a set of 24 items. Cronbach’s Alpha values of .902 for the Control group and .904 for the Experimental group indicate high internal consistency among the items used to measure the constructs in each group, suggesting that the items reliably assess the intended outcomes.

Discussion

This study aimed to assess the efficiency of Siddha Varmam therapy, a traditional Indian medical practice, in improving pain, stiffness, and functionality in patients with osteoarthritis. The results showed that the intervention group, which received Siddha Varmam therapy had significant developments in the WOMAC global score, the VAS for pain, and the clinical assessments of range of motion, compared to the control group, who received only medication (Table 1). These findings suggest that Siddha Varmam therapy can be an effective and safe alternative treatment for osteoarthritis, as it can significantly reduce pain, improve joint mobility, and enhance quality of life in patients .Whereas, in Table 2 siddha with yoga exercises also show consistent finding suggesting reliability statistics for the control and intervention groups, based on Cronbach’s Alpha coefficients, indicating high internal consistency among the items used to measure the constructs in each group, suggesting that the items reliably assess the intended outcomes.

The findings of this study are consistent with previous studies that have reported the benefits of Siddha therapy for various health conditions, especially osteoarthritis. For example, Ramaswamy RS, et al. [6] conducted a randomized controlled trial in India and found that Siddha therapy can be an effective alternative to NSAIDs for pain reduction, joint flexibility, and quality of life improvement in patients with osteoarthritis. In a randomised controlled trail study by Mehta P, et al. [8] also found that Siddha therapy has osteoarthritis- specific effects that can help improve the overall health of patients. Similarly, Banu NM, et al. [9] conducted another randomized controlled trial and found that 48 days of Varmam therapy, a type of Siddha therapy, resulted in clinical improvement in pain, stiffness, swelling, and range of motion in patients with osteoarthritis. Furthermore, it was observed that Varmam therapy provides significant pain relief and, although it may appear miraculous, it is rooted in fundamental human anatomy and scientific manipulation procedures primarily documented by Siddhars, the ancient practitioners of Siddha medicine.

Furthermore, Sreedhana CR, et al. [10] reported a case study of a 55-year-old female patient who had been suffering from osteoarthritis for two years. After 15 days of Siddha therapy, the patient reported a 50% reduction in knee discomfort and a noticeable increase in joint leg flexibility. The patient also reported a significant improvement in her ability to perform daily tasks.

These studies, along with the present study, provide evidence for the efficacy and safety of Siddha therapy for osteoarthritis. Siddha therapy combined with yoga exercises showed that there was a significant decrease in knee pain and stiffness. As compared to the control group, the experimental group had significant improvement in mobility and strength. Previous findings of Schilke et al. supports this theory, where 10 patients with knee pain, have undergone 8 weeks of the isokinetic muscle-strength-training program and showed a significant decrease in pain and stiffness [11]. Improvements were also shown in health-related quality of life, physical activities, general health & activeness, and overall mental health scale. This suggests that a multidimensional approach of Siddha with yoga provides better results in pain and functional disability in cases of chronic knee osteoarthritis with reduction of drug dependency [12]. This study adds to the growing body of literature on the benefits of traditional Indian medical practices for various health conditions.

Thus the study demonstrates that Siddha Varmam therapy, a traditional Indian medical practice, can significantly improve pain, stiffness, and functionality in patients with osteoarthritis, compared to medication alone. Siddha Varmam therapy, combined with yoga exercises, can offer a natural and holistic approach to treat osteoarthritis, without the adverse effects of medication.

Conclusion

The study confirms Siddha Varmam therapy’s effectiveness in pain reduction, stiffness, and refining functionality in osteoarthritis patients, with significant improvements noted (P<.001 for pain and stiffness; P=.002 for functionality) compared to standard treatments. These results highlight Siddha Varmam therapy as a holistic, effective alternative without the side effects of conventional methods. The strong correlation between VAS and WOMAC scores, along with high Cronbach’s Alpha values (.902 and .904), attest to the therapy’s reliable benefits and its potential as a preferred treatment for osteoarthritis management. In conclusion, Siddha therapy can be an effective alternative to NSAIDs for decrease in pain, joint flexibility, and enhanced quality of life in patients with osteoarthritis.