An exploration into the diagnosis and management of neck pain by Ayurvedic practitioners in South Africa

Abstract

Background The health care system of South Africa is growing exponentially and providing patients with various treatment options. Recently, Ayurveda has become popular because of its nature-based and spiritual approach to ailments. Neck pain has been researched to a great extent in allopathic medicine, but not in the context of Ayurvedic medicine. Although there is a wealth of information regarding Ayurveda and its basic principles, there are limited publications on the Ayurvedic approach to common musculoskeletal conditions such as neck pain. Therefore, the aim of this study was to determine the Ayurvedic approach to the diagnosis and management of neck pain by Ayurvedic practitioners in South Africa. Method A qualitative exploratory descriptive study was conducted using standardized open-ended questions. Eight Ayurvedic practitioners, from South Africa, from the provinces of KwaZulu-Natal and Gauteng, were interviewed to establish their methods of diagnosis and management of neck pain. The interviews were semi– structured and conducted in English and later transcribed verbatim. The transcripts were then analysed using thematic analysis to establish codes, categories and themes. Results Eight out of thirteen registered Ayurvedic practitioners in South Africa participated in the study. Five main themes emerged from the data: the Ayurvedic approach to management of neck pain, the Ayurvedic diagnosis of neck pain, the Ayurvedic treatment of neck pain, the use of modalities in the Ayurvedic profession for the management of neck pain and the basis of referral in the Ayurvedic profession to manage a patient with neck pain. Participants discussed the importance of the three dosha principle and the importance of knowing the “root cause” of an ailment as an integral part of the management of a patient with neck pain. The three dosha principle focuses on vata, pitta and kapha, which are the constituents of the human body. It is essential that there is homeostasis of the three doshas to maintain good health and a disease-free state. The participants, in this study, discussed the root cause of an ailment as being the underlying factors that bring about pain in the body. Participants stressed the importance of the “pulse diagnosis,” the integration of modern technology and the threefold principle of darshana, sparshna and prashana in order to properly diagnose a patient. These diagnostic tools emphasize the holistic approach of the Ayurvedic system of medicine. The treatment method varied amongst participants. Although each practitioner practices differently, the basic principles of the profession are still applied when administrating treatment to a patient. Treatment focused on panchakarma therapy, greeva basti, shirodhara, massage and potli therapy, herbal oils and medication. The goal of Ayurvedic treatment is to pacify the aggravated doshas, utilizing these various treatment options. Participants in this study focused on yoga, marma therapy and patient education as modalities that are utilized by the profession to assist in the management of neck pain. They discussed the importance of referral to the appropriate health care professional, so that the patient receives the best possible care. The results of this study revealed that the Ayurvedic system of medicine is a holistic system of medicine that addresses all aspects of the mind, body and spirit. In Ayurveda, the management of a patient relies on the patient, practitioner and the “three dosha principle”. The foundation of the “three dosha principle” focuses on vata, pitta and kapha. Essentially, various ratios of vata, pitta and kapha exist in every individual, however, when there is lack of homeostasis between these three elements, disease occurs in the body. The therapeutic goal in Ayurveda is to restore doshic balance in the body. Conclusion This is the first South African study to be conducted on the Ayurvedic management and diagnosis of the musculoskeletal condition, neck pain. This study will add to the body of literature and enable other practitioners to have a better understanding of Ayurveda, thus giving the patient the best, appropriate care available. The foundation of Ayurveda is the “three dosha principle” which the profession applies to holistic patient management, focuses on the mind, body and spirit of the patient, rather than the disease per se.