AVABAHUKA (FROZEN SHOULDER): A COMPREHENSIVE LITERARY REVIEW OF ITS AYURVEDIC AND CONTEMPORARY UNDERSTANDING

Abstract

Avabahuka is a Vata-predominant Amsa Sandhigata Vyadhi described by Acharya Sushruta among the eighty varieties of Vata Vyadhi, characterised by progressive pain, stiffness and restriction of movement at the shoulder joint. Clinically it corresponds closely to 'frozen shoulder' or adhesive capsulitis of contemporary orthopaedics, a condition affecting roughly two to five percent of the general population but rising to tento- thirty-six percent among diabetics, in whom it also tends to be more severe, more often bilateral, and more resistant to treatment. Modern management, centred on analgesics, physiotherapy, intra-articular corticosteroids and, in refractory cases, manipulation or arthroscopic capsular release, offers symptomatic relief but is frequently associated with recurrence, incomplete restoration of range of motion, or procedure-related morbidity. Beyond a conventional literary review of Avabahuka's Nirukti, Nidana, Samprapti, Purvarupa, Rupa, Sadhya-Asadhyata and classically indicated Chikitsa Sutra (Snehana, Swedana, Basti, Nasya, Agnikarma, Raktamokshana and Shamana Aushadhi), this article specifically addresses two areas under-represented in existing Avabahuka reviews: the pathophysiological and classical (Avarana-based) correlation between Avabahuka and Prameha (diabetes mellitus), and a structured synthesis of the sample sizes, interventions and outcome measures reported across published Ayurvedic clinical studies on Avabahuka. The review finds a coherent classical rationale for the clinically observed severity of diabetic frozen shoulder, and finds that, while every located clinical study reports a favourable direction of effect with no serious adverse events, the evidence base remains limited to small, heterogeneous, largely uncontrolled studies, highlighting a clear need for adequately powered comparative trials using validated composite outcome measures.