EFFECT OF UTSĀDANA (WET POWDER MASSAGE) IN DIABETIC DISTAL SYMMETRIC POLYNEUROPATHY (DSPN)-A PRE TEST POST TEST DESIGN

Abstract

Introduction: Diabetic Distal Symmetric Polyneuropathy (DSPN) is a prevalent and debilitating complication of diabetes mellitus, often leading to serious outcomes such as diabetic foot ulcers. The condition develops gradually and typically begins in the distal parts of the lower limbs, creating "stocking and glove" pattern of sensory impairment. Conventional management strategies offer limited symptomatic relief and are frequently associated with adverse effects. In Ayurvedic literature, while DSPN is not directly referenced, it is understood under the broader context of Prameha Upadrava (complications of diabetes). The clinical progression typically involves an initial predominance of Kapha dosha (numbness or supthi), followed by Pitta dosha (burning sensation), and ultimately Vata dosha (pain, tingling, degeneration). Materials and Methods: This prospective single-arm pretest–post-test interventional study with follow-up included 10 patients exhibiting symptoms such as numbness, burning sensation, and aching pain. All patients tested positive on the Michigan Neuropathy Screening Instrument (MNSI) confirming the diagnosis as DSPN. The intervention included an external Ayurvedic therapy, Utsādana (Wet powder massage), using Lakṣādi Cūrṇa,elādi Cūrṇa mixed with Ghṛita and Tila taila, massaged daily 45 minutes for 14 days. Results: The treatment led to a statistically significant reduction in the Neuropathy Total Symptom Score (NTS-6) with a p-value < 0.05, indicating clinically significant in reducing the Neuropathy Total Symptom Score (NTS-6) Discussion: Diabetic neuropathy is often considered a Kapha–Pitta or Kapha–Vāta predominant condition, where Kapha causes āvaraṇa of Vāta. Utsādana, due to its Snigdha rūkṣa and Kapha-hara properties, helps remove this obstruction and alleviates the symptoms. Conclusion: This prospective single-arm pretest–post-test interventional study highlights the potential role of Ayurvedic external therapies as supportive treatments in the management of DSPN.