Role of Ayurveda in the Management of Adult-Onset Distal Myopathy: A Clinico-Functional Case Report

Abstract

Adult-onset distal myopathy is a rare progressive neuromuscular disorder characterized by distal muscle weakness, impaired mobility, and reduced functional independence. In Ayurveda, the clinical features may be correlated with Mamsagata Vata under the spectrum of Vatavyadhi, where aggravated Vata Dosha leads to impairment of muscle tissue and neuromuscular function. Case presentation: A 65-year-old male presented with progressive weakness of both lower limbs and the right upper limb for two years, associated with difficulty in standing, walking, and performing activities of daily living. Clinical evaluation, electromyography, nerve conduction studies, magnetic resonance imaging, and genetic testing supported the diagnosis of adult-onset distal myopathy with predominant motor axonal involvement. Intervention: The patient was treated with a comprehensive Ayurvedic regimen comprising internal medications and external therapies including Dhanyamla dhara (Pouring medicated decoction) Abhyanga (medicated oil massage), Nadi Sweda (fomentation with steam), Jambeera pinda swedam (poultice prepared with lemon, and other herbes) Shastika Shali Pinda Sweda (poultice prepared with red variety rice, milk, medicated herbs), and Matra Vasti (oil enema). The treatment was planned according to the principles of Vatavyadhi Chikitsa, incorporating Ama Pachana, Srotoshodhana, Snehana, Swedana and Brimhana, along with supervised therapeutic exercises. The treatment period was for 13 days. Outcome: Following treatment, the patient demonstrated reduction in muscle stiffness and pedal oedema, mild improvement in muscle strength, the ability to stand independently for approximately five minutes, and assisted ambulation. The Barthel Index improved from 45/100 at admission to 60/100 at discharge, indicating enhanced functional independence. Conclusion: This case highlights the potential role of an individualized Ayurvedic treatment approach in improving functional ability and quality of life in adult-onset distal myopathy. Further well-designed clinical studies are required to establish its therapeutic efficacy.