A Randomised Controlled Clinical Trial on Efficacy of Siddha Varmam Therapy in the Management of Chronic Low Back Pain

Abstract

My interest in treating chronic low back pain grew as many patients approached the outpatient department of Siddha Central Research Institute, Chennai for chronic low back pain. I observed that there was some lacuna in understanding the sufferings of patients with chronic low back pain. Professional clinical practice is based mainly on the technical knowledge of the professionals not the experiential knowledge of the patient. Objective: 1. To develop a Varmam treatment protocol for chronic low back pain through consensual modified Delphi survey technique. 2. To evaluate the effectiveness of Siddha Varmam therapy (SVT) compared with Siddha Ennai Poochu (SEP) in reducing low back pain. This study is salient in many ways. 1. Delphi survey: Consensus arrived at in selecting Varmam points for SVT group. 2. Sample size: Previous studies had lower sample when compared to this study. 3. Randomized Controlled Trial Design: There were no such studies on Varmam. 4. Assessment: Assessment was blinded to the investigator to reduce Hawthorne effect (It is a type of reactivity in which individuals modify an aspect of their behavior in response to their awareness of being observed). 5. Quality of Life: This is first of its kind to study that has observed the effect of SVT and SEP on disability due to CLBP and quality of life. There is no study that have observed quality of life. 6. Pain reduction: Without internal medicines, SVT and SEP showed significant reduction in pain. No studies have been conducted so far with SEP and SVT alone as an intervention. Conclusion: This is a first study to evaluate effectiveness of SVT and SEP om the, aage, emt pf CLBP. It showed better results in the reduction of pain, functional disability and improvement of quality of life. Significant results seen in pain reduction, function disability and improvement in QOL encourages acceptability of those SVT and SEP in the present day hurried life. Limitations: Interventions were given for 12 days (short term) in CLBP, may be considered as a major limitation.