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A Dissertation on EVALUATION of EFFECTIVENESS of HOT MUSTARD PACK with FOMENTATION on PATIENTS with LUMBAR SPONDYLOSIS Submitted

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A Dissertation on EVALUATION of EFFECTIVENESS of HOT MUSTARD PACK with FOMENTATION on PATIENTS with LUMBAR SPONDYLOSIS Submitted A Dissertation On EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS Submitted by Dr. C. SENTHILKUMAR, B.N.Y.S (Reg. No. 461511005) Under the guidance of Prof. Dr. N. MANAVALAN, N.D. (OSM), M.A (G.T), M.Sc (Y&N), M.Phil, P.G.D.Y, P.G.D.H.M, P.G.D.H.H Submitted to The Tamil Nadu Dr.M.G.R.Medical University, Chennai In partial fulfillment of the requirements for the award of degree of DOCTOR OF MEDICINE BRANCH – I: NATUROPATHY POST GRADUATE DEPARTMENT OF NATUROPATHY GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI – 600 106. OCTOBER 2018 GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU CERTIFICATE BY THE GUIDE This is to certify that “EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS” is a bonafied work done by the Post graduate Dr.C.SENTHILKUMAR, Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai-600106, under my guidance and supervision in partial fulfillment of regulations of The Tamilnadu Dr.M.G.R.Medical University, Chennai for the award of degree of DOCTOR OF MEDICINE (M.D) – Naturopathy, BRANCH – I during the academic period October 2015 to 2018. Place: Chennai. SIGNATURE OF THE GUIDE Date: Dr.N.MANAVALAN, N.D (OSM),M.Phil, M.A(G.T); M.Sc (Y&N),P.G.D.Y; P.G.D.H.M; P.G.D.H.H, Head of the Department - Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai – 106. i GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU ENDORSEMENT BY THE HEAD OF THE DEPARTMENT I certify that the dissertation entitled “EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS” is the record of original research work carried out by Dr.C.SENTHIL KUMAR, Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai – 600 106, submitted for the degree of DOCTOR OF MEDICINE M.D – Branch – I (Naturopathy) under my guidance and supervision, and that this work has not formed the basis for the award of any degree, diploma, associate ship, fellowship or other titles in this University or any other University or Institution of higher learning. Place: Chennai. SIGNATURE OF THE H.O.D Date: Dr.N.MANAVALAN, N.D (OSM),M.Phil, M.A(G.T); M.Sc (Y&N),P.G.D.Y; P.G.D.H.M; P.G.D.H.H, Head of the Department - Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai – 106. ii GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU ENDORSEMENT BY THE PRINCIPAL I certify that the dissertation entitled “EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS” is the record of original research work carried out by Dr.C.SENTHILKUMAR, Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai – 600 106 submitted for the award of degree of DOCTOR OF MEDICINE (M.D) Branch – I (Naturopathy) under my guidance and supervision, and that this work has not formed the basis for the award of any degree, diploma, associate ship, fellowship or other titles in this University or any other University or Institution of higher learning. Place: Chennai. SIGNATURE OF THE PRINCIPAL Date: Dr.N.MANAVALAN, N.D (OSM),M.Phil, M.A(G.T); M.Sc (Y&N),P.G.D.Y; P.G.D.H.M; P.G.D.H.H, Head of the Department - Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai – 106. iii GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU. DECLARATION BY THE CANDIDATE I, Dr.C.SENTHILKUMAR, solemnly declare that this dissertation entitled “EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS” is a bonafied and genuine research work carried out by me at Government Yoga and Naturopathy Medical College and Hospital, Chennai from October 2015 - October 2018 under the guidance and supervision of Dr.N.MANAVALAN, N.D(OSM), M.Phil, M.A(G.T);M.Sc (Y&N),P.G.D.Y; P.G.D.H.M; P.G.D.H.H, Head of the Department - Department of Naturopathy. This dissertation is submitted to The Tamilnadu Dr.M.G.R.Medical University, Chennai towards partial fulfillment of requirements for the award of M.D. Degree (Branch – I –Naturopathy) in Yoga and Naturopathy. Place: Chennai Signature of the candidate Date: (Dr. C. SENTHILKUMAR) iv INSTITUTIONAL ETHICAL COMMITTEE GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI – 600 106. CERTIFICATE OF APPROVAL The Institutional Ethical Committee of Government Yoga & Naturopathy Medical College and Hospital, Chennai reviewed and discussed the application for approval of “EVALUATION OF EFFECTIVENESS OF HOT MUSTARD PACK WITH FOMENTATION ON PATIENTS WITH LUMBAR SPONDYLOSIS, project work submitted by Dr.C.SENTHILKUMAR, 2nd year M.D. Naturopathy, Post graduate, Government Yoga and Naturopathy Medical College and Hospital, Chennai. The proposal is APPROVED. The Institutional Ethical Committee expects to be informed about the progress of the study and adverse drug reactions during the course of the study and any change in the protocol and patient information sheet / informed consent and asks to be provided a copy of the final report. v COPYRIGHT DECLARATION BY THE CANDIDATE I hereby declare that the Tamilnadu Dr.M.G.R.Medical University, Chennai, Tamilnadu shall have the rights to preserve, use and disseminate this Dissertation / Thesis in print or electronic format for academic / research purpose. Place: Chennai Signature of the candidate, Date: (Dr.C.SENTHILKUMAR) © The Tamilnadu Dr.M.G.R.Medical University, Chennai, Tamilnadu vi ACKNOWLEDGEMENT First of all I thank the Almighty God for giving me perception and strength to complete this study successfully. The writing of this dissertation has been one of the most significant academic experiences I have ever had to face. Without the support, endurance and guidance of the following people, this study would not have been completed. I am thankful for their aspirant guidance, invaluably productive criticism and welcoming advice during the project work. I am sincerely grateful to them for sharing their ingenuous and illuminating views on a number of issues related to the project. It is to them that I owe my deepest gratitude. I am sincerely thankful and grateful to our beloved principal and The Head Of The Department, Department Of Naturopathy, Dr. N.MANAVALAN, N.D (osm), M.Phil., M.A (G.T); M.Sc (Y&N),PGDYP; P.G.D.H.M; P.G.D.H.H. for the guidance, acceptance and approval of this study. I take this opportunity to express my heart felt gratitude to my HOD, and also extend my gratitude towards Dr.S.T. Venkateswaran, HOD, Division of Yoga & Physical Therapeutics, Dr.R.S. Himeshwari H.O.D. Acupuncture and Energy Medicine GYNMC, Arumbakkam, Chennai-106, for their relentless support and encouragement. My special thanks to all the faculties for their constant support, sustenance, assistance and suggestions throughout this study. vii My sincere thanks to Dr. Chandrasekar for completing all the statistical data analysis required for this study. My heartfelt thanks to all the non-teaching staffs of GYNMC and especially the therapist for helping me in conducting the treatment. I thank all my friends and colleagues of GYNMC for their timely help and assisting me in completing the study I would like to thank the participants who accepted, regularly attended and co – operated in this study. Words won’t be enough to express the moral support that I received from my family members, especially parents & my spouse Mrs. M. Gomathi M. Pharm (Pharmaceutics) whose genuine love and affection made me overcome some very bad phases of life. Date: (Dr. C. SENTHILKUMAR) viii LIST OF ABBREVIATIONS USED DD Disc degeneration LS Lumbar spondylosis CT scan Computed Tomography MRI Magnetic Resonance Imaging NSAID’s Non-steroidal anti-inflammatory drugs LBP Low Back Pain CLBP Chronic Low Back Pain HMPF Hot Mustard Pack with Fomentation IVDP Intervertebral Disc prolapse VAS Visual Analogue Scale RODI Revised Oswestry Disability Index NTT Neural Tension Tests ROM Range of Motion SLR Straight Leg Raising SPSS Statistical Package for the Social Sciences ix ABSTRACT Objective: To evaluate the effectiveness of Hot Mustard Pack with Fomentation (HMPF) on Low Back Pain (LBP) in patients with Lumbar Spondylosis. Background: Lumbar spondylosis can be described as all degenerative conditions affecting the disks, vertebral bodies, and associated joints of the lumbar vertebrae and neurologic claudication, which includes: lower back pain, leg pain, numbness when standing and walking. Previous literatures have reported that mustard plasters are very effective in the reduction of pain among patients with various types of arthritis, knee pain, aching backs, etc. Present study envisioned towards evaluating the effect of HMPF on LBP. Design: Pre and post Experimental study Study Setting: Outpatients of Government Yoga and Naturopathy Medical College and Hospital (GYNMCH), Arumbakkam, Chennai. Method: The study included 30 subjects with lumbar spondylosis. The patients were randomly selected from the outpatient department of GYNMCH. The subjects abiding the inclusion and exclusion criteria were recruited to study the effect of hot mustard pack with fomentation. The pre-test and post-test data from the patients were collected and assessed with Visual Analogue Scale (VAS), Revised Oswestry Disability Index x (RODI) and additionally with Neural Tension Test (NTT) and Range Of Motion (ROM). RESULT: The study showed significant detraction in the pain and inability variables of the study participants. The post intervention data showed significant reduction of pain, disability, NTT, and ROM comparatively to that of the pre intervention data.
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