Article by Dr Raghuram Y.S. MD (Ay)
Swedana or fomentation (sudation, sweat inducing treatments, steaming treatment) is a specialized treatment of Ayurveda which helps in providing unparalleled relief in pain, swelling and stiffness associated with diseases like Amavata vis-à-vis Rheumatoid arthritis, Osteoarthritis, Low back pain etc.
Valuka Sweda or Baluka Sweda is a form of swedana which is included under the category of Pinda Sweda (bolus fomentation). In this procedure we use heated sand tied in a bolus to provide heat to the afflicted joints or body parts, especially in diseases like Amavata (Rheumatoid Arthritis), Urustambha (stiffness of thigh and lower limbs), Medoroga (diseases manifested due to disturbances in fat metabolism) etc.
Before going in detail about Valuka Sweda and the method of doing it, I would like to give a brief introduction of Swedana in a few paragraphs
स्तंभ गौरव शीतघ्नं स्वेदनं स्वेद कारकम्। (च.सू.२२/१२)
Stambha gaurava sheetaghnam swedanam sweda kaarakam (Ref-Charaka sutra sthana 22/12)
Swedana is a treatment procedure in which sweat is induced by application of heat and warmth in the form of steam or by bringing the body / body parts in contact with heated medicaments (powders, leaves, processed rice, sand etc) tied in boluses. Swedana provides relief from Stambha (stiffness and catches), Gaurava (heaviness) and Sheeta (coldness) in the body or body parts.
Swedana is said to be the best form of treatment in expelling morbid Vata and Kapha and also destroying the diseases manifested due to morbid Vata and Kapha.
Swedana is usually done after Abhyanga and or Snehana (administration of medicated oils and ghee for oral consumption in metered doses, as a pre-treatment procedure for cleansing treatments like Vamana – Therapeutic vomiting and Virechana – Therapeutic purgation).
We all know how relieved we feel after taking a hot water bath. Even after hot water bath, the body starts sweating, we feel lighter and energetic. The effect of sweating treatment taken after a soothing massage can be known only after having experienced it. After Swedana, the cells get activated and flush the toxins away. The cellular metabolism improves and we feel light and at ease.
There are many types of Swedana as explained in Ayurvedic texts. There are about 13 types of Sagni Sweda’s (sweat inducing treatments administered by procedures involving utilization of fire or heated materials) and 10 types of Niragni Sweda (sweat inducing treatments where in the fire or heated materials are not utilized (ex. covering thick blankets until sweat appears etc).
Again, Swedana can be done in 2 ways – Ruksha Sweda (dry fomentation) and Snigdha Sweda (wet fomentation or sweat inducing treatment done after giving oil massage or by using the medicinal drugs which are processed or fried in herbal oils). In some pathological conditions both forms can be skillfully combined as and when required. In conditions where pain and associated symptoms are due to ama (metabolic toxins having a sticky nature, tending to block the transport systems of the body and cause painful conditions), meda (contaminated or accumulated fat) and or kapha (morbid kapha) we generally prefer doing Ruksha Sweda or dry fomentation. In conditions where the pain and related symptoms are due to vitiation of only morbid Vayu, we generally prefer Snigdha Sweda (wet or unctuous fomentation)
Every form of Sweda can provide relief from pain, stiffness and swelling. But their area of utilization and the diseases and pathological conditions in which they are administered or preferred will differ. In this context I would limit my discussion to Valuka Sweda (sand bag fomentation or sand bolus fomentation.
Ama means metabolic wastes created by low metabolism and indigestion which have a sticky nature and has a tendency to produce pain and stiffness.
Meda means fat.
Valuka Sweda falls into the category of Ruksha Sweda and Pinda Sweda.
Pinda Sweda (Bolus Fomentation) –
Pinda means bolus, Sweda means inducing sweating. Thus in Pinda sweda, the medicaments, generally hot or boiled to tolerable temperature are tied in a cloth so as to make a bolus. The bolus is gently rubbed over the painful area. Heat is provided until sweating occurs.
Pinda sweda is generally done as a local fomentation, applied on the pain afflicted body parts. It can be expanded so as to cover the entire body also. There are many variants of Pinda sweda, the name is given on the basis of the material / medicaments tied within the bolus.
Example – Patra Pinda Sweda (leaves of medicinal plants which can relieve pain, stiffness and swelling are used in the bolus), Churna Pinda Sweda (herbal powders prepared by pounding the medicinal drugs which can relieve pain and associated conditions are tied in the bolus), Valuka Sweda (heated sand is tied in the bolus) etc.
What is Valuka Swedam?
Valuka means sand, Sweda is sweat, Swedana is sweat inducing treatment.
Valuka Sweda is a treatment in which sand is used for fomentation (sweat inducing) of painful parts
In this treatment, the sand is heated to tolerable temperature and tied in a bolus. The bolus is heated in a pan. The heated bolus is continuously rubbed over the afflicted area, low back in this case. This treatment is preferred in the presence of ama (intermediate products of digestion and cell metabolism, circulating or tissue toxins which get adhered in the cells due to their sticky nature, block the channels and transport systems of the body and cause pain and stiffness) and symptoms of morbid kapha (stiffness, swelling, heaviness etc). Valuka Sweda is said to be unparalleled treatment in the systemic manifestation of Amavata (Rheumatoid arthritis).
In which conditions is Valuka Sweda used?
Ishtika Sweda is used mainly to provide relief from pain, inflammation, swelling and stiffness (catch) associated with heel pain. Many times it also acts as a disease-modifier wherein it provides a substantial relief of more than 90% and a long standing one too.
Valuka Sweda is used in the treatment of –
Rheumatoid Arthritis (Amavata) – It is a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet and ankles. It has an autoimmune component also. Valuka Sweda is a treatment of choice in Amavata vis-à-vis Rheumatoid arthritis. It is extremely useful in relieving the pain, swelling and catches in RA. It should be preferred when symptoms and signs of morbid vata, ama and kapha are predominant i.e. pain, swelling, and stiffness, feeling of cold in the regions of joints with some range of disturbed movements. Valuka sweda should not be done when morbid pitta is involved in RA presenting with signs of inflammation like burning pain, redness, increase of heat etc.
Stiffness of the thighs (Urustambha) – This disease too is caused by morbid vata, kapha and ama. Thus Valuka Sweda is highly effective in the management of Urustambha, just like in Amavata.
Obesity, Over-weight, Disorders of fat metabolism (Medoroga) – Excessive accumulation or production of fat due to failure of clearance mechanism or metabolic errors leads to manifestation of many disorders in the body. Meda or fat belongs to Kapha varga (elements of body belonging to kapha). Meda and kapha have a tenant and abode relationship (ashraya-ashrayi sambandha). Kapha helps in the formation of Meda, stays in it and helps in proper metabolism of Meda. When morbid kapha increases in the body, the meda too increases. Similarly when due to sluggish gut and tissue metabolism there is excessive formation of ama (metabolic wastes) in the body, it leads to accumulation of excessive kapha and meda in the body. All 3, i.e. morbid kapha, meda and ama tend to create blocks in the body due to their property of getting adhered to the tissues and channels and produce many diseases. Valuka Sweda being a dry form of fomentation helps to liquefy and clear the stagnant morbid factors and cure pain, swelling and stiffness and other diseases caused due to excessive fat accumulation. This includes obesity and over-weight conditions.
Cystic swellings / joint effusions (Granthi) – Accumulation of fluids in a cystic swelling or effusions is due to excessive morbid kapha. Valuka Sweda helps in reducing the swelling and fluid collections in tissues and joints.
Note – In all the above said conditions, Valuka Sweda should be carried out without doing Abhyanga (massage with medicated oils). This means to tell that Ruksha Sweda (dry fomentation) is carried out in the above said conditions.
Snigdha-Ruksha Valuka sweda (combination of oleation and sudation) – shall be done in the below said conditions wherein it is permissible to apply oil before carrying out Valuka Sweda.
Chronic stages of RA (Jeerna or pravruddha Amavata) – where the inflammation has subsided but pain has been left over
Musculo-skeletal pains as in myalgia and or fibromyalgia (Mamsagata Vata)
How is Valuka Sweda done?
Valuka Sweda is done in the below said method –
Purvakarma (Pre-treatment procedures): This includes –
Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined. After careful assessment, it is decided if Valuka Sweda is suitable to the disease and diseased or not. The treatment line-up, materials and medicines which need to be used are enlisted.
Preparation for the treatment:
Materials needed for the treatment are collected beforehand. They are:
Valuka or sand – Since sand is the most important material used in this treatment, we need to choose the sand with caution. We need to collect the sand from the banks of a river. The area from where we collect the sand should be clean and sterile and not contaminated. Care should be taken that the sand should be devoid of thorns, shells, pebbles etc. Sand should not be too smaller or too larger in size. Medium sized sand will do.
Sterile clothes to tie the bolus
Elongated cloth bags of different dimensions for filling sand, 3×12 inch bags for upper limbs and hands, 4×12 inch bags for legs, 6×21 inch bags for back, hips etc.
Thicker threads to tie the cloth into bolus after placing sand in it
Pans for heating / frying the sand
Spoons for frying the sand
Stove for heating
Sterile napkins or tissue papers for wiping
For Abhyanga (massage) – Taila (medicated oil), Ghee (medicated ghee) or both suitable to the disease and diseased are collected and stored beforehand (in case of snigdha-ruksha sweda). Some effective oils used for Abhyanga are Vishagarbha Taila, Kottamchukkadi Taila etc
Medicines needed to conduct Virechana (therapeutic purgation) or Vasti (therapeutic enemas), enema cans and syringes, sterile cotton etc
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Pradhana Karma (Treatment proper):
Valuka Sweda – Method 1 –
The sand is heated or fried in a pan and the temperature checked. Caution should be taken to see that the sand is not heated too much because it can cause burns when applied over the patient’s body.
After checking the temperature of heated sand it should be poured at the center of a double layered sterile cloth. The cloth is now tied into a bolus. A strong thick thread can be used to tie up the upper portion of the knot of the bolus to check the outflow of sand from small openings during the treatment procedure.
The patient is made to sleep on a couch after getting undressed (if the whole body fomentation has been planned as in RA or musculoskeletal rheumatism) or asked to expose only the affected part to which the heat is to be provided (as in RA affecting knee or low back).
The bolus containing heated sand is slowly rubbed against the body in a gentle manner.
When the sand loses its temperature (as we can feel the temperature imparted by the sand by placing our hand on the cloth bolus), the bolus is replaced with another bolus which is filled with hot sand. If only one bolus has been prepared, the contents (sand) should be removed from the bolus, reheated and once again tied in the bolus.
The procedure is repeated for a time period of 30-40 minutes or as per the protocol planned by the physician.
Valuka sweda should be done until the signs of proper sudation are seen and until the sweating occurs.
Abhyanga (massage with herbal oils) can be done when snigdha-ruksha sweda (skilful combination of wet and dry fomentation) has been planned
Samyak Swinna Lakshana
Signs of proper fomentation (Samyak Swinna or Samyak Swedana Lakshanas) –
शीत शूल व्यूपरमे स्तंभ गौरव निग्रहे।
संजाते मार्दवे च एव स्वेदनात् विरतिर्मता॥(सु.चि.१४/१३)
स्वेद स्रावो व्याधि हानिः लघुत्वं शीतार्थित्वं मार्दवः च आतुरस्य।
सम्यक् स्विन्ने लक्षणं प्राहुः एतान् मिथ्या स्विन्ने व्यत्यनेने एतदेव॥(सु.चि.३२/२३)
Sheeta shula vyooparame stambha gaurava nigrahe
Sanjaate maardave cha eva svedanaat viratirmataa (Ref – Sushruta Chikitsa 14/23)
Sveda sraavo vyaadhi haanihi laghutvam sheetaarthitvam maardavaha cha aaturasya
Samyak svinnae lakshanam praahuhu etaan mithyaa svinne vyatyyane etadeva (Ref – Sushruta Chikitsa 32/23)
Properly done sweating therapy brings about the below said signs –
Sheetoparama – The feeling of coldness pacifies
Shuloparama – Pacification of pain
Stambha nigraha – reduction of stiffness
Gaurava nigraha – reduction of the feeling of heaviness
Maardava – smoothness of the body or body parts
Sweda praadurbhaava – sweating of body or body parts subjected to fomentation
Roga lakshana prashamanam – Pacification or reduction of the symptoms of the disease
Sheetaartitvam – Liking towards taking cold foods and comforts
Care should also be taken so as to see that the patient is not subjected to excessive or deficit sweating
Parameters for improper / less sweating (Asamyak / Heena Swinna / Aswinna Lakshana) – In this the symptoms opposite to those explained in the Ati Swinna Lakshana are manifested i.e.
Sheeto anuparama – no relief from the feeling of cold
Shula anuparamam – non-pacification of pain
Stambha anigraha – no relief from stiffness
Gaurava anigraha – no relief from heaviness
Amaardavam – lack of smoothness of the part
Aswedam – absence of manifestation of sweat
Alaghutvam – no feeling of lightness
Vyadhi anupashama – no relief from disease
Parameters of excessive / over sweating (Ati Swinna Lakshana) –
Pitta prakopa – aggravation of pitta
Asra prakopa – aggravation of rakta
Trushna – thirst
Murcha – loss of consciousness
Svara sadana – weakness of voice
Anga sadana – weakness of the body
Bhrama – giddiness
Sandhi peeda – joint pains
Jwara – fever
Shyava-rakta mandala – brownish-red eruptions
Chardi – vomiting
Valuka Sweda – Method 2 –
The heated sand is filled in the bags of various dimensions (matching with the length and breadth of various body parts). After testing the temperature of the sand filled bags, the upper free ends of the bag or knotted and tied with thick threads. The patient is made to sleep on the couch. These sand bags are placed beneath the painful parts of the body. The bags are changed once the sand loses its temperature.
Paschat Karma (Post-treatment procedures):
The body parts of the patient subjected to Valuka Sweda is wiped with sterile cloth dipped and squeezed in warm salt water or wiped with tissue papers. The couch is also cleaned of sand particles.
The patient is asked to relax for a while
Nitya Virechana – Daily metered dose of purgation with purgative decoctions or oils like Gandharvahastadi Kashayam, Gandharvahastadi Eranda tailam, Nimbamritadi Eranda Tailam etc can be administered if a small amount of detoxification is essential on a daily basis or if morbid Dosha’s need to be tackled (optional and strictly based on the decision of the doctor)
Vasti – Medicated enema’s can be combined with Valuka Sweda especially in chronic conditions of RA etc diseases. A combination of Sneha Vasti (enemas with medicated oils and ghee) with Brihat Saindhavadi Taila or Guggulutiktakam Ghritam, Mahanarayana Tailam or Dhanwantaram tailam / mezhupakam and Kashaya Vasti (Decoction enemas) with Erandamuladi Vasti or Dashamula Vasti or Mustadi Yapana Vasti is highly effective in Amavata and other musculoskeletal diseases. Lekhana Vasti’s (fat and kapha depleting enemas) can be done while managing obesity and diseases caused due to errors of fat metabolism. These therapies can be planned after finishing the course of Valuka Sweda.
External and internal therapies / treatments can be planned individually or in combination depending on the severity of the disease and strength and tolerance of the patient.
Vamana (therapeutic emesis) can be considered to expel morbid Kapha, pitta and meda if they show signs of severe aggravation
Discharge – The patient is discharged on daily basis (out-patient) or after the course has been completed (in-patient) after giving proper lifestyle and diet advises along with suitable medicines (oral). The patient is also advised to undergo the treatment twice or thrice in a year.
Duration of the course –
The number of days of treatment varies from 7-14 days depending on the nature and intensity of the disease
Benefits of Valuka Sweda –
Relieves pain, stiffness and swelling associated with Rheumatoid arthritis
Expels morbid ama, vata, kapha and meda
Causes sweating and brings about lightness and a feeling of health in the afflicted joints, muscles and soft tissues
Relieves stiffness and rigidity of thighs and lower limbs
Removes the blocks created by fat and corrects fat metabolism. Sweat is said to be a metabolic waste of fat. By removing the sweat, valuka sweda liquefies the stagnant fat and expels it, thereby correcting the fat metabolism.
When combined with Nitya Virechana and or Vasti, Valuka Sweda eliminates the body toxins, establishes health and tones up the joints and soft tissues
Improves the movements of the joints
Removes water retention in the tissues and effusion of joints
Contra-indications of Valuka Sveda:
Diabetes mellitus (can be done for a short period with caution, giving proper medicines to treat diabetes or in controlled and uncomplicated diabetes)
High blood pressure (Hypertension)
Severe varicose veins
Deep vein thrombosis
Limitations of Valuka Sweda –
Valuka Sweda is one of the best Ayurvedic treatments which is used in providing relief from pain and associated conditions related with Rheumatoid arthritis. But on the other hand it is not a sole remedy for RA. Parallel to it we might have to add some disease modifying drugs and or compounds and effective treatments for better relief.
Parallel Ayurvedic medications
Parallel Medications to expel morbid Vata, Kapha, Meda and Ama (Diseases modifying medications)
Kashaya’s (Herbal decoctions):
Rasnadi Kashayam or Rasnaerandadi Kashayam
Ghritam and Tailam (medicated ghee and oils):
Vati and Gulika (Tablets):
Mahavata vidhwamsini Ras
Medohara Vidangadi Lauha
Churna (powders) –
Just before finish,
Valuka Sweda is the best treatment which Ayurveda provides to tackle pain, swelling and catches related to Rheumatoid Arthritis. All you need to do is to meet an experienced Ayurvedic doctor and put forth your problems. The doctor will help you to get fit and healthy.
Caution – Valuka Sweda is an ‘easy form of treatment’ which can be carried out at home but make sure you are properly diagnosed in an Ayurvedic way. The best way of taking the treatment is to have it done under the supervision of the doctor.
Click to Consult Dr Raghuram Y.S. MD (Ayu)