Traditional wisdom through scientific evidence: a review of Marma manipulation in Amsa sandhimokśa (shoulder joint dislocation) with a special focus on the Milch method.

INTRODUCTION: Shoulder dislocations represent 50 percent of all major joint dislocations, with anterior dislocation being most common accounting for up to 97% of all shoulder dislocations. The shoulder is inherently unstable because the shallow glenoid fossa articulates with only a small portion of the humeral head. Various techniques are available for reduction, with Kocher's being widely practiced. However, both the Kocher and Hippocratic techniques are linked to complications like axillary nerve injury and humeral fractures. Traditional Vaidyas utilize several techniques, notably one similar to the rarely used Milch technique, which has been in practice for over 70 years. Studies show that the Milch technique demonstrates a higher success rate and a shorter time to achieve reduction without sedation compared with the Stimson technique. This review paper aims to investigate the integration of traditional healing practices, specifically Marma Chikitsa manipulation, with contemporary scientific principles.

METHODOLOGY: The relevant papers regarding shoulder joint dislocation were reviewed from scholarly articles.The concept of Amsa sandhimokśa was reviewed in various Ayurvedic treatises.

RESULTS: The Marma manipulation technique closely resembles the Milch technique in its biomechanical principle of utilizing leverage and controlled positioning rather than forceful traction, thereby facilitating effective correction with minimal pain and reduced need for sedation.

DISCUSSION: The various methods for addressing anterior shoulder joint dislocation should be carefully considered.

CONCLUSION: It is reported to be relatively atraumatic and painless, with a success rate comparable to more established methods.