Pain Management through Shiroabhyanga and Pratimarsha Nasya in Vataja Shirahshoola (Chronic Tension-Type Headache): A Case Report

Abstract

Vataja Shirahshoola, a condition described in Ayurvedic texts, closely resembles tension-type headache in modern medicine. It is primarily caused by vitiation of Vata dosha due to factors such as stress, irregular lifestyle and excessive mental strain. A 24-year-old male patient presented with symptoms of bitemporal headache, occipital pain, ocular pain with a sensation of eyeball protrusion and neck stiffness, persisting for 8 months, alongside a stressful condition and was diagnosed with Vataja Shirahshoola based on classical symptoms and ICHD-3 criteria. The patient underwent Shiroabhyanga (head massage) once in morning and Pratimarsha Nasya (nasal administration) with Tila Taila (sesame oil) twice daily for 45 consecutive days, without any concurrent oral medication. The patient's progress was assessed every 15th day using a validated Vataja Shirahshoola assessment scale and Visual Analog Scale (VAS). Stress was evaluated using the Hamilton Anxiety Rating Scale and Galvanic Skin Resistance Test. Follow-up assessments were conducted after 15 days to comprehensively evaluate the patient's symptom response. After 45 days of treatment, the patient experienced substantial improvement in bitemporal headache, occipital pain and marked reduction in neck stiffness. Stress level was reduced from moderate to mild was observed. No recurrence of symptoms was reported during the follow-up period. This case study demonstrates the effect of Shiroabhyanga and Pratimarsha Nasya with Tila Taila in managing Vataja Shirahshoola.