Effect of Jalaukavacharana (Leech Therapy) in the Management of Carpal Tunnel Syndrome with Special Reference to Khalli (Snayugata Vata): A Case Study

Background:  Carpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy caused by compression of the median nerve at the level of the wrist, resulting in pain, numbness, tingling sensation and functional impairment of the hand. Although there is no direct description of Carpal Tunnel Syndrome in classical Ayurvedic texts, the clinical features closely resemble Khalli, a Vata-pradhana disorder characterized by pain, stiffness, cramps and sensory disturbances affecting the extremities, including the wrist joint. In contemporary medical practice, management of CTS primarily includes analgesics, anti-inflammatory medications, splinting and local liniments, which provide only temporary symptomatic relief. Surgical decompression is often advised in chronic or severe cases. 
Aims and Objectives: The aim of this study was  to evaluate the therapeutic efficacy of Raktamokshana in the form of Jalaukavacharana in the management of Carpal Tunnel Syndrome W.S.R Khalli (Snayugata Vata) and to assess its role in reducing pain, numbness and improving the functional ability of the hand. 
Methodology: A 40-year-old female patient diagnosed with Carpal Tunnel Syndrome was treated with Jalaukavacharana, considering the condition as a Vatavyadhi associated with Rakta Dushti, followed by Pratimarsha Nasya. Clinical assessment was carried out before and after treatment based on subjective criteria.
Results: The patient showed significant improvement after treatment. Tinel’s sign, Phalen’s test and Durkan’s test were negative after therapy.The Symptom Severity Scale (SSS) score was reduced to Grade 1. The patient was able to perform all daily activities without any difficulty. No adverse effects were observed during the course of therapy.