Systemic and Local Ayurvedic Therapeutics in the Management of Spasticity in Cerebral Palsy: A Narrative Review

Abstract

Background: Spasticity is the most common motor impairment in children with cerebral palsy (CP), leading to muscle stiffness, contractures, pain, and progressive functional limitations. Although conventional therapies such as physiotherapy, oral antispastic agents, botulinum toxin, and surgery are effective, their long-term use is often limited by adverse effects, invasiveness, and high cost. Ayurveda offers a holistic approach through systemic and local therapeutic interventions aimed at correcting the underlying Dosha imbalance and improving neuromuscular function.

Objective: To review the role of systemic and local Ayurvedic therapeutics in the management of spasticity in cerebral palsy and discuss their probable mechanisms and clinical relevance.

Methods: A narrative review was conducted using published literature indexed in PubMed, Scopus, and Web of Science, together with classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya. Studies describing the pathophysiology of spasticity, modern management, Ayurvedic concepts, Panchakarma procedures, and related pharmacological evidence were reviewed.

Results: From an Ayurvedic perspective, the clinical manifestations of spastic cerebral palsy resemble Vatavyadhi, particularly Sthambha, Sankocha, and Snayugata Vata. Management primarily focuses on pacifying aggravated Vata through Basti, Shamana Aushadhi, Abhyanga, Swedana, Nasya, Shirodhara, and other Panchakarma procedures. Experimental and clinical evidence suggests that these interventions may improve muscle flexibility, reduce stiffness, enhance circulation, support neuromuscular function, and facilitate rehabilitation.

Conclusion: Ayurvedic systemic and local therapeutics provide a rational complementary approach for the management of spasticity in cerebral palsy. Integration of these interventions with conventional rehabilitation may improve functional outcomes; however, further high-quality clinical studies are required to strengthen the evidence base