Efficacy of Marma Chikitsa and Tens in Cervical Spondylosis: A Three Arm Parallel Group Randomized Clinical Trial

Abstract

Cervical spondylosis is a common degenerative disorder of the cervical spine characterized by chronic neck pain, stiffness, restricted cervical mobility, and associated neurological manifestations, which significantly affect daily activities and quality of life. Non-invasive therapeutic approaches such as Marma Chikitsa and Transcutaneous Electrical Nerve Stimulation (TENS) are increasingly being explored for effective symptom management. Objective: To evaluate and compare the therapeutic efficacy of Marma Chikitsa, TENS therapy, and their combined application in the management of Grade 1 cervical spondylosis. Methods: This randomized clinical trial (registered on 24/12/2024) was conducted between January and June 2025 at OPD-32 and the in-patient department. Thirty patients aged 40–70 years diagnosed with Grade 1 cervical spondylosis were randomly allocated into three groups (n = 10 each): Group A received Marma Chikitsa, Group B received TENS therapy, and Group C received combined Marma Chikitsa and TENS therapy. All participants underwent treatment for 2 weeks, followed by cervical stretching and strengthening exercises. Clinical outcomes were assessed on Days 1, 8, 15, and 30 using the Visual Analogue Scale (VAS), Short-Form McGill Pain Questionnaire (SF-MPQ), Neck Disability Index (NDI), and cervical range of motion (ROM). Results: All groups demonstrated statistically significant improvement in pain, disability, and cervical mobility (p<0.001). However, Group C showed the greatest reduction in pain intensity, improved functional capacity, and enhanced cervical ROM, particularly in forward flexion and rotational movements. Conclusion: The combined use of Marma Chikitsa and TENS therapy was more effective than either therapy alone, suggesting a safe, non-invasive, and beneficial integrative treatment approach for cervical spondylosis management.