Kerala Ayurveda Panchkarma


Intake of prescribed dose of medicated ghee in empty stomach is called Snehapana.


This is the primary preparation for all the panchakarmas. Snehapana, done once a day in empty stomach, is usually continued for 3 to 7 days depending on the type of sickness. The exact duration and type of ghee to be used are decided by the doctors who treat you considering the type of disease, age, place, climate, and body constitution

The treatment involves the removal of toxins and wastes from the body. It also calms down the mind and reduces mental stress. As a result, the body immunity increases, the effects of the ailments subside and frequent recurrence of the disease is prevented. It also increases the person’s appetite level and accelerates peristaltic movements of the intestine.

Indications for Snehapana

Skin diseases, Arthritic complaints.


Abhyanga massage is a type of massage therapy which is used by practitioners of Ayurveda to treat their clients. It is a unique rhythmic massage, which deeply nourishes the entire body with liberal amounts of warm herbal oil. Smooth, gentle movements used to rub the oil into the body, relieves fatigue and increases blood circulation. The Abhyanga oil massage enhances the complexion and luster of the skin. This is a full body massage which is usually done on a daIly basis


Abhyanga massage is done by two therapists on either side of the patient, who lies on the treatment table. The client lies on a specially designed table, and the massage therapist pours warmed and specially formulated herbal oil over his or her body. Sesame and coconut oils are commonly used, along with an assortment of herbs. The oil is allowed to soak in for several minutes before the massage therapist begins, using rhythmic, gentle strokes with the whole palm.

An Abhyanga massage can last up to an hour. After the massage is over, the client is encouraged to shower to take a steamy bath to encourage absorption of the oil. A regular routine of Abhyanga massage can be very beneficial for the skin. For people who cannot manage a daily massage, practitioners of Ayurveda recommend that people oil their feet, hands, and heads daily with herbal oil. Morning time is advisable to get this massage.

Indications for Abhyanga :-

Those who suffer from joint disorders, Muscular diseases, Metabolic disorders, skin diseases etc.

Contraindications for Abhyanga:-

Those who suffer from indigestion, during menstruation etc… A Ayurveda doctor only decide whether you want Abhyanga or not.


Udvartana is a full body massage that relieves muscle tension, strengthens the muscle connective tissue, improves vitality and energizes. In this your whole body is gently scrubbed with powdered, aromatic herbs in upward direction. It is usually done during Panchakarma therapies or Day Spa packages after a warm oil massage or full body steam therapy. It helps to cool your body down a bit, while drawing out toxins and nourishing your skin. This is a type of dry massage. This is useful in kapha type persons and also in obesity. It promotes circulation and detaches the toxins from skins of the body.


It is almost similar to Abhyanga but more invigorating. Also it uses herbal powder instead of oil. The paste is made with various organic grains, flours, herbs and oils and applied with upward strokes during massage. Udvartana is the massage done in opposite direction of hair. After the process the powder is removed from the body by using a dry towel. After taking rest for few minutes, hot water bath is given to the patient.

Udvartana massage is particularly used for people having Kapha dosha. Useful to remove the minor skin problems by allowing the impurities to move out of tissues as skin pores get opened. This massage reduces cholesterol; helps curb obesity strengthens muscles and so on.

Indications for Udvartana:-

This treatment is indicated for diseases like Hemiplegia, Paralysis, Obesity, etc.


Elakizhi is known by the name Patra potali pinda sweda also. Elakizhi is an innovative massage with medicated leaves in a steady rotational movement and is used to tackle joint pain, muscle cramps, stress and arthritis. In this massage certain herbal leaves would be held inside a small linen bundle and it would be soaked inside warm oil and massaged over the body by two masseurs. Massage is followed by medicated steam allowing the oil to penetrate the affected parts.

It can be done in a perfectly healthy person as well as to enhance his/her immunity, vitality and longevity of life.


Elakizhi prepared with various herbs. Ricinus, drum stick, tamarind and calotropis gigantia are among the herbal leaves used for the treatment. The leaves are fried together in neem or castor oil until a brown color is attained. Lemon pieces and coconut scrapes are then added to it. All these are tied in cloth as a bundle and dipped in medicated oil to massage the body. When the process is complete, patient is given a bath in moderately hot water.

This is done for 45minutes daily for a period of 07 to 14 days. Generally it is a powerful anti-inflammatory treatment for muscular and joint inflammations.

Indications for Elakizhi:-

Arthritis problems, Osteomyelitis, problems in the lower back area, Stiff joints, , Generalised body pain, Spondilitis, etc.


Njavarakizhi is known by other name also, that is Sashtikasali pinda sweda. This is massage with linen bags containing cooked njavara rice soaked continuously in a mixture of milk and decoction.

This procedure is highly rejuvenating, nourishing and prepares the individual to bear the stresses and strains of a busy lifestyle. It enhances physical consistency, strengthens the nervous system and improves the overall appearance of the skin.


A generous amount of medicated oil is applied to the whole body and then the body is massaged with small cotton cloth bundles filled with cooked Njavara rice. It is another special Kerala Ayurveda, full-body massage therapy. Boluses of njavara rice, which is boiled and cooked a herbal decoction from Sida rhombifolia (Kurumthotti in Malayalam) and wrapped to make a bundle.

Usually there are two masseurs who start fomentation in an identical manner one from each side. The movement of hands has to be always from upward downwards and the Kizhi has to be kept always at a constant temperature. There are mainly 7 positions in which the patient has to be during the fomentation process. Once the procedure has been carried out for the required amount of time, the medicinal rice paste is applied over the body for some time and wiped off with palm leaf scrapers and the patient can bathe after applying oil on the body.


Indications for Njavarakizhi :-

Rheumatism, Joint pain, Hypertension, Hyper cholestorolenia, Skin disorders, etc.


Podikizhi is a method of therapeutic sweating. The body is thoroughly massaged with linen bags containing herbal ingredients in powdered form.


Podikizhi is also known as Churna Pinda Sweda . A type of Ayurvedic massage treatment with bundles of herbal powder. Podikizhi is effective in curing arthritis, paralysis and neuro-muscular diseases. In this therapy, several types of grains like Horse gram , Sesame seeds, Black gram and other curative ingredients are powdered fried and tied up in linen bundles . As moderate heat is required to sweat body , the bundles have to be warmed up periodically by dipping in warm medicated oil, or herbal juices. Before this therapy light Abhyanga is given.

After that, the patient is given a bath in moderately warm water. The treatment is an good to remove toxins and balance tridosha – vata , pita and kapha. Duration of the treatment is about 45 minutes.

Indications for Podikizhi:-

Degenerative joint disorders, Paralysis, many diseases caused by disrupted Vatha and Kapha doshas like rheumatic disorder, arthritis, Spondilitis and paralysis, etc.


pizhachilPizhichil treatment is also called Sarvangdhara Ayurveda Treatment. Pizhichil is a special form of Ayurveda treatment that combines rich oil massage with a special heat treatment. Pizhichil is an excellent remedy for optimum relaxation in Ayurveda. The treatment is also beneficial for various ailments such as nervous weakness, sexual weakness, hypertension, Vata imbalances, and limbs emaciation.

The therapy has been used since ancient times as kings used to take this treatment. Hence, the treatment is also called ‘Treatment for aristocr


Pizhichil squeezing warm medicated oil all over the body with the help of cloth pieces, which are periodically dipped into vessels containing oil. During this indulgent treatment medicated and warmed Ayurvedic oil is continuously poured over the body excluding head and neck while two practitioners rub and stimulate the skin using hands and special cotton cloths. The process is performed with the person both lying down.

The masseur usually begin by squeezing oil on to the shoulders and then down the hands of the patient. Each masseur uses one hand to pour the oil while massaging with the other. After the treatment mild masasage is given followed by hot water bath.

Pizhichil protects the body from illnesses and builds up immunity for a healthy life.

Indications for Pizhichil:-

Joint problems, Muscle tension, Hemiplegia , Paraplegia, poor blood circulation, Arthritis, etc.


Same relaxing treatment as Shirodhara but instead of herbal oil, herbal milk is poured over the forehead or over the whole body. Ksheeradhara massage is an ayurvedic healing treatment that alleviates fatigue, improves memory and helps with lack of vitality.It is also effective in curing insomnia, chronic headaches, ear and nose impairments. It is found to be very effective in providing a profound relaxed feeling to the central nervous system.


It is performed by pouring warm herbal milk over the patient’s body. Ksheeradhara involves two therapists that, along with the milk, pour warm ayurvedic oil over the patient. It is performed in seven standard massage positions in Kerala and lasts approximately 40 minutes.

Decoctions made of various herbs will be added to the milk


Ksheeradhara is of two types – shirodhara and sarvangadhara. While shirodhara is carried out for the head, Sarvangadhara covers the whole body except head. Ksheeradhara is effective in the treatment for hypertension, depression, anxiety, insomnia et

Indication for Ksheeradhara :-

It is usually prescribed for the disorders of pitta,skin diseases, suffering from headaches, psoriasis,and auto immune disorders.


The word Takra means butter milk. Dhara with medicated butter milk is called as Takradhara.It can be done either for the head alone (sirodhara) or for the whole body (sarvangadhara).

Takradhara a natural way to cure sun stroke. It reduces headaches, increase digestive power and alleviates anorexia. It is very effective in combatting certain types of migraines, falling and graying of hair and other specific Pitta disorders, where cooling and refreshing therapies are recommended.


This is similar to Shirodhara but buttermilk is poured onto the forehead, instead of herbal oil. This Ayurveda treatment method which involves continuous flow of medicated butter milk to the centre of forehead continuously for up to an hour a day. The buttermilk mixture flows on the forehead and the body is massaged like in Shirodhara. It is very cooling and very effective in skin diseases, like psoriasis.

Indications for Takradhara:-

Mental worries, Insomnia, Insanity, skin diseases, Chronic headaches like Migraine, ear nose diseases etc.


The word “Shirodhara” is made of two terms – Siro which means head and Dhara which means flow. In this Ayurveda treatment medicated oils, milk or buttermilk are poured on the forehead in a special way. The most common method is used with medicated oils. This makes the person feel relaxed. It is also the treatment for persons with mental tribulations. Sirodhara is a proven therapy for the treatment of different types of Hair loss.

Shirodhara ayurvedic treatment sharpens the sense organs, is beneficial for diseases linked with head, eyes, neck, ears, throat and other parts of the head.


After giving a good head massage herbal oil is poured in an uninterrupted flow from a hanging vessel to the forehead and scalp. The treatments start with oil application on head and body. Then a cloth piece is tied around the patients forehead to protect oil from dripping to the eyes. Patient is made to lie on the treatment table on his back and tip of the wick hanging from the Dhara pot which is a clay pot . Then medicated oil is poured into the Dhara pot after heating to mild warm condition. The flow is adjusted to make it straight and this is allowed to fall on patients forehead and this is continued for the specific duration. Oil massage is given to the patient along with Dhara.

Duration of the treatment is about 45 minutes to one hour.

Indications for Shirodhara:-

Insanity, Insomnia, Diseases of the head, eye, ear, and mouth.


DhanyamladharaWarm herbal liquid is poured all over the body in a rhythmic way through a special vessel for specific time for certain days in Dhanyamladhara treatment.


Dhanyamla is an extract of some cereals and vinegar from citrus fruits. The is prepared when Navara rice, horse gram, millet, sliced citrus fruits and dried ginger are tied in linen cloth and boiled in water. The herbal extracts are collected into the pot and it is used for Dhara therapy. Boiling continues round the clock till the treatment is over. Duration of the therapy is 7-14 days.

Dhanyamladhara is very effective for diseases or health problems caused by Vata Dosha. It is a remedy for hemiplegia paralysis rheumatic complaints and vata predominant diseases etc.

Indications for Dhanyamladhara:-

Arthritis, Gout, Sciatica.


Shirovasti treatment is applied for Vata related diseases. In this treatment, warm medicated oil is retained over the head for a certain amount of time.


Prior to the treatment, warm herbal oil is applied all over the body to prepare the body for the main treatment. It rejuvenates the nerve endings. In the next step, a leather cap of about six to eight inches is tied around the head. Patient is seated in a upright position and the warm medicated oil is poured on the head through the sleeve and retained there for about 30 to 45 minutes based on the person’s tolerance level. After the treatment, the patient is given hotwater bath.

The treatment is highly effective for dryness of nostrils, mouth and throat, facial paralysis, severe headache and other vatha based diseases.

Indications for Shirovasthi:-

Facial paralysis, Head ache, Cataract, Earache, Deafness.


Warm medicated oil is retained in herbal paste boundary on the chest is called Urovasti. Urovasti is an effective treatment for respiratory problems, heart disease and muscular chest pains.


Before the treatment, body is softly massaged with warm oil. Then specially prepared warm herbal oil is poured on the chest area and kept inside an herbal paste boundary made of black gram dough. It enhances blood circulation and builds strong muscle and connective tissues. The duration for the treatment is 45-60 minutes. It is also a preventive treatment for heart from strokes and other related blocks.

Indications for Urovasti:-

Urovasti is mainly done to treat the pain in the Sternum.


Kativasti is highly effective treatment for back pain and spinal disorders. It is an ayurvedic procedure of retaining warm medicated oil over the lower back.


Kativasti is an Ayurvedic process in which specially prepared warm medicated oil is kept inside the lower back with herbal paste boundary. This treatment lasts for 45 minutes to 1 hour. Before the treatment whole body is given a smooth massage.

Kativasthi alleviates lower back pain and spinal disorders. The treatment helps to increase the blood circulation, strengthens muscle and connective tissues and lubricate the joints keeping them flexible and pain free.

Diseases like chronic back ache, sciatica, rheumatoid arthritis, lumbago, osteoarthritis, weakness of lower limbs etc. are treated using Kateevasthi.

Indications for Kativasti:-

It is effective in low back aches


Thalam is an effective treatment for ENT Problems, Insomia, Migraine, hypertension, skin diseases, etc.


Medicinal powder mixed with herbal oil is applied on the crown or forehead. Different kinds of thalam are used according the nature of the illness. It also cures conditions such as lack of memory, inability to concentrate, lack of willpower, etc. Duration of the treatment is 14 to 28 days.ciatica,osteoarthritis of the hip etc



Herbal paste is applied on patient’s head in a thickness of one finger. The paste is made out of gooseberry cooked in buttermilk. Mild massage is done on his body and neck during the treatment. The treatment is beneficial for Mental diseases, Insomnia, Hair Fall and Dandruff.


Anjana treatment is a Rejuvenation Therapy for the region above neck. It is administered on eyes for giving eyes a soothing feeling. Herbal extract applied on the eyes to cleanse, removes itiching and burning sensation in the eyes.


Karnapoorna means ears are filled with medicated liquid.


As preparatory step, ear lobes are massaged with herbal oil. Then the patient is made to lie down on one side and warm medicated oil applied to the ear for 5 to 10 minutes. Then the patient allows to turn and it is repeated in the other ear. This process helps to clean the ears and avoids ailments associated with the ears. This treatment is very effective for deafness, earache and humming of the ear etc

Indications for Karnapoorana:-

Ear ache, Tinnitus.


NetradharaPouring herbal decoctions in a continuous stream over the eyes is called Netradhara.


Netradhara is a special therapy for problems related to eyes. In this treatment, medicated liquid is poured continuously over the eyes and the process takes the total time of 20 min. This cleansing therapy soothes and relax strained eyes, delays cataract, helps in treating chronic conjunctivitis and improves eye sight.

Indications for Netradhara:-

Diseases of the eyes like dryness, burning sensation, etc…


Warm oil cloth is applied to forehead and it is good for headaches, insomnia, and tension. The heat relaxes tension in muscles enabling a release of blockages.


A piece of cloth folded to palm size is drenched in herbal oil is kept on the patient’s crown or forehead. Oil is poured on the cloth periodically throughout the treatment time to keep it wet. The oil is retained there for certain time. It relaxes the nerves and brain cells, and improve the person’s memory level. Duration of the treatment is about 45minutes.

The duration and type of medicines used are decided by the physician based on the person’s body nature and condition. However, in most of the cases the therapy is continued for 7 to 14 days and gives effective results.

This therapy is useful for prolapsed discs, damaged joints, chronically tense tendons and muscles, memory loss and insomnia.

Indications for Pichu

Tremors, Arthritic complaints.