INTEGRATIVE AYURVEDA AND PHYSIOTHERAPY INTERVENTIONS FOR CHRONIC MUSCULOSKELETAL PAIN: A COMPREHENSIVE REVIEW

Abstract

Chronic musculoskeletal pain is a chronic and disabling condition that is affected by inflammatory, neuroimmune, biomechanical, psychological and functional processes. Symptomatic treatment is frequently used, and more comprehensive, patient-oriented, treatment strategies are required, incorporating both pain mechanisms and long-term functional recovery. This comprehensive review examines the role of integrative Ayurveda and physiotherapy interventions in the management of chronic musculoskeletal pain. The review synthesizes evidence on biomedical and Ayurvedic perspectives of pain, Ayurveda-based interventions such as Panchakarma, Basti, Kati Basti, herbal formulations, yoga, and lifestyle regulation, alongside physiotherapy approaches including therapeutic exercise, pain neuroscience education, postural correction, neuromuscular rehabilitation, electrotherapy, and psychologically informed care. Current evidence suggests that Ayurveda may support systemic regulation, inflammation control, pain relief, and holistic restoration, while physiotherapy provides structured rehabilitation aimed at movement recovery, strength, function, and self-management. Their integration offers a clinically relevant model for chronic low back pain, osteoarthritis, cervical pain syndromes, and inflammatory musculoskeletal disorders. However, the evidence base remains limited by clinical heterogeneity, variable treatment protocols, small-scale studies, and insufficient long-term outcome data. Further studies are needed on standardized, individualized protocols; pragmatic clinical trials; safety monitoring; cost effectiveness; and implementation frameworks involving multiple disciplines. Integrative Ayurveda–physiotherapy care could be a viable approach to enhance pain, function and quality of life, as well as ensure long-term recovery in chronic musculoskeletal pain.