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=== Reason of limitation of panchakarma in management ===
 
=== Reason of limitation of panchakarma in management ===
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The reason why pancakarma therapies are ineffective in urusthambha is due to four reasons. The tridosha which is getting vitiated due to visharupa ama (toxic metabolites in rasadhatu) become saamadosha on interaction with ama rasadhatu. This saamadosha will be directed to lower limbs by fat. So the two reasons being the adherence (paicchilyam) produced by ama and obstruction by medas. Due to these causes, the doshas are unable to move out of uru. The third reason is asthi is site of vata which is inherently shita (cold leading to stiffness) predominant. Kapha has cold properties leading to obstruction and stiffness. The fourth reason is mudha-vatata (vata in asthi is devoid of movement) due to ama and avarana and hence movement of kapha outwards is not facilitated. Moreover  kapha is immobile.  
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The reason why pancakarma therapies are ineffective in urusthambha is due to four reasons. The tridosha which is getting vitiated due to visharupa ama (toxic metabolites in [[rasadhatu]]) become saamadosha on interaction with ama rasadhatu. This saamadosha will be directed to lower limbs by fat. So the two reasons being the adherence (paicchilyam) produced by ama and obstruction by medas. Due to these causes, the doshas are unable to move out of uru. The third reason is asthi is site of vata which is inherently shita (cold leading to stiffness) predominant. Kapha has cold properties leading to obstruction and stiffness. The fourth reason is mudha-vatata (vata in asthi is devoid of movement) due to ama and avarana and hence movement of kapha outwards is not facilitated. Moreover  kapha is immobile.  
    
Panchakarma therapy is prescribed only when doshas are in a state of getting expelled out from nearest external orifices. In urusthambha due to adhering nature of doshas, obstruction by fat, decreased metabolic activity in asthi and also due to immobile kapha-vata, srotashodhana (clearing channels), abhishyandana (flowing nature of doshas) or paaka (proper metabolic activity) do not take place. This shows the inadequacy to facilitate mobility and koshdha gati (movement of dosha towards GIT) of doshas. Hence panchakarma therapy is not advisable in this circumstance.
 
Panchakarma therapy is prescribed only when doshas are in a state of getting expelled out from nearest external orifices. In urusthambha due to adhering nature of doshas, obstruction by fat, decreased metabolic activity in asthi and also due to immobile kapha-vata, srotashodhana (clearing channels), abhishyandana (flowing nature of doshas) or paaka (proper metabolic activity) do not take place. This shows the inadequacy to facilitate mobility and koshdha gati (movement of dosha towards GIT) of doshas. Hence panchakarma therapy is not advisable in this circumstance.
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