Abstract
Background: Keelvayu is one of the Vatha Rogam described in Siddha System of Medicine which can be compared to Rheumatism of Western Medicine. Among the 10 types of Keelvayu, Azhal Keelvayu (Osteoarthritis of the Knee joint) is one of the types which has been studied upon in the present study.

Objectives: To determine the role of internal administration of Mudakku Churanam and external application of Sivappu Kukkil Oil in the management of Azhal Keelvayu patients.

Materials and Methods: The researcher administered questionnaire was used to collect the data. Hundred and fifty (150) clinically diagnosed Azhal Keelvayu patients were selected out of 1050 patients screened and systematically divided into three groups of fifty (50) each during the period July 2010 to July 2011 at Siddha Teaching Hospital, Kaithady. Group I was treated with Mudakku Churanam orally, Group II with Sivappu Kukkil oil as an external application and Group III with Mudakku Churanam orally and Sivappu Kukkil oil as an external application. Evaluation visits were made at baseline and 5th, 10th, 15th, 20th, 25th, 30th and 40th days. Effect of treatment was evaluated on changes in the signs and symptoms (swelling, tenderness and restricted movement). Primary efficacy variables were analysed by the score as a difference between the visits on the first day of the treatment, the middle part of the treatment (20th day) and the end of the treatment (40th day).

Observations and results: Statistically highly significant improvement (p<0.001) was seen in the reduction of joint swelling, tenderness and improved range of movement were observed in all three groups on 20th day and 40th day, while the mean reduction in Group III is highest
indicating the synergistic effect of the drug with oil application.

Conclusion:The response observed when Mudakku Churanam was administered along with Sivappu Kukkil oil was significant in reducing the complaints of Azhal Keelvayu.