Materials required:

1. Medicinal powders (Nagaradi choorna / Jatamayadi choorna / Kottamchukadi choorna etc. according to the doshapradhanya)  50 – 100g
2. Bandage cloth (15 cm X 2 m) – 1
3. Leaves of Eranda, Arka etc. (to cover the area) – Q.S.
4. Amla dravya (Dhanyamla /  Takra / Vinegar) – 50-100 ml
5. Oil for upanaha – 50 ml
6. Oil for abhyanga – 30 ml
7. Saindhava – 20 – 30 g
8. Attendent – 1

Pre operative procedure:

Medicine for upanaha can be made with or without heating according to disease. Choorna, Saindhava, taila, amla dravya are added in order to make a paste. Then it must be heated in case of sagni upanaha up to 39^oC-41^oC or applied as such in case of niragni upanaha. Skin sensitivity should be tested before tying.

Procedure:

The patient should be allowed to be in a comfortable position, exposing the joint or body part to be tied with upanaha dravya. The part is cleaned and abhyanga should be done locally with lukewarm oil, if indicated. The prepared upanaha dravyas should be pasted on the affected part thickly and uniformly about 1 – 2 cm thickness and is covered with available Vatahara patras (after slight warming). Then it should be tied with a bandage cloth. According to region, suitable bandaging techniques should be adopted. It is usually done in the night so that it can be there for about 12 hours. Bandhana is not mandatory. Bandhana is usually done in ekanga upanaha. In sarvanga upanaha it is done as sankara sweda. Apply suitable bandage in a position comfortable for the patient.

Post operative procedure:

After removing upanaha dravya from the body, the part should be washed well with lukewarm water. The process should be done on consecutive days for prescribed period.

Precautions:

1. The bandage should not be too tight or too loose.
2. The upanaha dravya must be of suitable consistency, so that it should not fall off from its position.
3. It should not be applied to wounds.
4. Check the sensitivity of the skin before the procedure.
5. It is better to avoid oil for the first 2-3 days.

Complications and management:

Sometimes some drugs may produce itching and reddish discolorations and burning sensation. Stop the procedure temporarily and manage the condition accordingly. Local application with drugs like Nalpamaradi kera / Eladi kera is advised. The treatment can be restarted within few days.