Standard operating procedure of Hanupichu- A Narrative mini review

Abstract

Background: Hanu Sandhi is considered as a major joint in head area. It is considered a Bahuchala sandhi and is more prone for Vataja disorders. For Hanusandhigata Roga the local therapies described are Hanu Basti and Hanu Pichu. Hanu Pichu is an ayurvedic treatment procedure where a sterile cotton pad dipped in medicated oil is placed on Hanu Sandhi. Despite its traditional relevance in managing conditions such as Hanu Graha, Temporomandibular joint (TMJ) dysfunction, myofascial pain, and local inflammatory states, standardized guidance on its method, indications, and procedural safety remains unclear. A structured narrative mini review was planned to consolidate the available classical knowledge and standardize the operating procedure guidelines. Objective: The goal is to combine classical references with clinical studies to outline a Standard Operating Procedure (SOP) for the practice of Hanu Pichu, and highlight its therapeutic rationale, procedural steps, and mode of action. Methods: A narrative literature review of Bṛihattrayi and Laghutrayi were screened for descriptions related to Pichu and Hanu-roga and Secondary data were collected from peer-reviewed journals, clinical case reports, and institutional SOPs available were collected. Conclusion: Hanu basti and Hanu Pichu are the therapies effective for TMJ disorders, However, Hanu Pichu is a safe, cost-effective, and minimally invasive Ayurvedic intervention for TMJ-related disorders when performed according to standardized guidelines. Hence Hanu Pichu can be a choice of practical and preferable treatment option in routine clinical practice. This structured narrative review provides a consolidated SOP guidelines that highlight its therapeutic rationale, procedural steps, and mode of action.