Panchakarma is the purification therapy used in Ayurvedic medicine. The word panchakarma means five actions and refers to five procedures intended to intensively cleanse and restore balance to the body, mind, and emotions. Panchakarma is used by Ayurvedic physicians as a treatment of a wide variety of health conditions and as a preventative measure.


Ayurvedic medicine is the oldest healing system in the world, originating in the ancient civilizations of India some 3,000–5000 years ago. Ayurveda means knowledge of life in Sanskrit.

Panchakarma is based on central concepts of Ayurveda, which state that disease is caused by the build-up of toxic substances in the body and by imbalances in the body and mind.

Today, Ayurvedic medicine is used by millions of people, including 80% of the population of India. Ayurveda has become an increasingly accepted alternative medical treatment in America during the last couple of decades, aided by the efforts of Deepak Chopra, a conventionally trained M.D. who has written several bestsellers based on Ayurvedic principles.

Several Ayurvedic institutes and health clinics have been established in America that perform panchakarma and research on its healing effects. The ideas behind panchakarma have influenced other alternative treatments.

Environmental medicine studies how the accumulation of environmental substances in the body may cause disease, and detoxification therapy utilizes cleansing the body as its central treatment.


Panchakarma is used in Ayurvedic medicine to treat almost all diseases, particularly those that are chronic, metabolic or stress-related in origin.

Panchakarma has been used to treat allergies, asthma, arthritis, cancer, chronic fatigue syndrome, colitis, high cholesterol, depression, diabetes, digestive disorders, heart disease, hypertension, immune problems, infections, inflammation, insomnia, nervous disorders, obesity, skin problems, and ulcers. Panchakarma may be used alongside intensive conventional treatments including chemotherapy and surgery, to support healing and recovery.

Panchakarma is safe and non-toxic, and can be used as prevention and to increase general well-being. Panchakarma is limited in treating traumatic injuries, acute pain, and conditions requiring immediate surgery or invasive procedures.


The first step of any Ayurvedic treatment is a thorough examination and diagnosis by an Ayurvedic practitioner, who determines the type and extent of panchakarma treatment required.

According to Ayurvedic theory, physical and emotional traits are classified as three doshas—vata, kapha, and pitta. Each individual has all three doshas with one predominating. If an imbalance occurs, diseases/conditions appear.

Panchakarma rebalances the doshas, bringing them back to equilibrium and the individual back to good health. The physician may prescribe herbal remedies and recommend dietary and lifestyle changes that may be enacted before, during and after panchakarma.

Ayurvedic doctors believe that disease generally starts in the digestive tract. Due to poor diets, bad health habits, and other causes, digestion can be impaired, causing a toxic substance called ama to accumulate in the body.

Ama interferes with normal functioning and the flow of energy, creating imbalances and disease. One goal of panchakarma is to cleanse the body of excess ama, and to restore the body’s digestive power (agni).

In panchakarma, there are two main types of therapy. Shamana is the supportive therapies that include the preparation and post-therapy measures.

The main treatment is called shodhana and refers to pancakarma’s five main cleansing and elimination procedures. During preparation for panchakarma, oil therapy (termed snehana in Ayurveda) is the first treatment. Patients are given oil massages—abhyangais full body massage and shirodhaya is forehead massage.

They are fed dietary oils to lubricate the digestive tract, and are sometimes administered oil enemas. For stress-related and mental conditions, a special oil massage is given during which oil is steadily poured onto the patient’s forehead.

Oil therapy may be used for up to a week before the main treatment. Sweating therapy (swedana) is another preparation that uses saunas, steam rooms, heated clothing, herbal poultices, and exercise.

The five main methods of panchakarma are therapeutic vomiting (vamana), purgation (virechana), enema therapy (niruha basti for medicated enemas and anuvasana basti for oil enemas), and nasal cleansing (nasya).

Depending on the health problem, one or more of these methods are used to cleanse the body and promote healing. Other Ayurvedic therapies may be used in conjunction as well.

Vamana uses herbal solutions or salt water to induce vomiting. This treatment is used for skin problems, asthma, diabetes, chronic sinus or lung infections, epilepsy, heart disease, and digestive disorders. Niruha basti uses special herbal solutions, and treats conditions including skin diseases, liver problems, abdominal tumors, parasites, and chronic fevers.

For therapeutic enemas, medicinal oils and herbal solutions are used to cleanse the lower bowels. Niruha and anuvasana basti are used to treat conditions such as constipation, arthritis, nervous disorders, colitis, headaches, muscle weakness, and lower back pain.

During nasya, medicated oils or powders are administered into the nostrils to cleanse the sinuses. This therapy is used to treat conditions of the head, including mental disorders, headaches, and ear, nose, and throat problems.

After cleansing methods are performed, patients go through an important aftercare stage called paschata karma. Patients are advised to rest, avoid certain activities, and often receive attention from nurses and doctors.

Psychological care and counseling may be part of the healing program, as panchakarma strives to cleanse the patient of emotional problems in addition to physical ones. Patients are also counseled about preventative practices. Dietary changes are carefully planned, and lifestyle considerations are examined and recommended.

Exercise programs, such as yoga, and stress-management techniques, including meditation, may be introduced to patients during or after panchakarma, and herbal remedies may be prescribed as well.

Panchakarma treatment can vary in length from a couple days to several weeks. Some clinics offer in-patient services, during which patients are intensively treated around the clock with medical supervision, dietary therapy, exercise, yoga, meditation, massage, and other therapies.

Most clinics offer out-patient services, during which panchakarma treatments may take two or more hours per day until completed. Some clinics provide housing arrangements for visiting patients.

The cost of panchakarma treatment from Ayurvedic clinics averages around $300 per day, not including initial physician fees, housing, and herbal prescriptions. Clinics with in-patient services are more expensive, and the costs vary with services. Insurance coverage of panchakarma varies, depending on the policy and whether the practitioner is a licensed physician.


Patients should be thoroughly diagnosed and cared for by a qualified Ayurvedic practitioner. Patients should seek panchakarma treatment from reputable clinics with adequate staff and facilities.


Certain panchakarma methods are not appropriate for specific health problems, and some should not be performed on children, pregnant women, and the elderly. Panchakarma treatments should only be administered by qualified and experienced practitioners.

Side effects

During panchakarma, fatigue, malaise, headaches, congestion, general illness, and an increase in symptoms may occur as side effects. Also, because panchakarma seeks to release stored emotional problems from the patient, some people can experience mental disturbances and depression during treatment.

Research and general acceptance

The majority of clinical trials in Ayurveda has been conducted in more than 40 research institutions in India, many supported by the government, with findings published in India and European scientific journals. Because Ayurveda has been outside the Western scientific system for years, research in America is just beginning.

In general, allopathic medicine is skeptical of Ayurveda and reluctant to fund research. Much research in America is being supported by the Maharishi Ayur-Ved organization, which studies the Ayurvedic products it sells and its clinical practices, including panchakarma.

One interesting study was performed in the Netherlands with panchakarma and Maharishi Ayur-Ved products. A group of patients with chronic illnesses, including asthma, bronchitis, hypertension, and diabetes, were treated with panchakarma and other Ayurvedic remedies.

Strong results were observed, with nearly 80% of the patients improving and some chronic conditions being completely cured. Other studies have shown that panchakarma can lower cholesterol and improve digestive disorders.

Diabetes, acne, and allergies have been successfully treated with Ayurvedic remedies, and many Ayurvedic herbs have been proven effective in lab tests. Ayurvedic treatments, including panchakarma, have been used successfully to support the healing process of patients undergoing chemotherapy.

Currently, the National Institutes of Health (NIH) is also funding studies on Ayurveda. Outside of scientific research, there are many patients who give testimonials to the effectiveness of panchakarma, which may be obtained from Ayurvedic clinics.