Shiro (shiras in Malayalam) means head and dhara is an unbroken flow (of anything). Shirodhara is the continuous flow of medicated oil through the head. Sesame oil is used in most parts of India, while coconut oil is the main base in Kerala. However there are also other oil based chosen based on the different requirements of the person. The patient will be laid on a special wooden plank on his or her back. A tiny stream of oil continuously oozes out of a vessel with a central hole. The oil falls on the center of the forehead of the person. The oil will be comfortably warm and the process continues for 30 to 45 minutes. The person experiences unexplainable relaxation and brightness.

Shirodhara often comes after full body oil massage (pizhichil or Abhayanga). The environment that the practitioner prepares for the therapy will also be free of any noise and most suited for deep relaxation, which provides complete rest to mind. It allows one to overcome stress related conditions like insomnia, anxiety, chronic headaches, hypertension and asthma. It also strengthens hair and skin of the head.

Shirodhara brings in several benefits including improved blood circulation to the brain, provides nourishments to hair and scalp, reduces nervous tension, and helps in sound sleep. There can also be different conditions of head, throat, eyes, ears and nose. Fits and epilepsy are two main conditions for which shirovasthi is suggested.

It improves the functioning of sense organs and central nervous system. Shirodhara also improves your mood and fights depression.

The choice of medicines depends on the constitution (prakriti) of the person, the season, and the specific conditions of the person.

A masseur spreads warm medicated oil all over the body (below neck) from a lump of cloth soaked in medicated oil. Shirodhara (application of medicated oil to the head) sometimes accompanies pizhichil.

The kings and aristocrats that ruled the country used to undergo pizhichil therapy and the treatment is called aristocratic therapy.

The whole procedure can end in less than an hour or can continue for 90 minutes. The duration is determined by the physician according to the physical capabilities of the person taking this therapy. It can also continue for seven, 14 or 28 days.

Pizhichil is unique to Kerala Ayurveda practices and is very beneficial in conditions like arthritis, paralysis, nervous disorders, joint pain, muscle cramps, etc. It also improves blood circulation, muscle reflexes, nervous system, relaxes full body and mind, enhances sexual ability and brings general sense of well being to the person.

The massage mainly aims at alleviating imbalances caused to Vayu. Imbalances occurred to vayu due to stress and tensions associated with lifestyle activities. An imbalance to Vayu dosha can disturb the balance of other two doshas of tridosha – pitta and kapha. The oil massage releases the elements of imbalance from the system, thereby facilitating a scheme of complete balance, both for body and mind.

The choice of medicated oils and procedures requires elaborate diagnosis by a knowledgeable Ayurvedic physician. The masseurs also should be well trained in massage therapy. Though a royal treatment, a person must always make sure that he or she goes to a knowledgeable physician who has the assistance of knowledgeable hands.

Other spellings for pizhichil can be pishichil, pizichil, pizhicil, pilichil, pizhi, pizhiyal, and moreÂ…

In the massage program, the kizhi (boluses of njavara made into a handheld bag) is dipped in warm decoctions. There can be two or four masseurs applying kizhi to the whole body of the person. This makes the body of the person perspire and this method provides direct nourishment to soft tissues near the skin.

The therapy can last for up to an hour a day and continues for 14 days. Persons suffering from joint pains, rheumatism, bad cholesterol, weak and underdeveloped limbs, and certain skin disorders can take an appropriate njavarakkizhi therapy or simply kizhi therapy.

Kizhi or njavarakkizhi therapy is associated with steam bath with medicated herbs, and abhayanga or specialized medicated oil therapy.

The possible spellings for kizhi or njavarakizhi can be navarakizhi, navarakkizhi, njavarakkizhi, njavarakizi, njavarakkizi, kihzi, etc.

Kizhi therapy like Njavarakizhi includes taking the medicinal powder, oil, decoctions, or anything in a kizhi and applying it over the body of a person.

Ila kizhi or ela kizhi has medicinal leaves wrapped in the bag and applying all over the body, podi kizhi has herbal medicinal powders in the bag, while njavarakizhi has special njavara rice boiled with medicines.

All these kizhi are useful for different conditions like problems to bone – rheumatism, arthritis, muscle pain, joint pains, sports injury, etc.

Shirodhara, or the dhara treatment given to head is most common.

Dhanyamla dhara is dhara over different body parts other than head.

The name of dhara varies with the kind of material used for the dhara.

Oil – sneha dhara, Taila Dhara
Butter milk – takra dhara
Milk – ksheeradhara

It is used for a variety of conditions like spinal disorders, rheumatism, arthritis, asthma, neurological disorders, spondylosis, etc.

Another therapy associated with tharpanam is pudapakam or pudapakom, with similar procedures.