• Rooksha swedam: with kottamchukkadi choornam: the medicine (fine powder of kottamchukkadi choornam) is tied in a cotton cloth bag and dry heated on a hot plate. This heated herbal bag is applied on and around the point or region of pain. The herbal bag is re-heated very frequently to maintain a steady range of heat on the applied part, which makes it necessary to be heated every 2 or 3 minutes. One session lasts for 20 to 30 minutes and is repeated twice daily in the beginning and thereafter tapered to once daily in a period of 5–7 days. The herbal bag has to be replenished with new medicine, after 2.5 hours of use. The procedure is done usually with the patient lying down, though on occasions it can be done with the patient sitting with proper support

• Pichu: with dhanwantharam thailam: the procedure is done with the patient lying down. The point of most severe pain and all areas of the chest-wall, where pain is felt are marked. A thick wad of cotton is taken with enough width and length to cover most of the areas of severe pain. Dhanwantharam oil is warmed to bearable hot and poured into a flat-bottomed stainless steel vessel. The cotton wad is soaked in the warm oil. After confirming (by the therapist/self) that the oil’s heat is bearable, the soaked cotton is kept over the region of the chest, so as to cover the areas and points of pain. The wad is replaced by another similarly warm soaked wad, when the temperature of it falls to that of body temperature. This process is repeated so that the regions of pain over the chest wall, is kept soaked in warm oil for 30 minutes daily. This process is advised to patients who has very chronic pain and especially when the pain is spread over a region of the chest wall. The process may yield results in terms of pain reduction immediately, but a more sustained relief and complete resolution of pain may take 2–3 weeks of continuous daily application of pichu

• Uro-tarpan: with dhanwantharam thailam

• Uro-tarpan is done when the pain is extremely intense and localized to one or nearby few points. The points of pain are marked and a small well is made around and enclosing it with a paste of dough and water, with the walls of the well at least 3 cm tall (from the chest wall skin). Dhanwantharam thailam is warmed in a steel vessel and when bearably hot, is slowly poured into the well along its walls, so as to fill the well with oil, sufficient to create a depth of two cm. Thereafter warm oil is repeatedly poured into the well to replace oil taken out to reheat. A constant temperature ranging between 39 and 42 degrees is maintained for the oil. The process is continued for a period of 20–30 minutes, daily. This process, since it involves use of very hot oil and over extended period of time, is performed by a skilled therapist and not taught to the patient to perform at home, considering the complications careless handling of the oil can cause to the patient

• Uro-dhara: with milk decoction made of dasamoola (a group of 10 medicinal roots), and kuchla (seeds of strychnos nuxvomica): when pain is very severe, and spread over a larger area of the chest, and associated with swelling over the ribs, we resort to uro-dhara. In this a herbal brew is made with dasamoola and kuchla (50 grams coarse powder put in 1 L of milk and 12 L of water, heated to boil and reduced to 10 L, filtered). The treatment is done with the patient lying on a specialized table called droni, which has groves and gradations that allow liquid poured into it, to be collected at one end of the table. The patient is made to lie with the painful regions of chest exposed upwards and brew (warmed to 39–40 degree Celcius) is poured over the area, so that the brew falls on the chest wall from a height of 2.5–3 cm, using a suitable vessel. This brew is collected from the table and reheated to be reused in the process. This process is continued for a period of 30–40 minutes every day. The process has to be repeated to for 5–7 days and each day fresh medicine has to be prepared