Manal Kizhi, also known as Valuka Sweda, is a type of fomentation method in which we use heated clean sand tied in a bundle to provide heat to the pain afflicted joints, particularly in diseases such as Amavata (Rheumatoid Arthritis), Urustambha (thigh and lower limb stiffness), Medoroga (diseases manifested due to disturbances in fat metabolism), and so on.

Manal Kizhi is the most effective treatment for chronic progressive disease-causing inflammation in the joints, resulting in painful deformity and immobility, particularly in the fingers, wrists, feet, and ankles. Valuka Sweda is the best choice when Vata, Kapha, and Ama doshas are predominant. Its dry heating property liquefies the morbid Kapha and Ama, allowing good circulation and clearing the blocks. It boosts fat metabolism. It reduces inflammation and makes joint movements easier. Sometimes, powdered brick is used for treatment instead of sand, and this is known as Ishtika Sweda. It is beneficial in pain management in the heels due to issues like calcaneal spur among others.