Elakizhi or Pathrapotalaswedam is a type of massage done by bundles or cloth bags filled with herbal leaves and some other ingredients. Compared to Abyanga (oil massage) this one is stronger as the bundles are applied or pounded on the body. The type of leaves or the other ingredients can be variable depending on the condition of the disease. The leaves are cut in to small pieces and fried in neem oil or any other suitable oil with the other ingredients and tied in 4 cotton cloth pieces to make the bags. These are usually warmed in neem oil or castor oil through out the massage. This massage is usually done by 2 persons and for 45 minutes. After the massage the patient is allowed to take rest for a few minutes and later a hot water bath is given.
After the gentle body massage, the warm bundles are applied all over the body from neck to the legs. Special care should be given on the joints and muscles where ever pain and inflammations are present. As the herbs present in the bundles are anti-inflammatory in action, they have an affinity towards the weak muscles and joints. With the warmth of the bundles and the pounding of them on the affected part the peripheral circulation will be increased and it will help to enhance the absorption of the active ingredients.