Back pain is like youth leaving the body.
Gridrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. Although low back pain is a common condition that affects as many as 80-90% of people during their lifetime, true sciatica occurs in about 5% of cases. Sciatica is more common between 30 and 50 years of age. Pain in sciatica is very severe, which makes the patient difficult to walk; hampering the daily routine of the individual.
Basti is the most important among panchkarma due to its multiple effects. Basti is not only best for vata disorder but also equally effective in correcting the morbid pitta , kapha, rakta. Charak has considered, Basti therpy as half of the treatment of all the disease, while some authors consider it as the complete remedy for all the ailments. Gridrasi is characterized by piercing type of pain/stiffness cramps, beginning from Sphika (Hip) region and gradually radiates down to Kati (Back), Uru (Thigh), Janu(Knee), Jangha(Calf) and Paada (foot) region (are due to Vata) and along with these, systemic symptoms which includes Gaurava (heaviness), Tandra (drowsiness) and Aruchi (anorexia) (are due to Kapha). Pain in the leg generally unilaterally caused by irritation of Sciatica Nerve, there may be numbness, difficulty in moving or controlling the leg. Pain, generally travel from back of thigh to back of calf and may also extend upwards to the hips and downwards to the foot. So comparatively Sciatica resembles with the Gridhrasi which is described in Ayurvedic text. Despite technological and pharmacological advances in modern science the management of sciatica is still a medical problem, where no permanent medical treatment is available, except some palliative measure. No satisfactory treatment available in modern medical science, patients depends on pain killers which has temporary action. Chances of reoccurrence are high even after surgery. So to fulfill the expectations in the management of Sciatica from the Ayurvedic point of view is the need of the hour.
Signs:-Tenderness in lumbo-sacral area, SLR test positive, Lasagne’s sign positive.
Symptoms:-Dragging type of pain radiating from lower, back region to left or right limb, associated with numbness, tingling sensation and heaviness of the limb.
TREATMENT: As a Vatavyadhi (diseases due to vata), general treatment of Vata is applicable in Gridhrasi. The treatment principle of Gridhrasi is Siravyadha (venesection), Basti karma (enema therapy), and Agnikarma (cauterizaion).
Snehana(Oleation Therapy):Snehana (oleation therapy) is the first and important treatment of all Kevala Vatika conditions (vitiation of vata only). Snehana can be done externally as well as internally.
Pada Abhyanga/Sarvanaga Abhyanaga: By the application oil to the feet, roughness, immobility, dryness, fatigue, and numbness are instantaneously cured and even strength and steadiness of feet will increases. Most importantly it does the prevention of, the Sciatica, cracking of feet, constriction of vessels and ligaments of lower limbs.
Kati Basti: (Topical application of medicated oil): The procedure of applying heat to the sacral or lumbar region by retaining warm medicated oil with in a specially formed frame on this area is known as Kati Basti. It is indicated in painful condition of low back region. It is the most effective procedure in reducing pain, as it increases blood circulation at the site of lesion, pain will get reduced by the entry of new oxygenated blood at the site of lesion. Taila’s are selected according to the condition Roga and Rogi and even also Kashayas can also be used where ever there is a involvement of Kapha Dosha is there.
Kati Pichu: It is preferred when patient is unable to lie in prone position for long time. As per the condition of the Dosha’s, Taila’s are to be selected. It can be done at OPD level also.
Swedana (sudation treatment)– Repeated Swedana (sudation) is the most important treatment of Vatavyadhi. Swedana is good in reducing Soola (pain), Sthambha (stiffness), Gourava (heaviness), which are the cardinal features of Gridhrasi. Bahya Swedana at the site of Vata Prakopa with Nadi, Prasthara, Ruksha Sweda according to condition. Type of Sweda adopted in different types of Gridhrasi are as follows, Different specialized Panchakarma procedure which provides simultaneous Snehana and Swedana
Kayaseka (Pizhichil)- A part of Kerliya Panchkarma. Good for external snehana and Swedana.
Patra Pinda Swedana– Patra Pinda Swedan is a form of Sankara Swedana. The word Sankara as it suggests the mixture of different medications or drugs when used in form of Pinda or Pottali, it is called as Pinda Swedana. Good for external senahana in Gridhrasi- It also provides muscles strength and relief in muscles spasm.
Shashtika Shaali Pinda Sweda-One of the varieties of Bahya Snehana, gives immediate results because it acts at the site of lesion and pacify the Vata Dosha.
Mridu Virechana: Mainly for the correction Agni and to treat the Ama condition Mridu Virechana is adopted prior to Basti Karma. For example constipation in Vata Prakruti person or Vata predominant disease by Erand Taila, Hingu-TrigunaTaila is given. For removing Ama and constipation in Kaphaja Prakruti or Kapha predominant disease by Nishotha Churna+ Sunthi Churna+ Madhu can be given.
Basti : (Therapeutic enema): Niruha Basti (Decoction enema): The composition of the medicine administered in the form of Basti contains Kwath (herbal decoction), Sneha (medicated oil), Madhu (Honey), Saindhava Lavana (rock salt) and Kalka (herbal powder).In Kevala Vataja and Dhatu Kshayaja condition Shamana or Brumhana Basti containing more number of Sneha Basti’s can be adopted.
Raktamokshana: Raktamokshana can cure the diseases when other treatments do not have effect on nature of diseases or when other treatments fails to manage the diseases.It gives immediate relief in pain of Gridhrasi. It is helpful to eliminate Doshas from Shakha and in this therapy, there is no need to bring the Doshas in Koshtha.
Various sites of Raktamokshana:
4 Angula up or low from Janu Sandhi (back side)
4 Angula up from Gulpha (back side).
In between the Kandara and Gulpha (Inner side)
Agnikarma (cauterizaion) The site of Agnikarma (cauterization) is the Snayu (tendon) which passes below the little toe of feet. Agnikarma is contraindicated if there is Daha (burning sensation), Vidaha (pricking pain). Agni karma can be done in conditions where Bheshaja (medicines), Kshara (extract of ashes), Sastrakarma (surgical operations) are failed. Agni Karma with Loha Salaka (metallic cautery) about two or four Angula around the Gulpha also can be done.
Shamana Aushadi:- Palliative treatment with Dasamuladi kwatha, Sephalika Daladi kwatha, Panchamula Kashaya, Krishna Prayoga in Vata Kaphaja Gridhrasi, Eranda Phala Payasa, Rasnadi Guggulu, Triyodasanga Guggulu, Saindhavadya Tailam, Rasnadi Kashaya, Ajamedadi Churna, Yograja Guggulu, Rasna Saptaka Kwath, Ksheerabala 101 drops with milk two times a day, Panchasakara Churna. Ekangaveera Rasa, Dasmoola Kwatha, Ashwagandha Churna, Trayodashanga Guggulu etc.
Preventive Measures: Hard bed, Matra Basti, Proper Posture, Pada Abhayanga, Proper Dinacharya (Daily regims) and Ritucharya (Seasonal regims).
CONCLUSION: Gridhrasi is a Vatika Nanatmaja Vikara. It cannot be considered as a single disease. It is a symptom with certain specifications explained above. As the Nidana (cause) for vatakopa (aggrevaion of vata) can occur due to Dhatu kshya (depletion of tissue) and Avarana (clouding of doshas), Gridhrasi can occur due to both these reasons. Lakshana of Gridhrasi may vary from person to person due to variation in Samprapti. In kevala vatika (vata only) condition, Brimhana therapy (nourishing therapy) is enough while in Avarana conditions, treatment of Avarana should be done followed by that of kevala vatik condition. Depending upon the condition of the patient, the treatment can be planned. Vata is chief among the three Doshas and the functional requirement for both Kapha and Pitta, if co-ordination of Vata gets disturbed then the disease is going to manifest.
NOTE: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. contact 9483328411. The drugs described in this article are for general information/educational purpose only. Anyone should not use these without consulting a qualified Ayurveda doctor/physician.