A Review On Diagnosis And Treatment Of Gridhrasi With Ayurvedic Approac

P a g e | 88 Review Article ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION International Research Journal of Ayurveda & Yoga An International Peer Reviewed Journal for Ayurveda & Yoga VOLUME 4 ISSUE 8 1- PG Scholar, Department of Kayachikitsa, SDM Trust Ayurvedic Medical College, Terdal, Karanataka. 2- Professor Department of Kayachikitsa, SDM Trust Ayurvedic Medical College, Terdal, Karanataka. 3- Assistant Professor Department of Kayachikitsa, SDM Trust Medical College, Terdal, Karanataka. 4- Professor & HOD Department of Kayachikitsa, SDM Trust Medical College, Terdal, Karnataka. Corresponding Author :- Shraddha .D. Karande, PG Scholar, Department of Kayachikitsa, SDM Trust Ayurvedic Medical College, Terdal, Karanataka. Article received 26 th July 2021 Article Accepted 23 rd August 2021 Article published 31 st August 2021 ABSTRACT: - Introduction- Gridhrasi is painful and troublesome disease. If not treated on time it can led to serious conditions. Signs and symptoms of Gridhrasi are very similar to Sciatica. Causes of Gridhrasi are poor lifestyle, stress, improper posture, continuous jerky movements, Long traveling, that put maximum pressure on the spine and pelvis. About 60%-80% of people get affected by low back pain and 5% of those become victims of sciatica Material and methods- The Review of literature includes screening of classical literature, Contemporary Ayurvedic Literature and Internet Sources related to Gridhrasi were explored to collect sufficient data for the study. Aims and objectives- To assess and elaborate the etiological components of Gridhrasi Result and Conclusion- Ayurveda offers ample of better options in management of Gridhrasi. To fulfil the expectations from the Ayurvedic field, and to find out more effective and safe therapy for Gridhrasi. Keywords - Gridhrasi, Charak, sciatica This work is licensed under a creative attribution -Non-commercial-No derivatives 4.0 International License commons How to cite this article : Karande DS, Hiremath S.S, Hudedmani I, Badiger M.S., A Review On Diagnosis And Treatment Of Gridhrasi With Ayurvedic Approach, IRJAY. [Online] 2021;4(8): 88-92. Available from: http://irjay.com ; DOI: https://doi.org/10.47223/IRJAY.2021.4811 A Review On Diagnosis And Treatment Of Gridhrasi With Ayurvedic Approach. Shraddha. D. Karande 1 , S.S Hiremath 2 , Irappa Hudedmani 3 , M.S. Badiger 4

P a g e | 89 Review Article ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION INTRODUCTION Low back soreness has become a very prevalent problem in every age group in India and overseas as a result of lifestyle changes, and it is on the rise. According to a big study, there are 28.0 episodes per 1000 people per year for low back pain with sciatica and 11.6 episodes per 1000 people per year for low back pain with sciatica [1] Low back pain affects men somewhat more than women and is most common in the working population, with individuals aged 25–64 years having the highest frequency. Because modern medicine lacks a specific treatment for sciatica, an extensive study was conducted to gain a thorough understanding of the idea of sciatica in Ayurvedic terms [2] Ayurveda texts provide a detailed description of how to treat Vata Vyadhi , while only a few professionals provide a clear account of how to treat Gridhrasi [3] The purpose of this study is to gain a better knowledge of the pathology of Gridhrasi and to finalise a treatment strategy based on Ayurvedic principles Among the 80 varieties of Nanatmaja diseases, Gridhrasi is the most tenacious and noticeable. Gridhrasi is a painful condition in which a person's ability to sit and walk is hampered, interfering with his daily activities. Almost all of Gridhrasi's indications and symptoms are similar to those of sciatica, as described in modern sources. Its detailed symptomatology has been described in ayurvedic texts for over 5000 years, despite the fact that this condition was only discovered by contemporary medicine two centuries ago. Due to the lack of detailed descriptions of the ailment in Ayurveda classics, physicians have found it difficult to treat such patients. As a result, the current study was undertaken in order to comprehend the notion of disease Gridhrasi and to develop a therapy regimen in line with it [4] Nidana (Etiology) of Gridhrasi Nidana has not been cited in the case of Gridhrasi. So the nidana factors that cause Vata vyadhis are regarded causative factors, and it has been attempted to explain how they cause the condition. In the instance of Nidana In Vatavyadhi is, there isn't much of a distinction. In all Vatavyadhis, the main distinction is in Samprapti. The differences in Vata prakopaka karan as, such as Gridhrasi and Pakshaghata, are attributable to the Samprapti Vishesa of vitiated dosha. The causes of Vata vyadhi are clearly stated in Charaka [5] and Bhavaprakasha [6] however the causes of Vata vyadhi are not clearly documented in Sushruta samhita, Astanga Sangraha, and Astanga Hridaya, for example. However, the causative components of triggered Vata dosha are available in these works. Gridhrasi is a nanatmaja type of Vata sickness, hence the vata provoking stimuli can also be considered the cause of Gridhrasi. In addition to this, in Charaka Samhita, Astanga Sangraha and Ashtanga Hridaya, the specific causes of Vata Vyadhi i.e. dhatukshaya and avarana have also been mentioned [7] Purvarupa of Gridhrasi Gridhrasi is one of the 80 varieties of Vatavyadhi, therefore the small symptoms that appear before the sickness manifests might be considered Purvarupa. Rupa of Gridhrasi In Gridhrasi The cardinal symptoms are Ruk, Toda, Stambha, and Muhu-spandana . To be

P a g e | 90 Review Article ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION more specific about the pain's path, Chakrapani claims that it begins at Sphik and then radiates to Kati, Prishtha, Uru, Janu, Jangha, and Pada in that order. Acharya Sushruta and Vagbhata both add Sakthik-shepa-nigraha to the list of cardinal signs. Tandra, Gaurava, Aruchi, Bhaktadwesha, Mukhapra-seka , and others are Vata- Kaphaj Gridhrasi's lakshana. Vatik Lakshana has been characterised as De-hasyapravakrata, Janu, Uru Sandhi Spurana, and other signs and symptoms by Bhavaprakasha, Madhavnidana, and Yogaratnakara. Pain in Payu has also been included to Vangasena's list of symptoms. [8] Gridhrasi is a Vata Vyadhi , thus the general Samprapti of Vata Vyadhi , as well as the specific description available, are used to explain Samprapti. There are two primary reasons why Vata becomes vitiated. Dhatukshaya and Margavarodha are their names. In Gridhrasi , exposure to mild but continuous trauma to the Kati, Sphik region occurs as a result of poor posture, riding in jerky vehicles, carrying heavy loads, digging, etc. or, in some cases, spinal cord injury, improperly treated pelvic diseases are responsible for producing Sthanavaigunya at Kati, Sphik, Prishta , and other locations [9] They may not be able to develop the disease at first, but with the acquisition of some Vyanja-ka Hetu (excited cause), they may be able to do so. The Samprapti is performed here by Apatarpana, Santarpana, or Agantu-ja. Doshika Dominance in Gridhrasi According to Charaka, Sushruta and Vagabhaṭa Vata Dosha is dominance in Gridhrasi. Samprapti Ghatak Dosha –Vata, Kapha pradhan Dushya –Rakta, Mamsa, Meda, Nadi Adhishthan - Kati, Uru, Janu, Jangha, Pada Srotas –Raktavaha, Mamsavaha, Medavaha,Asthivaha Sroto dushti prakar - Sanga, Sira granthi Agni –Vishmagni, Mandagni Vyadhiswabhava –Aashukari/ Chirkari Sadhyta - Naveen –Krichrasadhya Chikitsa -Sutra: Aushadha is one of the four constituents of Chikitsa Chatush -Pada according to Ayurveda. Gridhrasi is one of Vata Vyadhi's general therapy lines, which can be detailed here. These treatment ideas are divided into three sections for easier comprehension: 1. Nidana Parivarjana 2. Shodhana Chikitsa - Snehana Karma (Snehana Karma)- Only Niroopastambhi-ta Vata should be used for Sne-hana. The word Snehana encompasses both outward and internal Snehana . Internally, Mahasneha and Snehapana chaturvidha are recommended. Taila, on the other hand, is commended in Vata-Vyadhi since it has the exact opposite qualities of Vata. Trivrut, Aarag-vadha, and Erand Taila should be employed for Virechana Karma [10] Nasya Karma with Erandmuladi Kwath. NiruhBasti using Erandmuladi Kwath, Anuvasan Basti of Saindhvadi tail is very beneficial for disease. Agnikarma- Charaka mentions Siravedha (between Kandara and Gul-fa), Basti (between Anuvasan and Niruh), and Agnikarma as Gridhrasi treatments [11] Siravedha - Sushruta, being the master of Shalyatantra has advised only Siravedha at Janu after

P a g e | 91 Review Article ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION flexion. Siravedha four Angula above or below Janu is mentioned for Gridhrasi in both Ashtanga Samgraha and Ashtanga Hridaya [12] 3. Shamana therapy is a type of environmental treatment. It is typically used in the form of pharmacological treatment based on the severity of the sickness and the Rogi's health. Rasna Saptaka Kashaya, Yogaraja Guggulu, Triphala Guggulu , and others are instances. 4. Rasayana and Vajeekarana: Rasayana, Vajeekarana, Balya, Brimhaniya, and Jeevaniya types of medications should be administered, according to ancient Acharyas, especially those belonging to Madhura and others. DISCUSSION Gridhrasi can be equated with the modern-day condition Sciatica syndrome, which is characterised by pain in the distribution of the sciatic nerve, which begins in the buttock and radiates downwards to the posterior aspect of the thigh, calf, and the outer border of the foot due to spinal nerve irritation. Modern science has various treatments for sciatica, such as conservative treatment, epidural steroid injection, peri-radicular infiltration, and surgical treatment, although there are consequences. As a result, as compared to allopathic treatment, the Ayurvedic method is far superior. Nidana Parivarjana, Sodhana Chikitsa (Snehana, Swedana, Virechana, Basti, Raktamokshana, etc.) and Shamana Chikitsa are the primary methods of disease therapy. Although Sodhana is advised for Bahu-dosha, Shamana is required to remove the remaining Dosha after the Shodhana process. The first and most important principle of Ayurvedic disease treatment is Nidana Parivarjana . It prevents sickness from progressing further by limiting Dosha vitiation. Gridhrasi is one of the 80 Nanatmaja Vatavyadhi kinds. Margavaranajanya Samprapti is present in Vatakaphaja Gridhrasi , and this impediment is alleviated by performing srotoshuddhi. The Sneha Virechana swiftly clears obstructions in the Srotas and alleviates Vata vitiation. As a result, Mridu nature's Sneha Virechana aids Shula control in Gridhrasi. Vata, notably Apana and Vyana Vayu Dushti, can be found in Gridhrasi. Basti is based in Pakwashaya and begins its storey there. Vayu's natural habitat is Pakwashaya. Basti's Prakruta Sthana conquers vitiated Vata, and Vata residing in other regions of the body is immediately defeated. Basti removes Malasanghata and so preserves Apana Vayu's Anulomagati , which helps to alleviate Gridhrasi's symptoms. Basti affects the intestine's normal bacterial flora, which is necessary for the creation of vitamins B 6, B 12, and C. Basti Chikitsa reduces ketoacid and pyruvic acid levels, resulting in a rise in vitamin B production. There may be a generalising dilation of the heated blood arteries on the centres responsible for body temperature regeneration. The vasomotor centres are affected by heating, resulting in a general rise in temperature CONCLUSION Vataj Nanatmaja Vyadhi is Gridhrasi. Gridhrasi features Vata prominently. The key sign in Gridhrasi is Saktikshepanigraha, which affects the elevation of the lower leg. Vata is sometimes linked with Kapha , resulting in Vatakaphaja Gridhrasi. Gridhrasi's Samprapti is triggered by either Dhatukshaya or Margavarana. Sankocha will be given to the Sira and Kandara of the

P a g e | 92 Review Article ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION affected limb. Nitamba, Kati, Prusta, Uru, Jangha, and Pada all have leg discomfort emanating from them. Toda, Muhuspandana, and Stambha accompany the anguish. With Panchkarma , Ayurveda takes a unique approach to the care of the symptoms indicated above. The various symptoms of Snehana and Swedana are effective. Siravedha, Agni Karma, and Basti Karma are all mentioned here. Gridhrasi is a Shoola Pradhana Vyadhi illness produced by Prakupita Vata. Gridhrasi as an illness, as well as its diagnosis and treatment, may be found in Ayurvedic books dating back thousands of years. The detailed study of the condition sheds light on Gridhrasi's dangers and provides crucial information for successful care. Acknowledgment: Nil Financial Support: Nil. Conflict of Interest: Nil REFERENCES 1 Das S, A manual on clinical surgery including special investigation and differ-ential diagnosis, 6 th edition 2004; pub-lished by dr. s.das; p no- 225,226. 2 Baily L, short practice of surgery;24 th edition, 2004; Outline of Orthopedics; by john CrawfordAdams, David L Hamblen; 13 th edition,2000; pp.200-2024. 3 Davidson’s principles and practices ofmedicine, 17 th edition, edited by C.R.WEwards I.A.D. Bouchier ,C.Haslett published by ELBS with Churchill livingstonein 1996 pp.8645. 4 Nicholas A. Boon, Nicki R. Colledge,Brian R. Walker, Davidson’s Principles and Practice of Medicine, Churchill Livingstone Elsevier Limited, 20 th edition(2006), Page no.1242. 5 Tripathi B Charaka Samhita (Agnivesh) Part 2-charaka chandrika Hindi Commentary Published by ChaukhambaBharti Academy, Gokul Bhawan, GopalMandi Lane,Varanasi, 2009. Page No. 35 6 Murty K.S, Bhav Prakash of Bhavmishra vol. 2- Eng-lish tranlation ,published by Chaukhamba kris-handas Academy, Gopal MandirLane,Varanasi, 2015. Page No. 331 7 Deva R, Health Media, Sciatica Shabdakalpa drumavol, Chaukambha Sanskritseries Varanasi,1967 page 348. 8 Murty K.S Sushruta Samhita vol. I English translation ,published by Chaukhambha Orientalia Vara-nasi,2014.pag.no.472.1 9 Tripathi B Charaka Samhita (Agnivesh) vol. V, Eng-lish translation, Published by Chaukhamba krishandas Academy, Gopal Mandir Lane,Varanasi, 2015. Page No. 35. 10 Tripathi B, Charaka Samhita (Agnivesh) Part 1-charaka chandrika Hindi Commentary Published by Chaukhamba Bharti Academy, Gokul Bhawan, Gopal Mandi Lane,Varanasi, 2009. Page No. 391 11 Singhal A, Gupta K (2017) Conceptual Study on the Management of Gridhrasi . Int J Complement Alt Med 10(2): 00332 12 Singhal A, Gupta K (2017) Conceptual Study on the Management of Gridhrasi . Int J Complement Alt Med 10(2): 00332

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Nidana, Madhura, Ayurveda, Vata, Kapha, Gridhrasi, Samprapti, Basti, Sushruta, Chalaka, Vatavyadhi, Kayachikitsa, Dhatukshaya, Siravedha, Vatadosha, Agnikarma, Margavarodha, Sciatica, Classical literature, Shamanacikitsa, Shamana Therapy, Ayurvedic approach, Snehana karma, Shodhana Chikitsa, Nidana Parivarjana, Sodhana chikitsa, Low Back Pain, Vatakaphaja Gridhrasi, Poor lifestyle, Vataj Nanatmaja Vyadhi, Erand taila, Shoola Pradhana Vyadhi, Gridhrasi symptoms, Saktikshepanigraha.