Management of gridhrasi w.s.r to sciatica through panchakarma: a case report
Journal name: Ayushdhara
Original article title: Management of gridhrasi w.s.r to sciatica through panchakarma: a case report
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Santosh Kumar Bhatted
Associate Professor, Department of Panchakarma, All India Institute of Ayurveda, New Delhi, India.
Alok Kumar Meher
PG Scholar, Department of Panchakarma, All India Institute of Ayurveda, New Delhi, India.
Kavita
PG Scholar, Department of Panchakarma, All India Institute of Ayurveda, New Delhi, India.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Management of gridhrasi w.s.r to sciatica through panchakarma: a case report
Year: 2020 | Doi: 10.47070/ayushdhara.v7i3.566
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Sciatica, referred to in Ayurveda as Gridhrasi, is a prevalent musculoskeletal condition affecting over 10 million individuals annually in India. It is characterized by pain radiating from the lower back to the legs, often accompanied by weakness and cramps in the lower extremities. This pain can significantly impair mobility and quality of life. The case report discusses a 40-year-old female patient who experienced lower back pain and related symptoms for a decade. She received Panchakarma treatment, which included a series of Ayurvedic therapies aimed at alleviating her condition, resulting in marked improvement.
Vata Dosha and its Management
In Ayurveda, Gridhrasi is categorized under Nanatmaja Vata Vyadhi, indicating that it results from the aggravation of Vata dosha. The treatment approach focuses on Vata pacification, utilizing therapies to relieve pain associated with this dosha imbalance. The patient underwent multiple Panchakarma treatments over 18 days, including Sarvanga Abhyanga (full body oil massage), Sarvanga Rooksha Choorna Pinda Swedana (herbal bolus steam therapy), and Erandmooladi Yoga Basti (medicated enema). These treatments are recognized as effective Vata-shamaka methods, enhancing blood circulation and easing pain and stiffness.
Effectiveness of Panchakarma Treatments
The patient showed a significant reduction in various symptoms following the treatment protocol. Evaluations using subjective symptom assessment and the Rolland and Morris Questionnaire indicated approximately 56.5% improvement in overall conditions, including reductions in pricking pain, pulling pain, stiffness, and advancements in functionalities such as walking speed and the straight leg raise test. The combination of treatments effectively addressed the aggravated Vata, leading to substantial symptom relief and functional improvement for the patient.
Conclusion
The case highlights the effectiveness of Panchakarma therapies in managing chronic conditions like Gridhrasi (sciatica). Even though the patient had suffered from her symptoms for many years, the structured Ayurvedic interventions provided substantial relief and improved her mobility. This study underscores the need for a multimodal approach in treating sciatica, combining traditional practices with contemporary understanding for optimal patient outcomes.
FAQ section (important questions/answers):
What is Gridhrasi and its symptoms?
Gridhrasi, known as sciatica, is characterized by lower back pain radiating down the legs, stiffness, pricking pain, and weakness in the lower extremities. Symptoms might include difficulty in walking and cramps, significantly impacting daily activities.
What treatments were used for this case of Gridhrasi?
The treatments included Panchakarma techniques such as Abhyanga, Rooksha Churna Pinda Swedana, Patra Pinda Swedana, and Abhyantara Basti. These treatments aimed to relieve pain, reduce stiffness, and pacify the aggravated Vata dosha.
What were the results after the treatment of the patient?
After 18 days of treatment, the patient showed marked improvement with significant relief in symptoms. For instance, pricking pain and stiffness experienced a 66.6% relief, while overall disability decreased by 56.5% according to the Rolland Morris Questionnaire.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Management of gridhrasi w.s.r to sciatica through panchakarma: a case report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Pain:
Pain is a significant symptom of sciatica, described in detail within the text. It is characterized by radiating discomfort from the lower back to the legs. The case report discusses the application of various treatments to alleviate this pain in the context of Panchakarma therapy.
2) Vata:
Vata is one of the three doshas in Ayurveda and is described as being aggravated in cases of Gridhrasi (sciatica). The text discusses the use of Vata-pacifying treatments, including oils and therapies to manage the symptoms attributed to Vata imbalance.
3) Gridhrasi (Gridhrashi, Grdhrasi):
Gridhrasi, the Ayurvedic term for sciatica, signifies severe sciatica-like symptoms. It includes pain radiating from the lower back to the legs, stiffness, and other discomforts. The term highlights the characteristic 'vulture-like' gait due to this condition.
4) Pinda (Pimda):
[see source text or glossary: Pinda]
5) India:
India is the country where the case study was conducted, at the All India Institute of Ayurveda in New Delhi. Sciatica is noted to have a high prevalence in India, with over 10 million cases annually.
6) Abhyanga (Abhyamga):
Abhyanga is a therapeutic oil massage mentioned as part of the Panchakarma treatment for Gridhrasi. It is said to pacify Vata dosha, provide pain relief, and improve symptoms related to conditions like sciatica by nourishing the body tissues.
7) Basti:
Basti refers to an Ayurvedic enema treatment, which is considered effective for Vata disorders such as Gridhrasi. In the case report, Yoga Basti with Erandamooladi Nirooh Basti was administered to target the primary location of Vata dosha and alleviate symptoms.
8) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine utilized in this study to treat Gridhrasi (sciatica). Techniques like Panchakarma and specific herbal formulations are employed to balance the doshas and treat the condition effectively.
9) Stiffness:
Stiffness, a key symptom of Gridhrasi (sciatica), is characterized by the inability to move freely. The treatments like Sarvanga Rooksha Churna Pinda Svedana and Abhyanga were administered to alleviate this symptom and enhance mobility.
10) Disease:
Disease in this context refers to Gridhrasi, characterized by pain, stiffness, and other symptoms affecting the spine and legs. Ayurvedic treatments aim to manage and alleviate these symptoms effectively.
11) Taila (Thaila):
Taila refers to medicated oils used in Ayurvedic treatments. Dhanwantaram Taila is mentioned in the case study for Abhyanga and Sarvanga Patra Pinda Swedana, both of which help in alleviating Vata-induced symptoms.
12) Patra:
Patra refers to leaves used in Patra Pinda Swedana, a type of fomentation therapy. This treatment involves using leaves and oils to alleviate pain and stiffness, making it beneficial for conditions like Gridhrasi.
13) New Delhi:
New Delhi is the location of the All India Institute of Ayurveda, where the case study was conducted. The institute provided the setting for the application of Ayurvedic treatments to manage the patient's Gridhrasi.
14) Vatadosha (Vatadosa, Vata-dosha):
Vata-dosha, one of the three doshas in Ayurveda, is responsible for movement and neurological functions. In the case of Gridhrasi, its aggravation leads to symptoms like pain and stiffness, necessitating treatments that specifically pacify Vata.
15) Vatahara (Vata-ahara):
Vata-hara treatments are therapies specifically aimed at pacifying Vata dosha. These treatments are crucial in managing conditions like Gridhrasi, which is characterized by Vata aggravation.
16) Dosha (Dosa):
Dosha refers to the fundamental bodily humor in Ayurveda. Vata, Pitta, and Kapha are the three doshas, with Vata playing a significant role in the manifestation of Gridhrasi symptoms as discussed in the case report.
17) Asthi (Ashthi):
Asthi, meaning bone, is involved in Gridhrasi where the bone and marrow (Majja) systems are affected. Ayurvedic treatments aim to strengthen these structures and alleviate symptoms of Vata aggravation.
18) Majja:
Majja, or bone marrow, is highlighted in the text in the context of orthopedic and neurological systems. Treatments like Abhyanga aim to nourish the Majja Dhatu, thereby helping in conditions such as Gridhrasi.
19) Delhi:
Delhi is the broader location context within which the All India Institute of Ayurveda is situated, highlighting the geographical context of the study conducted on Gridhrasi management.
20) Kumar:
[see source text or glossary: Kumar]
21) Hara:
Hara is a term in Ayurveda that means 'to remove' or 'to alleviate.' In this context, Vata-hara practices aim to alleviate conditions caused by an aggravated Vata dosha, as seen in the case of Gridhrasi.
22) Vatavyadhi (Vata-vyadhi):
Vata-vyadhi refers to diseases caused by aggravation of Vata dosha. Gridhrasi is classified as a Vata-vyadhi, where treatments focus on balancing Vata to mitigate symptoms like pain and stiffness.
23) Abhyantara (Abhyamtara):
[see source text or glossary: Abhyantara]
24) Irritation:
Irritation of the sciatic nerve causes pain and other symptoms associated with Gridhrasi. Ayurvedic treatments aim to soothe and alleviate this irritation through various means such as Panchakarma procedures.
25) Medicine:
Medicine in the context of Ayurveda includes herbal formulations, oils like Dhanwantaram Taila, and therapeutic practices like Basti, all of which are used to treat symptoms of Gridhrasi effectively.
26) Svedana:
Svedana refers to fomentation or sweat-inducing therapies used in Ayurveda. In this case, Sarvanga Rooksha Churna Pinda Svedana and Patra Pinda Svedana are employed to relieve stiffness and pain associated with Gridhrasi.
27) Samtosha (Samtosa, Santosa, Santosha, Santosh):
[see source text or glossary: Santosh]
28) Vedana:
Vedana, meaning pain, is a primary symptom in conditions like Gridhrasi. Treatments in Ayurveda focus on Vedana-sthapana, or pain relief, to improve the patient's quality of life.
29) Vyadhin (Vyadhi):
Vyadhi, meaning disease, describes the pathological state in Ayurveda. Gridhrasi is a type of Vata-vyadhi, where treatments aim to correct the underlying dosha imbalance causing the illness.
30) Sneha:
Sneha refers to oleation therapy using oils in Ayurveda, which is crucial for Vata-pacifying treatments. Abhyanga with Dhanwantaram Taila is an example of Sneha used to treat Gridhrasi.
31) Ushna (Usna):
[see source text or glossary: Ushna]
32) Virya:
[see source text or glossary: Virya]
33) Guru:
[see source text or glossary: Guru]
34) Yoga:
Yoga here refers to the compounded Ayurvedic formulations like Erandamooladi Yoga Basti, used for detoxifying and balancing Vata dosha, thus helping in the treatment of Gridhrasi.
35) Vaha:
Vaha in the text pertains to Strotas (channels in the body) that are afflicted in Gridhrasi. The treatment aims to pacify Vata and strengthen these bodily channels, particularly Asthi Majja Vaha Strotas.
36) Drug:
Drug in this context refers to Ayurvedic medicinal formulations employed to treat Gridhrasi, which include herbal concoctions like Erandmooladi Yoga, oils for Abhyanga, and churnas for Svedana.
37) Vedanasthapana (Vedana-sthapana):
Vedana-sthapana refers to pain-relief treatments in Ayurveda. The case study outlines treatments like Sarvanga Abhyanga and Basti, which are employed specifically to alleviate Vedana in Gridhrasi patients.
38) Inflammation:
Inflammation is a key pathological process in sciatica or Gridhrasi. Treatments like Ayurvedic oil massages and herbal enemas aim to reduce inflammation along with other symptoms associated with the condition.
39) Majjadhatu (Majja-dhatu):
Majja-dhatu refers to the bone marrow tissue in Ayurveda. Treatments aimed at nourishing and strengthening Majja-dhatu, such as those involving Dhanwantaram Taila, are employed in the management of Gridhrasi.
40) Asthimajjan (Asthimajja, Asthi-majjan):
Asthi-majja Strotas, or the channels related to bone and marrow, are particularly affected in Gridhrasi. Ayurvedic treatments aim to nourish and strengthen these channels, alleviating symptoms of pain and stiffness.
41) Discussion:
Discussion elaborates on the effectiveness of the Ayurvedic treatments for Gridhrasi in the case study. It highlights the observed benefits and explains the rationale behind using specific therapies.
42) Spandana (Spamdana):
[see source text or glossary: Spandana]
43) Sthapana:
[see source text or glossary: Sthapana]
44) Stambha:
[see source text or glossary: Stambha]
45) Prakopa:
[see source text or glossary: Prakopa]
46) Snigdha:
[see source text or glossary: Snigdha]
47) Apathya:
Apathya refers to the dietary and lifestyle modifications to be avoided in Ayurveda. In the context of Gridhrasi treatment, observing Pathya and avoiding Apathya can influence treatment outcomes.
48) Samaka (Shamaka):
[see source text or glossary: Shamaka]
49) Viddha:
[see source text or glossary: Viddha]
50) Jangha (Jana-ogha, Jamgha):
[see source text or glossary: Jangha]
51) Pathya:
Pathya encompasses dietary and lifestyle measures that support treatment in Ayurveda. In the case of Gridhrasi, appropriate Pathya involves following specific recommendations to pacify Vata and support healing.
52) Pitta:
Pitta, another dosha in Ayurveda, though not predominantly discussed, is mentioned with Vata in the context of Dhanwantaram Taila, which pacifies both Vata and Pitta and helps relieve nerve irritation.
53) Matra:
[see source text or glossary: Matra]
54) Dhatu:
Dhatu refers to the tissues in the body. Ayurveda treats diseases like Gridhrasi by nourishing Dhatus (like Majja) through therapies such as Sneha (oil treatments) to balance Vata and restore health.
55) Ayus (Ayush):
[see source text or glossary: Ayush]
56) Pulse:
Pulse rate, monitored during the case study, helps gauge the patient’s general condition during treatment. The case reported a pulse rate of 76/min, indicating a normal cardiovascular status.
57) House:
[see source text or glossary: House]
58) Sida (Shida):
[see source text or glossary: Sida]
59) Bala:
[see source text or glossary: Bala]
60) Pada:
[see source text or glossary: Pada]
61) Janu:
[see source text or glossary: Janu]
62) Vayu:
Vayu is another term for Vata dosha in Ayurveda. Dominating the sense of touch, it plays a significant role in conditions like Gridhrasi, where its imbalance causes severe neurological symptoms.
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