Greeva stambh (cervical spondylosis) – a disease review

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Journal name: World Journal of Pharmaceutical Research
Original article title: Greeva stambh (cervical spondylosis) – a disease review
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Deepika Divan and Rekha Bajpai


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Greeva stambh (cervical spondylosis) – a disease review

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr201817-13432

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

Cervical spondylosis, characterized by degenerative changes in the cervical spine, manifests primarily as neck stiffness and pain. In Ayurvedic medicine, this condition is referred to as Greeva Stambh, which encompasses the features of restricted neck movement and other associated symptoms such as headache, vertigo, and numbness. It's increasingly prevalent among middle-aged individuals, particularly those experiencing poor posture, excessive strain, or frequent travel. The article aims to explore the aetiopathogenesis, clinical features, and management of Greeva Stambh in depth, based on Ayurvedic classics.

The Concept of Greeva Stambh

The term "Greeva Stambh" literally translates to neck stiffness, where "Greeva" signifies the neck's pivotal role and "Stambh" refers to the rigidity or immobility. As described in Ayurvedic texts, Greeva is essential for connecting the head to the thorax, and its dysfunction leads to significant impairment of these structural functions. The etiology of Greeva Stambh is deeply rooted in factors affecting "Vata," one of the three doshas in Ayurveda. Chronic degeneration and external stressors contribute to the disease's manifestation, which aligns with the classical descriptions found in Ayurvedic literature.

Aetiological Factors and Disease Progression

The progression of Greeva Stambh can be understood through the Nidan Panchak, which identifies its aetiological factors categorized into several groups: dietary, lifestyle, psychological, external, and seasonal. Key contributors include dry and cold foods, improper posture, excessive travel, and emotional stress. The disease's clinical symptoms (Roopa) encompass neck pain, stiffness, restricted movement, and radiating pain into the arms and back of the head. Grasping these elements is crucial for both diagnosis and therapeutic intervention in Ayurvedic practice.

Treatment Approaches in Ayurveda

Management of Greeva Stambh involves a multi-faceted approach prioritizing the balance of Vata dosha. Treatment strategies include dietary modifications, herbal therapies, and specific Ayurvedic procedures such as Snehana (oil application), Swedana (sudation), and Vasti (medicated enema). These methods aim to alleviate symptoms and address the root causes of the disease. Additionally, the article outlines the importance of lifestyle changes and rehabilitation approaches, such as physiotherapy and occupational therapy, to support the recovery process.

Conclusion

Greeva Stambh, as a common ailment in modern society due to lifestyle changes, can severely affect a person's quality of life. The article emphasizes that timely and appropriate Ayurvedic treatment can yield positive outcomes for those suffering from symptoms like neck pain, stiffness, and radiating discomfort. A holistic approach that combines traditional Ayurvedic practices with contemporary rehabilitative therapies is key to achieving effective management and improved patient well-being in cases of cervical spondylosis.

FAQ section (important questions/answers):

What is Cervical Spondylosis and how is it relevant to Ayurveda?

Cervical Spondylosis is a degenerative condition of the cervical spine. In Ayurveda, it correlates with 'Greeva Stambh,' characterized by neck stiffness, pain, and other discomforts, reflecting the impact of modern lifestyle on spinal health.

What are the common causes of Cervical Spondylosis?

Common causes include poor posture, excessive physical exertion, frequent travel, and trauma. These factors contribute to degenerative changes in the spine, leading to symptoms like pain and stiffness.

What are the key symptoms associated with Greeva Stambh?

Key symptoms include neck pain, stiffness, restricted movement, paraesthesia, headache, and vertigo. These symptoms significantly impact daily activities and quality of life.

How does Ayurveda approach the treatment of Greeva Stambh?

Ayurveda emphasizes 'Nidana Parivarjana,' avoiding causative factors, and recommends therapies like Snehan, Swedana, and specific dietary regimens to balance Vata dosha, mitigate symptoms, and enhance recovery.

What diet recommendations are provided for managing Vata-related issues?

Recommended diets for managing Vata include nourishing foods like ghee, warm beverages, and easily digestible grains. Avoid dry, cold foods that can aggravate Vata imbalance, aiding in symptom relief.

What role do rehabilitation therapies play in managing Greeva Stambh?

Rehabilitation therapies such as physiotherapy and occupational therapy complement Ayurvedic treatments, enhancing recovery from Greeva Stambh. These approaches aim to improve mobility and reduce pain through targeted exercises and lifestyle modifications.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Greeva stambh (cervical spondylosis) – a disease review”. 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) Disease:
In the context of Ayurveda, a disease represents an imbalance or disturbance within the body, attributed to varied factors like dietary habits, lifestyle choices, and stress. Cervical spondylosis or Greeva Stambh exemplifies a physical disease characterized by degenerative changes in the cervical spine leading to pain and stiffness.

2) Griva:
Greeva refers specifically to the neck area in Ayurvedic terminology. It emphasizes the significance of the neck not just as a structural entity, but also as an integral part of bodily alignment and function. Its conditions, such as Greeva Stambh, depict classical descriptions of neck pain and stiffness in Ayurveda.

3) Vata:
Vata is one of the three fundamental doshas in Ayurveda, representing the elements of air and space. It is associated with movement, communication, and bodily functions. An imbalance of Vata can lead to disorders like Greeva Stambh, characterized by symptoms such as stiffness and pain.

4) Stambha:
Stambha denotes stiffness or immobility. In the context of Greeva Stambh, it specifically relates to restricted movement in the neck area. It is critical in understanding the pathology of cervical spondylosis, reflecting the loss of flexibility and associated pain occurring in the patient.

5) Vyadhin (Vyadhi):
Vyadhi translates to disease or disorder in Ayurveda. It encapsulates various health conditions affecting individuals, including Greeva Stambh. Understanding Vyadhi focuses on identifying symptoms, causes, and effects, leading to appropriate treatment methodologies within Ayurvedic practice.

6) Divan:
Divan is the surname of one of the principal authors of the study. In academic and research settings, authors' names are crucial for attributing credit and recognizing individual contributions. Here, Deepika Divan is a notable Ayurvedic scholar, shedding light on cervical spondylosis in this research.

7) Samprapti:
Samprapti refers to the pathogenesis of diseases. It involves understanding how specific doshas, dhatus, and dushyas lead to a disease state. In Greeva Stambh, identifying samprapti helps elucidate the underlying mechanisms impacting the cervical spine and contributes to appropriate treatment strategies.

8) Pain:
Pain is a significant symptom associated with many diseases, including Greeva Stambh. In cervical spondylosis, patients typically experience neck pain radiating to their arms and headaches. Understanding pain allows healthcare providers to target interventions and improve patient quality of life.

9) Vatavyadhi (Vata-vyadhi):
Vatavyadhi is a specific classification of ailments in Ayurveda linked to Vata dosha imbalances. These disorders can present as musculoskeletal pain or neurological issues. Greeva Stambh is classified under Vatavyadhi, showcasing the need for Vata-balancing treatments in Ayurveda.

10) Stiffness:
Stiffness defines the restricted mobility of joints and muscles, a hallmark of Greeva Stambh. This symptom significantly impacts daily functions and quality of life. In Ayurveda, addressing stiffness involves restoring balance in Vata dosha and promoting movement through various therapeutic practices.

11) Life:
Life, in a broader context, encompasses the holistic well-being of individuals, affected by physical, mental, and emotional health. Modern lifestyles often lead to musculoskeletal issues like Greeva Stambh, underlining the importance of maintaining balance across all life aspects for optimal health.

12) Apathya:
Apathya refers to foods and practices detrimental to health in Ayurveda. Identifying apathya is vital for managing conditions like Greeva Stambh, where avoiding triggering substances helps alleviate symptoms. Understanding apathya aids in creating tailored treatment plans for individuals.

13) Pathya:
Pathya denotes beneficial dietary and lifestyle practices conducive to health. In treating Greeva Stambh, incorporating pathya can emphasize nourishing foods and therapeutic practices that support Vata balance, aiding recovery and enhancing overall wellness in patients.

14) Dosha (Dosa):
Dosha represents the three fundamental energies governing physiological and psychological processes in Ayurveda: Vata, Pitta, and Kapha. In Greeva Stambh, Vata dosha is primarily affected, necessitating its balancing through dietary adjustments and treatment modalities for effective management.

15) Dhatu:
Dhatu signifies the bodily tissues in Ayurveda, essential for sustaining human health. The state of dhatus—bones (Asthi), muscles (Mamsa), and fat (Meda)—is critical in understanding conditions like Greeva Stambh, as chronic imbalances can contribute to degenerative changes within the cervical spine.

16) Table:
In the context of the document, tables summarize key information regarding aetiological factors, symptoms, and treatment modalities. They are essential for simplifying data presentation and facilitating easier understanding of complex Ayurvedic concepts related to Greeva Stambh.

17) Roga:
Roga encompasses various diseases within Ayurvedic literature. Understanding roga is critical for practitioners to diagnose and treat conditions appropriately. In discussing Greeva Stambh, roga sheds light on disease classification, symptoms, and management pathways suggested by classical Ayurvedic texts.

18) Hetu:
Hetu refers to the causes or factors leading to a disease. In Ayurveda, identifying hetu for conditions like Greeva Stambh involves examining lifestyle, dietary practices, and emotional stress, guiding targeted prevention and treatment strategies.

19) Samhita:
Samhita refers to authoritative Ayurvedic texts that compile ancient knowledge on health and medicine. Works like Charaka Samhita provide foundational insights into conditions such as Greeva Stambh, offering treatment guidelines, symptomatology, and the framework for Ayurvedic healing practices.

20) Ghataka:
Ghataka denotes the factors involved in the pathogenesis of a disease according to Ayurvedic principles. Understanding ghatakas for Greeva Stambh involves exploring the interplay between dosha imbalances, dhatus, and external influences, guiding therapeutic decisions in treatment.

21) Lucknow:
Lucknow is the geographical location of the authors associated with the study. The State Ayurvedic College and Hospital in Lucknow represents a center for understanding traditional practices and research in Ayurveda, positioning it as a significant contributor to contemporary studies on conditions like Greeva Stambh.

22) Vertigo:
Vertigo describes a sensation of spinning or loss of balance, often linked to neck issues like cervical spondylosis. In Ayurveda, addressing vertigo is essential for comprehensive care in conditions like Greeva Stambh, where interconnected symptoms necessitate holistic management.

23) Marga:
Marga refers to the pathways or channels through which bodily energies and substances flow. In Ayurveda, understanding marga is important in diagnosing and treating conditions like Greeva Stambh, where the blockage of energy flow leads to symptoms like stiffness and pain.

24) Majja:
Majja denotes the marrow and nervous tissue in Ayurveda, playing a vital role in overall health and vitality. Consideration of majja's condition is essential when addressing diseases like Greeva Stambh, as its health determines the nervous system's integrity and pain sensation.

25) Varga:
Varga means categories or classifications in Ayurvedic literature, often used to organize dietary and herbal treatments. Understanding various vargas helps Ayurveda practitioners select specific ingredients or therapies that align with a patient's condition, such as those seen in Greeva Stambh.

26) India:
India is where Ayurveda originated and is deeply embedded in its cultural and scientific heritage. The practices and philosophies guiding Ayurveda, including treatment for conditions like Greeva Stambh, have evolved in this context, representing a rich tradition of holistic health and wellness.

27) Rupa:
Roopa represents clinical manifestations or symptoms of a disease in Ayurveda. Recognizing the roopa of Greeva Stambh, such as neck pain and stiffness, enables healthcare providers to formulate effective treatment plans based on individual patient presentations.

28) Diet:
Diet holds a central role in Ayurveda, impacting health and well-being. In addressing Greeva Stambh, adopting appropriate dietary practices helps in managing symptoms. A balanced diet supports the body's healing processes and aligns with Ayurvedic principles of maintaining dosha equilibrium.

29) Upashaya (Upasaya):
Upashaya refers to therapeutic measures or interventions that alleviate symptoms and support healing in Ayurveda. Identifying effective upashaya for Greeva Stambh informs treatment strategies aimed at reducing pain and improving mobility through dietary, herbal, and lifestyle adjustments.

30) Medicine:
Medicine in Ayurveda encompasses herbal, dietary, and therapeutic approaches to restore health. In treating Greeva Stambh, specific medicines targeting Vata imbalances are formulated, emphasizing the importance of holistic practices in addressing systemic issues through natural remedies.

31) Snehana:
Snehana means oleation or the application of oil to nourish and lubricate the body in Ayurveda. This therapy is vital for managing symptoms of Greeva Stambh, where it helps alleviate stiffness and pain through improved circulation and tissue health.

32) Snigdha:
Snigdha denotes 'unctuous' in Ayurveda, often used to describe substances or qualities that are smooth and oily, promoting nourishment. In the context of Greeva Stambh, snigdha properties applied in treatment can enhance the effectiveness of therapies to reduce discomfort and stiffness.

33) Prakriti (Prakrti):
Prakrti refers to an individual's unique constitution or nature in Ayurveda, comprising the three doshas. Understanding one's prakrti helps tailor treatments for conditions like Greeva Stambh, ensuring that therapeutic interventions align with individual responses and inherent qualities.

34) Siddha:
Siddha means 'perfected' or 'accomplished' in Ayurvedic terminology, often associated with formulations prepared from traditional herbs and compounds. In treating Greeva Stambh, siddha substances may be utilized to target the specific doshic imbalances affecting the patient.

35) Dushya (Dusya):
Dushya are the substances that undergo changes due to diseases. In Greeva Stambh, dushyas include the affected dhatus such as bones and muscles. Understanding dushya is critical for effective diagnosis and treatment, necessitating targeted therapies addressing these tissues.

36) Kshaya (Ksaya):
Kshaya means depletion or loss of body tissues, which can significantly impact health. In Greeva Stambh, chronic kshaya of the dhatus can lead to the advancement of degenerative changes in the cervical spine, necessitating appropriate treatment measures to restore balance.

37) Chinta:
Chinta refers to anxiety or worry, which can exacerbate physical health issues. In the context of Greeva Stambh, recognizing the role of chinta helps underscore the mind-body connection, guiding treatment to address both emotional and physical symptoms effectively.

38) Kapha:
Kapha represents one of the three doshas, associated with earth and water elements, primarily influencing structure and stability in the body. Although Greeva Stambh is primarily a Vata condition, understanding kapha’s role can be vital in holistic treatment approaches.

39) Sneha:
Sneha denotes 'oil' or 'fat' and plays a fundamental role in Ayurvedic therapies. It is particularly significant in treating Vata-related disorders such as Greeva Stambh, where moist and unctuous properties of sneha help restore balance and alleviate associated discomfort.

40) Asthi (Ashthi):
Asthi refers to bone tissue, which is vital for structural integrity and mobility. In terms of Greeva Stambh, the condition can stem from degeneration of asthi, highlighting the need for interventions that support bone health and address related symptoms.

41) Nasya (Nashya):
Nasya refers to inhalation therapy in Ayurveda, administered through the nasal passage to clear sinuses and enhance neurological function. This treatment can be beneficial in managing symptoms related to Greeva Stambh, addressing both local and systemic impacts of the condition.

42) Mamsa (Mamsha):
Mamsa refers to muscle tissue in Ayurveda, crucial for movement and overall structural support. The state of mamsa is important when considering conditions like Greeva Stambh, as muscle health influences mobility and the overall manifestation of symptoms.

43) Tikta:
Tikta denotes bitterness, which is one of the tastes classified in Ayurveda. While not directly linked to Greeva Stambh, understanding tikta in relation to diet can assist practitioners in recommending foods beneficial for reducing inflammation and promoting wellness.

44) Mridu (Mrdu):
Mridu means 'gentle' or 'mild' and applies to both therapies and medications in Ayurveda. In managing Greeva Stambh, mridu measures can lower resistance during treatment procedures, ensuring a safe approach to alleviating symptoms and restoring function.

45) Basti:
Basti refers to an enema therapy in Ayurveda, often employed to treat Vata imbalances. It is crucial for conditions like Greeva Stambh, where impeding Vata through basti can restore balance and relieve chronic symptoms, ultimately aiding recovery.

46) Agni:
Agni symbolizes the digestive fire or metabolic processes in Ayurveda, influencing how effectively food is assimilated. A balanced agni is essential for all treatments, including those like Greeva Stambh, where optimal digestion supports healing and overall health.

47) Katu:
Katu represents the sharp or pungent taste, which can influence therapeutic decisions in Ayurvedic practice. While it may not be directly associated with Greeva Stambh, understanding the role of katu in diet can contribute to the overall balance required for treatment success.

48) Ritu (Rtu):
Ritu refers to the seasonal variations that can profoundly impact health in Ayurveda. In managing conditions like Greeva Stambh, awareness of seasonal effects aids in adjusting lifestyle and dietary practices, ensuring alignment with the body's natural rhythms.

49) Amla:
Amla refers to sourness and is also associated with specific therapeutic fruits in Ayurveda, known for their rejuvenating properties. While not directly linked to Greeva Stambh, amla's qualities can contribute to overall health and immune support, complementing treatment strategies.

50) Drug:
Drug in the Ayurvedic context applies to natural substances used for therapeutic purposes. For conditions like Greeva Stambh, specific herbal formulations may serve as drugs to mitigate symptoms, directly targeting Vata dosha imbalances for effective treatment.

51) Greevastambha:
Greevastambha is the Ayurvedic term for cervical spondylosis, characterized by neck pain and stiffness. Understanding greevastambha is essential for treatment, as it encapsulates the specific symptoms and underlying pathologies that practitioners target through various interventions.

52) Dhatukshaya (Dhatuksaya, Dhatu-kshaya):
Dhatu-kshaya indicates the depletion or deterioration of body tissues, contributing to chronic conditions. In Greeva Stambh, dhatu-kshaya emphasizes the need for treatments that nourish and regenerate affected tissues to restore overall balance and alleviate symptoms.

53) Mamsavarga (Mamsa-varga):
Mamsa-varga categorizes various sources of muscle tissue in Ayurvedic medicine, highlighting the importance of mamsa in maintaining structural integrity. In Greeva Stambh, understanding mamsa-varga informs treatment strategies focusing on strengthening and nourishing muscles.

54) Phalavarga (Phala-varga):
Phala-varga groups fruits and their therapeutic benefits in Ayurveda. While primarily a dietary aspect, recognizing phala-varga supports holistic health practices and encourages incorporating beneficial fruits that promote recovery and enhance overall wellness.

55) Raktashali (Raktasali, Rakta-shali):
Raktashali refers to specific types of rice noted for their health benefits in Ayurveda. Diet, particularly including raktashali, may contribute positively to nutritional balance during recovery from conditions like Greeva Stambh, emphasizing the importance of mindful eating.

56) Adhishthana (Adhisthana):
Adhisthana denotes the site of disease manifestation in Ayurveda. In the case of Greeva Stambh, understanding adhisthana is vital for localized treatment approaches that directly address the affected cervical region and support healing efforts.

57) Vatadosha (Vatadosa, Vata-dosha):
Vata-dosha denotes the energy governing movement and communication in Ayurveda. In Greeva Stambh, vata-dosha is often imbalanced, necessitating treatment aimed at pacifying it to alleviate symptoms and restore proper function of the cervical region.

58) Agnikarma (Agni-karma):
Agni-karma is a therapeutic procedure involving heat application to the affected area. In conditions like Greeva Stambh, agni-karma can be beneficial for alleviating pain and improving circulation, aligning with Ayurvedic principles focused on promoting healing through targeted interventions.

59) Samtarpana (Santarpana):
Santarpana refers to the nourishing and supportive practices that restore balance and health in Ayurveda. In managing Greeva Stambh, santarpana may include dietary adjustments and therapies that promote recovery and rejuvenation of the cervical spine and adjacent tissues.

60) Anubandha (Anubamdha):
Anubandha indicates associated or secondary dosha involved in a primary disease condition. In Greeva Stambh, recognizing anubandha factors like kapha can aid an Ayurvedic practitioner in adopting a multi-faceted treatment approach to achieve comprehensive healing.

61) Bileshaya (Bilesaya, Vilesaya, Vileshaya):
Bileshaya refers to a specific type of meat categorized in Ayurveda. Its inclusion in dietary considerations acknowledges the significance of balancing nutrition in treating conditions. In Greeva Stambh, understanding bileshaya helps tailor food recommendations according to patient constitution.

62) Rajamasha (Rajamasa, Raja-masha, Rajan-masha):
Rajamasha represents a category of legumes noted for their health benefits in Ayurveda. Incorporating rajamasha into the diet can align with treatment strategies for Greeva Stambh, promoting tissue repair and overall health during recovery.

63) Abhighata:
Abhighata signifies physical trauma or injury that can lead to subsequent health issues. In the context of Greeva Stambh, recognizing abhigata as a potential contributor allows for a comprehensive assessment of patients, informing treatment focused on injury recovery.

64) Avagahana:
Avagahana involves therapeutic immersion or soaking in medicated oils, uplifting circulatory function and relieving tension. This method of treatment may be applied in managing conditions like Greeva Stambh, aiding in alleviating symptoms and enhancing mobility.

65) Prajagara:
Prajagara denotes wakefulness or absence of sleep, a common symptom associated with discomfort or pain conditions like Greeva Stambh. Addressing prajagara involves restoring normal sleep patterns through treatment strategies that prioritize overall well-being.

66) Parushaka (Parusaka):
Parushaka relates to coarse or dry foods in Ayurvedic practice, which can aggravate certain dosha imbalances. In treating Greeva Stambh, avoiding parushaka can facilitate symptom relief by preventing further aggravation of Vata dosha.

67) Knowledge:
Knowledge represents a cornerstone of Ayurvedic practice, encompassing the understanding of doshas, diseases, therapeutic methods, and lifestyle choices. In treating conditions like Greeva Stambh, profound knowledge enables practitioners to deliver effective, evidence-based care and enhance patient outcomes.

68) Samvahana:
Samvahana pertains to therapeutic touch and massage in Ayurvedic healing. It aims to soothe the body and mind, making it especially relevant in the management of Greeva Stambh by alleviating stiffness and promoting relaxation in affected areas.

69) Vitiation (Vitiated):
Vitiation indicates the disturbance or imbalance of doshas that contribute to disease states. In Greeva Stambh, the vitiation of Vata is central, reflecting the need for treatments that specifically focus on restoring equilibrium within this critical energy.

70) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine originating from India, emphasizing holistic health and well-being through balanced living. Treatment strategies for disorders like Greeva Stambh utilize Ayurvedic principles, offering integrative approaches that encompass diet, lifestyle, and therapeutic practices.

71) Abhyanga (Abhyamga):
Abhyanga refers to the traditional Ayurvedic practice of oil massage. This therapy is beneficial for conditions like Greeva Stambh, as it enhances circulation, alleviates tension, and promotes relaxation, supporting overall recovery through nurturing touch.

72) Brimhana (Brmhana):
Brimhana denotes nourishing or revitalizing therapies aimed at restoring health. In the context of Greeva Stambh, brimhana practices may involve dietary changes and treatments that focus on rebuilding strength and resilience in affected tissues.

73) Nishpava (Nispava):
Nishpava signifies specific herbal formulations used in Ayurvedic treatments. These formulations may be applied in managing conditions like Greeva Stambh, needing tailored approaches to restore balance and functionality in the cervical spine effectively.

74) Madhyama:
Madhyama represents a moderate or balanced condition in Ayurveda. In dealing with Greeva Stambh, maintaining a madhyama approach allows for therapies that promote equilibrium in doshas and symptomatic relief without overwhelming the patient's system.

75) Pradhana:
Pradhana refers to the primary or dominant factor in a given context. In Greeva Stambh, identifying pradhana influences guiding treatment decisions is essential for aligning therapies with the specific needs of the patient’s condition.

[Note: The above list is limited to 75. Total glossary definitions available: 157]

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Discover the significance of concepts within the article: ‘Greeva stambh (cervical spondylosis) – a disease review’. Further sources in the context of Science might help you critically compare this page with similair documents:

Vatavyadhi, Chikitsa, Pathyapathya, Clinical feature, Nidana Parivarjana, Cervical Spondylosis, Management of disease, Middle-age group, Pathophysiological aspect, Nidan Panchak, Aetiopathogenesis, Cardinal feature, Sanshodhan Chikitsa, Symptoms of disease.

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