Gridhrasi vis a vis Sciatica and its Ayurvedic management


The Ayurvedic treatises in the context of Vata Vyadhi explain a painful condition afflicting the lower limbs called ‘Gridhrasi’ wherein the pain along with stiffness, sensation of pins and needles, gripping and pulsations start in the spik or the buttocks [gluteal region] initially and gradually encroach the regions of the posterior aspect of kati (pelvis and lumbo sacral regions), ooru (thigh), jaanu (behind the knee), jangha (leg) and pada (foot) in that order. This occurs due to the vitiation of vata. But when kapha gets involved with vata stupor, heaviness of the body and anorexia are also associated with the above said complaints.

Gridhrasi can be compared with the ‘Sciatica’ explained in the modern texts due to a close resemblance in the manifestations of both the conditions.

Sciatica:

Sciatica is a term used to explain a set of symptoms including pain numbness tingling and weakness starting from the low back and or buttocks and radiating towards the foot through the back of the thigh, knee joint and the leg when one or more of the 5 nerve roots forming the sciatic nerve or the sciatic nerve itself is either compressed or irritated.

Sciatica is neither a disease nor a condition. It is the symptom or manifestation of some other back problem which is by rule unilateral.

Sciatic Nerve: It is the longest and largest nerve of the human body. It starts in the low back and innervates whole of the lower limb till foot. They are two in number one innervating the left lower limb and the other to the right. It is formed by the union of spinal nerves L4 L5 S1 S2 and S3; wherein L stands for Lumbar and S stands for Sacral. In its course it passes through the buttock, the posterior aspect of the thigh, leg and the foot innervating the skin and muscles therein. Its articular branches supply the hip joint as well. Its branches i.e. Tibial and Common Peroneal nerves innervate the muscles of the leg and foot.

Radiculopathy: It is a term used to describe the problem in which one or more of the spinal nerves or roots of those nerves are affected and hence do not work properly. This in turn leads to radicular pain, weakness and numbness in the limb supplied by the afflicted nerve or nerve root. When the nerve roots of the spinal nerves contributing in the formation of sciatic nerve are affected a similar radiculopathy afflicting the concerned limb occurs where in the pain is seen radiating downwards along the course of the nerve affected.

Causes:

Generally one or more of the problems of the low back become the causes of Sciatica.

They are as said below –

Common Causes:

*Intervertebral Disc Herniation or Disc Prolapse

*Pyriformis Syndrome

*Spinal Stenosis

*Degenerative Disc Disease

*Spondylolisthesis

*Sacro-Iliac Joint Dysfunction

*Pelvic injury or fracture

Other causes:

*Pregnancy

*Tumors

*Osteo Arthritis

*Rheumatoid Arthritis

*Osteo Porosis

*Fibromyalgia

*Pelvic Infections

*Reiter Syndrome

*Infectious causes of arthritis

*Cauda Equina Syndrome

Symptoms:

*Pain – The pain may vary from a mild discomfort to a severe agonizing one. It is often complained as a shooting or a burning type of pain radiating along the limb. The pain worsens on standing or sitting or even lying down. Pain increases on coughing or sneezing or laughing or when the subject has a hard bowel movement.

*Numbness

*Feeling of pins and needles or tingling sensation.

*Muscular weakness.

*Difficulty in moving the leg or foot or difficulty in controlling the leg.

Diagnosis:

*Thorough case recording and examination of the patient

*X-ray, MRI, CT scan, MR Neurography

*Chest X-ray to rule out the thoracic causes

*Abdomino-Pelvic USG to rule out any abdominal or pelvic causes

*Urine routine to rule out the renal causes

*ESR to rule out infections

When to refer a patient?

The patient should be immediately referred to the surgical or emergency department when the patient presents with one or more of the below said complaints –

*Progressive weight loss or deterioration of general health

*Night sweats and fever for long period

*Progressive weakness and numbness involving both the limbs

*Bowel and bladder incontinence

*Severe pain which is not getting well after a long period in spite of trying all sorts of

medication

*Cauda-equina syndrome

Ayurvedic management of Sciatica:

*Shodana:

Urdhwa and adho shuddhi – Vamana and Virechana are the purificatory measures which   are implemented to get rid of the morbid kapha and pitta respectively.

  • Gridhrasi is a vata vyadhi. Vamana logically need not be given in the diseases of vata origin. But Acharya Chakrapani suggests to bring about Urdhwa shuddhi by administering Vamana before giving Vasti. He further emphasizes that giving vasti which is a treatment of choice in vata vyadhis without giving vamana will be a waste exercise and will be unfruitful.
  • Virechana any how is a useful remedy in all the vata vyadhis. Snehayukta Virechana especially by regular use of eranda taila is very useful when there is no association of kapha. But when there is heaviness and stiffness of lower limb along with mild to moderate pain, the association of kapha should be suspected and rooksha virechana in the form of choorna and kashayas can be given. Eg – Trivrit choorna, Hareetaki choorna, Gandharvahastadi kashayam etc.
  • Vasti: After koshta shuddhi vasti will be highly effective in relieving the complaints of gridhrasi or sciatica.

Guggulutiktaka ghrita or Narayana taila or Sahacharadi taila can be used for

anuvasana or matra vasti.

Dashamoola kashayam or Erandamooladi kashayam as kashaya vastis have been

proved to be highly effective in gridhrasi.

*Sthanika:{Local treatments}

  • Kati vasti or Prishta vasti
  • Kati Pichu
  • Abhyanga and patra panda sweda
  • Shastika shali panda sweda
  • Upanaha and Lepa
  • Agni karma
  • Sira vedha
  • Pada Abhyangam

*Shamana Chikitsa (Palliative treatment or oral medication):

The below mentioned medicines can be effectively prescribed in Gridhrasi-

Sahacharadi kashayam tablet

Rasna saptakam kashayam

Gandharvahastadi kashayam

Trayodashanga Guggulu and Yogaraja Guggulu

Dashamoola and Dhanwantararishtam

Masha taila, Ashta katvara taila, Ksheerabala 101 and Dhanwantaram 101 tailas

*Patent products from Arya vaidya nilayam:

Lumbaton softgel capsules or/and Lumbaton tablets

Nervine tabs

Do’s when having sciatica:

  • Apply alternate cold and hot packs in the region which is painful
  • Sleep on a firm mattress without using pillow
  • Sleep in a childs position keeping a pillow in between the flexed legs or keep a pillow
  • below the knees while sleeping supine
  • Back belt may come in handy

Don’t’s when having sciatica:

  • Don’t bend down suddenly while sitting or trying to lift an object. Slowly sit down
  • flexing your knees and get up slowly by supporting your hands against the floor.
  • Don’t rush and push with your work since you have a sensitive back
  • Don’t jump and jolt. Be careful while climbing stairs.

Ayurveda effectively treats Sciatica and the associated conditions.

Believe….Trust ….and try it…..

You will feel the difference…of having a painless back and experience that the life was never moving so easily…

The above said treatments are not only for those suffering a low back ache or sciatica… It is also for those who do not want to have back and leg problems in future…

Yes Ayurveda also helps in prevention of many a health problems and make you immune to fight against them…

After all Prevention is better than cure…..Isnt it?

For details contact: Dr Raghuram Y.S,MD(ayu),

Consultant Physician

Arogya Ayurvedic Centre

12th cross,Jayanagar 7th Block/Off K.R. Road

Bangalore – 82

Landmark: Opp Upahar Sagar hotel/Behind Shastry’s Bakery

Ph: 9480071422/080-26766291

Mail us at: drraghuramys@gmail.com

drraghuram@avnarogya.in

Visit us at: www.avnarogya.in

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