Kati-Shoola (Low Back Pain, Lumbar Spondylosis) is the most common ailment which is evidenced as the leading cause of disturbance of life-activities on a daily basis globally. We can find at least one person per family who complains of Low Back Pain. It is one of the most common life-style disorders also. In modern day practice it is diagnosed as Low Back Pain (LBA), Lumbar Spondylosis or Lumbago.
Spondylosis (Degenerative osteoarthritis) is a painful condition of the back, any area of the back but when it mainly affects the lumbar or low back area it is called as Lumbar Spondylosis. It is caused due to the degeneration of the inter-vertebral discs.
Lumbago is the term used to denote the pain in the muscles and joints of the low back.
LBA affects 60-85% of people at some point of their lives. Many people have a mild to moderate (acute) low back pain. Most of them subside within 6 weeks due to administration of pain killers or due to rest and corrections in life-style. When the pain and related symptoms persist for more than 3 months it will be called as Chronic LBA. It is estimated that around 20-45% of people suffer from Chronic LBA which requires regular medical attention & frequent medicines. In spite of all these, the pain may get stubborn as time passes. Back Pain has been termed as “an illness in search of a disease” (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697338/).
Inter-Vertebral-Disc-Prolapse (IVDP) or bulge & Sciatica (Gridhrasi) are other common causes of Severe Low Back Ache.
Effectiveness of Panchakarma in the treatment of Kati-Shoola / Kati-Graha:
Ayurveda offers a complete, wholesome, effective and integrated approach in terms of dealing with Kati-Graha and Kati-Shoola with special reference to LBA and Lumbar Spondylosis.
Panchakarma procedures are the most effective form of approach while dealing with acute or chronic back pain.
While all 5 forms of Panchakarma need not be administered or rather do not fit into a treatment protocol for a given patient at a given time in a given condition of disease, Virechana (Therapeutic Purgation) and Vasti (Medicated enemas) are the treatment of choice in many conditions.
Virechana (Adho-Virechana) – Therapeutic purgation can be given as:
- Sadhyo-Virechana – Instant or stat Virechana in which the purgation or a laxative of mild to moderate strength is administered for 1 day after initial pre-procedures of Abhyanga (Medicated massage) and Swedana (Steaming or fomentation). This is ususlly preferred in mild to moderate conditions. Sadhyo Virechana is also given in selected cases just a day or couple of days before a course of Vasti
- Krama Virechana – Virechana is done in a methodical way i.e. preceded by Snehana (oleation) and Swedana (Steaming). Virechana is also followed by Samsarjana Krama (Dietetic recommendations as a post-operative procedure). Later Shamana Oushadas (oral medications as follow up) followed by Balya (strengthening) and Rasayana (Rejuvenation) medicines are advised and prescribed.
- Nitya Virechana – Daily Laxative – In some stubborn back pains we need to give a mild laxative everyday (which suits the constitution and pathological condition of the disease). This can also be adopted after Nitya Virechana as a part of follow up or maintenance or parallel with some external treatments like Abhyanga, Kati Basti
Benefits of Virechana in Kati-Shoola / Kati-Graha:
- Detoxifies the body of its toxins and unwanted wastes
- Regulates metabolism
- Corrects the imbalances of Pitta and Vata (associated Kapha too) and thus helps in controlling and halting the inflammation and degeneration taking place at various levels. Thus the pain, stiffness and other associated symptoms are taken into control
- Enhances conductivity of blood and nutrition in the joints, muscles and soft tissues
- Relaxes the body and mind, makes body lighter
- Improves health status and immunity, rejuvenate and re-boot the cells
Vasti / Basti – Medicated Enemas:
Vasti or Basti is a name given for medicated Enemas. Vasti is not just a medicine given from the anal route to flush off the contaminants and wastes from the intestines; it is a big science by itself. Ayurveda considers Vasti as Ardha-Chikitsa (half of the sum of all the treatments of the world put together). Vasti is mainly to control the Vayu (and balance the other Doshas). Disturbed Vayu/Vata is the main culprit in the causation of painful conditions which includes Kati Shoola / Kati Graha. In many conditions of Back Pain Low, a course of Vasti would be considered mandatory to fortify the effects of Virechana. In severe conditions of Low Back Pain, Virechana and Vasti courses can be skilfully planned as a combo-therapy.
VASTI can be administered as-
- Sneha Vasti – Enemas with medicated ghee / oil / both in the prescribed proportions (Anuvasana Vasti, Matra Vasti). The quantity and choice of lipids in each form of Vasti will differ from patient to patient and condition to condition.
- Kashaya Vasti or Asthapana Vasti – Enemas with medicated decoctions. Ksheera Vasti where milk is the base is preferred in some conditions of LBA where evacuation and nourishment are simultaneously needed or in those who cannot tolerate the intensity and strength of Kashaya Vasti
- Matra Vasti – Enemas with medicated lipids in a small proportion for a longer period
Skilful combination of Sneha and Kashaya Vasti is preferred in treatment of LBA
Benefits of Vasti in Kati-Shoola and Kati-Graha:
- Controls Vayu / Vata and regulates all the activities in the body and mind. It also balances the vitiation of Pitta and Kapha. Thus Vasti is an unparalleled choice in Pain relief.
- Cleanses the bowels, detoxifies the system
- Corrects the bowel-bladder functions by rectifying the vitiated Apana Vayu and hence relieves the pressure on the back
- Restores fluid imbalances and hence increase the lubrication of joints and soft tissues
- Brings flexibility to the back (and other joints of the body too) and enables free movements
- Activates, fortifies, normalises and stabilizes Metabolism
- Nourishes, strengthens and rejuvenates the Bones, Bone Marrow, Joints and Nervous system
- Helps in relieving degeneration and inflammation
- Enhances tissue integrity and cellular immunity
Vamana – Therapeutic Vomiting:
- Vamana or Therapeutic Vomiting is not generally preferred in the treatment line-up of Kati-Shoola / Kati-Graha but it is not totally excluded as well. It is a matter of choice for the physician and comes handy when the Back Pain Low is mainly due to sluggish metabolism especially at the stomach level leading to accumulation of toxins in the cells and joints.
- Vamana can be thought of when Kapha predominant symptoms are tracked down in the patient with an un-usual stiffness in the low back. In such cases skilful planning of Vamana (Sadhyo Vamana) followed by a course of Virechana will give outstanding relief.
Effect and Relief enhancing Combo’s…..
The above said options of Panchakarma therapies can be clubbed skilfully with external procedures like Abhyanga (Medicated Massage), Swedana (Fomentation), Kati-Vasti (Oil pooling over the Low Back area), Pinda Sweda (Bolus fomentation) viz Patra-Pinda Sweda, Choorna Pinda Sweda, Shashtika Shali Pinda Sweda etc, Dhara (pouring in stream of medicated liquids like ghee, milk, oil etc), Lepa (Application of medicated pastes), Upanaha (medicated poultices) etc for better and long-standing relief
Back-Pains have a bad habit of recurrence….
In many conditions of LBA multiple courses of Panchakarma procedures may be required viz a couple of courses in a year, may be for a couple of years until things get stabilized.
Any treatment is not ultimate. Servicing should be essentially be followed by Maintenance. The patients should not take the relief for granted. They should put equal effort in maintaining the relief by following a disciplined life-style, diet protocol, keeping away from stress etc.
Have you tried Ayurveda remedies and Panchakarma for Low Back Pain yet?
If not, do not delay. Take the opinion of your nearest Ayurveda Doctor for a better relief from Back Pain Low.
Recommend the same for an ailing friend, relative or a member in your closer circle….They will surely be thankful to you for doing so…..
Do take care of your back…………
Pictures courtesy (with thanks):
Dr Raghuram Y.S.
MD(Ay), Ayurvedic Rheumatology
Consultant Ayurvedic Physician
Speciality: Joint and Spine care
Bengaluru, Karnataka, India