Suffering From Sciatica Pain?: Solution in Ayurveda

Gridhrasi or sciatica is a severely painful situation in which pain radiates to the lower legs (one side or both). It may start from the lower back to downward or from down to the upper lower back. The course generally occupies from origin to supply or distribution area of the sciatica nerve due to its compressive or irritative factor.   In Ayurveda pain is explained with terms Toda, Spandana, Graha, Stambha, and Vedana from Kati-Pradesh to Padanguli (foot). Gridhra term stands for vulture that pierces its beak withdraw it forcibly and result in a severe jerk like action similarly action occurs with the nerve so named as Gridhrasi in Ayurveda or another possible reason is gait appearance like vulture due to tilting of body towards affected part

Causative factor/Nidana –

Aharaja/ Dietary:

• Ruksha/dryness Guna by its Shoshana/dry up property is reducing the lubricative property in the body which manifest as stiffness in Kandra/tendons and joints of legs.
• Excessive intake of Sheeta/Cold Ahara leads to Stambhan in Srotas, Snayu, Kandara etc.  which result in restricted movements of joints in lower extremities. 
• Intake Laghu/light Guna is does Lekhana karma leads to Osteoporosis in bony tissues.
•  Excessive ingestion of Katu, Tikta and Kashaya rasa provokes Vata dosha. Atialpa, Atilaghu Ahara and Abhojana can leads to loss of Bala, varna, upachaya, Oja etc. It causes harm to Sharir, mana, buddhi, indriya and affects the sara of all dhatus.

Viharaja:

• Atijagarana/ night awakening
• Diwaswapa/ day
• Ativayavaya/ excessive indulgence in sexual activity
• Excessive walking, swimming, exercise etc.
• Atyasana/ excessive food intake.
•  Suppression of natural urges
• Riding or fall off from fast moving object

Manasika/mental cause:

• Excessive stress
• Over anxiety
• Excessive depression
• unstable mentality or desires.

Kala: Often seasonal variation may also act as a causative factor.

Lakshana/Symptoms:

• Pain starts at sphika and then radiates to kati, prishtha, uru, janu, jangha and pada in order.
• Toda/ pricking pain
• Stambha / feeling of tightness in legs- restricted join movements
• Spandana/Pulsating, trembling sensation
• Sakthikshepa Nigraha/ restricted movement of the joints affected limb
• Kati-Uru Jaanu Madhye Bahuvedana
• Tandra (drowsiness)
• Gaurav (Heaviness)
• Aruchi, (Anorexia)
• Mukhapraseka
• Dehasyapravakrata, (Gaitdisturbance)

Types of Gridhrasi:

Based on sign and symptoms it is majorly of two types Gridhrasi:

• Vataja- Dehasyapravakrata (gait disturbance) and Suptata(numbness)
• VataKaphaja Gridhrasi: Tandra, Gaurav, Arochaka, Mukhapraseka and Bhaktadwesha.

UPASHAYA – ANUPSHAYA:

Upashaya is the suitable use of drug, diet, and behavior, which are contrary to etiology or disease or produce effects contrary to them, while Anupshaya aggravates the disease. Satmya, Pathya, Upshaya has the same meaning.

Ayurveda Samprapti Ghataks/ elements of pathogenesis

SADHYA-ASADHYATA/ Prognosis: Generally, as per Ayurved its prognosis is similar to Vata Vyadhies, very difficult to cure. However, it also depends on many factors like Bala of Nidana & Rogi Bala, the strength of dosha Prokopa, the sthana of the disease, severity of signs and symptoms, duration of the disease, Rogamarga, Dhatudushti, etc.

CHIKITSATreatment

• Principle of treatment/ Chikitsa Siddhanta–The first and the foremost principle to be adopted in the treatment of each and every disease is Nidana Parivarjana (to avoid the nidana of the disease).
• Vishishta Chikitsa for Gridhrasi:-The effective and specific treatment of Gridhrasi cannot be single-lined as it is a multifactorial disease, as the pathology involves multiple varying factors. Vitiated Vata and association of Kapha dosha stemming out from the pakwashaya, afflicting the asthi dhatu vitiating snayu and Kandara affecting in the asthi produces the illness. Therefore, the procedures mainly aimed at the rectification of the imbalances of Vata dosha as well as Kapha dosha if associated forms the sheet anchor of treatment of Gridhrasi.
• Treatment therapies-

1. Snehana: Snehana or oleation therapy- Used externally (abhyanga, avagaha,parisheka etc.and internally both.
2. Swedana:  In forms of swedana procedures, avagaha sweda, pizhiccil, nadisweda, patrapinda sweda, pinda sweda and upanaha sweda may be used which reduces the stiffness.
3. Vamana: Medicine-induced vomiting to cure the internals of the body to break the chain of pathogenesis.  
4. Virechana:  Sneha Virechana of Mridu nature is another Medicine induced purgation therapy to cure the internals of bidy to break the chain of patghogenesis.  helps in controlling Shula in Gridhrasi.
5. Basti: Best treatment modality of Vyana vata induced disorder is Basti Chikitsa.
   1. Niruha Basti: Best choice for Niruha basti is Erandamuladi Niruha and Dashamuladi
   2. Anuvasana basti: Use of vatahara tailas like bala taila, mulaka taila, ksheerabala taila, prasarani taila  are considerd as Anuvasana basti
6. Raktamokshana: – Siravyedha:  Siravyedha four angula above and four angula below at the site of knee joint.
7. Agnikarma: Agnikarma at  Antara Kandara Gulpha or  Pada kanisthika anguli (little toe of the affected leg).
8. Shamana Chikitsa/ conservative treatment : Following Chikitsa can be included under shamana chikitsa–
   1. Vedanashamaka chikitsa – To pacify the severity of pain.
   2. Vatahara chikitsa – Elimination of vitiated Vata Dosha.
   3. Kaphahara chikitsa – Pacification of vitiated Kapha Dosha.
   4. Deepana & pachana chikitsa – To balance the Agni

Shamana aushadhi (Conservative medicine  ) used in Gridhrasi:

PATHYA-APATHYA: