Ayurvedic management of Sciatica
Sciatica is not a disease but a group of symptoms including pain, numbness, tingling and weakness along the path of Sciatic nerve. It starts from low back, buttocks and radiating to foot through posterior part of thigh. It is actually a symptom of back problems and this affects only one side. Sciatic nerve is the largest and longest nerve of the body. It originates from fourth lumbar spine to third sacral spine. Irritation or compression of the nerve by different causes results in this condition. These causes are intervertebral disc prolapse, lumbar spondylosis, lumbar stenosis, spondylo listhesis, spasm of lumbar muscle and tumor. Pain in Sciatica is shooting, sharp and severe. Prevalence of Sciatica is around 5%. It is more common in youth and middle aged. Ayurvedic literature explains a condition called Gridhrasi which is similar in presentation to Sciatica.
- Pyriformis syndrome
- Spinal stenosis
- Degenerative disc disease
- Sacro iliac joint dysfunction
- Osteo porosis
- Cauda equina syndrome
- Osteo arthritis of Lumbosacral spine
Signs and symptoms
- Stabbing or pulling pain on lower back radiating to posterior thigh, calf and to the foot.
- Numbness or tingling along this area.
- Burning sensation
- Aggravation of pain on walking
- Muscular weakness.
Sciatica is described in Ayurveda as Gridhrasi. Gridhra means vulture and pain felt by the patient is similar to picking the flesh by a vulture. This nature of pain gives the name Gridhrasi. Ayurvedic concept considers three humors which control all physiological activities in the body and its equilibrium, sustain life. They are Vatha, Pitha and Kapha. Body parts where Vatha humor is prominent are Pakwashaya (lower intestine), Kati (Lumbosacral region), sakthi (legs), srothra (Ears), Asthi (Bones) , and Sparshanendriya (Skin). It is obvious that apart from ears, all other sites are related to Sciatica (Gridhrasi) disease one way or the other.
Pathogenesis of Gridhrasi or Sciatica
Ayurvedic classic, Yogaratnakara give details of its pathogenesis in detail. Vatha is vitiated by its own causes such as Kriyathiyoga (over use) of lumbo-sacral joint and food which is bitter, astringent and pungent. Vitiated Vatha affects buttock, pelvis, hip, thigh, knee, lower leg and foot leading to symptoms such as stiffness, pricking pain, numbness, catching pain and muscle twitches.
Gridhrasi: Two types
1. Vatha predominant:
Throbbing pain, pain in the knee, hip, thigh region, muscle twitches, numbness, lack of sensation and gait changes are the main symptoms.
2. Vatha Kapha predominant:
Rigidity, less appetite, lethargy and excessive salivation.
- Sodhana: Vamana and Virechana
- Vasthi: Medicated enema
- Dahakarma: Cauterization
- Samanoushadhas: Alleviating drugs
Vamana or medicated vomiting is especially useful in Vatha Kapha predominant Gridhrasi. In this procedure, during morning, patient with empty stomach is given steaming. After drinking specific quantity of herbal decoction or milk, herbal powder which induces vomiting is given. Now vomiting starts and when medicine is gone out vomiting stop itself. If it doesn’t, and physician feels that purification is achieved, then supporting measures will be taken to stop vomiting.
Virechana or medicated purgation with purgative oils or powders may be given .But since Sciatica is a Vatha predominant condition; virechana with medicated oil is generally advised.
After doing above mentioned procedures for purification, food which is easy to digest is given for two or three days or till appetite is strong. Then Vasthi or medicated enema is done. In this procedure, herbal decoction, herbal powders, honey, rock salt, medicated oil etc are mixed in a unique way and administered through anus. Vasthi procedure is the most important and useful treatment for Vatha aggravated conditions.
Abhyanga and Udvarthana
Massaging body with herbal powders (Udvarthana) or medicated oils relieves pain and stiffness of sciatica.
During the initial stage of the disease, to get rid of edema and pain in the low back lepa is useful. In this procedure, a paste is made from herbs and after making it warm it is applied over the painful part. When it is dried, it will be removed after spraying some luke warm water to soften the dried paste. Process is repeated many times.
Cauterization or dahakarma is done with hot salaka (special equipment) when other procedures fail to give results. Daha is done over the painful part.
Keeping warm medicated oil inside space provided by dough made with black gram flour kept over lumbosacral part.
Food and Lifestyle modification
- Easy to digest food
- Avoid activities requiring strain to low back
- Do yoga postures strengthening back muscles and increase flexibility.
Herbal decoctions such as Sukumaram Ks, Dhanwantharam Ks, Rasnasaptaka Ks are useful .Pills like Yogarajaguggulu, Tryaodasanga guggulu are indicated. For internal and external administration Sahacharadi thail, Dhanwantharam thaila etc are generally used.
Nirgundi (Vitex nigundo) , Gandharva hastha (Ricinus communis ), Sahachara ( Barleria prionitis ) , Rasna (Alpinia calcurata ) , Guggul( Comiphora mukul) are some of the useful herbs for sciatica .
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