Sciatica (Gridhrasi)

Background

Sciatica refers to pain, numbness and tingling of lower limb resulting from injury or compression of sciatic nerve. The pain of sciatic nerve originates from lower back and radiates towards buttocks, back of thighs, below the knee up to the foot. The pain is usually get worse on prolonged sitting, standing and walking and relieved by lying down. The sciatica mostly affects the early and middle aged peoples, heavy weight lifters and persons who are engaged in the occupations in which continuous pressure on back is used. The common causes of sciatica are herniated disc, spinal stenosis, spondylolisthesis, piriformis syndrome, osteoarthritis, osteoporosis and sometimes during pregnancy. As the sciatica is considered as a manifestation of underlying diseases, the line of treatment is to treat underlying cause which irritate/ compress the sciatic nerve. Besides this, bed rest, physiotherapy, analgesics and muscle relaxants are being used. Sometimes surgical intervention may be required.

In Ayurveda, Gridhrasi (Sciatica) is considered as one of the important Vata Vyadhi (neurological disorders). The disease is characterized by stiffness, pain and pricking sensation initially at the hip and gradually radiating towards waist, back, thigh, knee and calf region along with frequent pulsation at these sites. Two types of Gridhrasi have been described viz. Vataja and Vatajakaphja. In both the main vitiated dosha is Vata.

Intervention/ Approaches

The following are some interventions/ approaches based on CCRAS research from published sources.

In case of tenderness of sciatic nerve and stiffness:

Nirgundi Ghrita -1o ml with 60ml Nirgundi (Vitex negundo) Kashaya once in a day (at 6. am for 45 days).

Suddha Guggulu (Commiphora wightii) - lgm with 60ml Nirgundi Kashaya twice a day (at 12.00 pm and 6.00 pm) for 45 days.

Abhyanga - Nirgundi taila for 45 days.

In case of early stage of sciatica where pain is radiating to back of the leg up to toe:

• Hingutriguna Taila -10 ml to 15 ml thrice a day for 21 days.
• Dashamula Bala Kwatha - 20ml thrice a day for 21 days.
• Swedana - Nirgundi Patra Pinda Sweda twice a day for 21 days.

In case of severe pain with disturbed gait due to pain and difficulty in move the leg or foot:

• Trayodashanga Guggulu - 2gm thrice a day with warm water for 2 days.
• Vishatinduka Vati - 25Omg thrice a day with warm water for 21 days.
• Abhyanga - Nirgundi Taila.
• Swedana-Patra Pinda Sweda for 21 days.

In case of severe pain, tingling sensation & numbness, stiffness and muscles weakness:

Snehapana - Nirgundi Ghrita from 1st to 7th day.
Swedana -Vashpa Sweda from 8th to 10th day.
Virechana - On 11th day.
Samsaijana - Light diet from 12th to 13th day.
Shamana treatment-

• 10ml Nirgundi ghrita with 60ml Nirgundi Kashaya once a day (at 6 am) from 14th to 184day.
• 1 gm Shuddha Guggulu with 60ml Nirgundi Kashaya twice a day (at 12.00 pm and 6.00 pm) from 14th to 18\lay.

Abhyanga- Nirgundi Taila from 14th to 18th day.
Yoga Basti - 5 Anuvasana and 3 Niruha vasti

• Anuvasna vasti- Nirgundi Taila on 19th, 20th, 22nd, 24th and 26th day.
• Niruha vasti-Nirgundi Kashaya on 21st, 23rd and 25th day.

Shamana treatment - same as for 14th to 18th day from 27th to 45th day.

In cases of excruciating pain with discomfort in walking:

• Abhyanga- Mahavishagarbha Taila for 15-20 minutes.
  
  • Swedana- Nadi Sweda with RasnaSaptaka Kwatha for 20 minutes.
  • Siravedha- It should be stopped when total amount of blood letting becomes about 50-100ml.
• Abhyanga- Mahavishagarbha Taila for 15 days.
  
  • Swedana - Nadi Sweda with Rasna Saptaka Kwatha for 15 days.
  • Shuddha Kupilu Beeja Chuma (Strychnos nuxvomica) - 50mg twice a day for 15 days.
  • Yograj Guggulu - 2 tablets thrice a day for 15 days.

Medicinal Plants useful in Sciatica (Gridhrasi)

Source : Central Council for Research in Ayurvedic Sciences