SCIATICA - GRUDHRASI

GRUDHRASIGRUDHRASIDEFINATION:DEFINATION:

gaRQa`vat\ calato gaRQa`vat\ calato yaismana ÈÈyaismana ÈÈ

MORDERN ASPECT : SCIATICAMORDERN ASPECT : SCIATICA

The gait of the patient is like a vulture. The gait of the patient is like a vulture.

It is a disease of the sciatic nerve-the It is a disease of the sciatic nerve-the longest nerve in human body. longest nerve in human body.

ORIGIN AND ROOT VALUE OF SCIATIC NERVE

COURSE OF NERVECOURSE OF NERVE

NIDAN PANCHAKNIDAN PANCHAK

NIDAN NIDAN : CAUSATIVE FACTORS OF: CAUSATIVE FACTORS OF VATAVYADHIVATAVYADHI

++– LUMBAR DISC PROLAPSELUMBAR DISC PROLAPSE– DIFFERENT DISEASES OF SPINAL COLUMNDIFFERENT DISEASES OF SPINAL COLUMN– TUMORS OF SPINAN CORDTUMORS OF SPINAN CORD– SOME DISORDERS OF HIP JNT LIKE FIBROSITISSOME DISORDERS OF HIP JNT LIKE FIBROSITIS– SOME PARTICULAR DISORDERS OF PELVISSOME PARTICULAR DISORDERS OF PELVIS– TECHNICHAL JOBS LIKE LIFTING HEAVY WT TECHNICHAL JOBS LIKE LIFTING HEAVY WT – OCCUPATIONS OCCUPATIONS – ASSAULT ON DIFFERENT MARMASASSAULT ON DIFFERENT MARMAS– MISTAKES DURING ADMINISTRATION OF INJECTABLESMISTAKES DURING ADMINISTRATION OF INJECTABLES– DM-NEURITIS MAY DEVELOP DM-NEURITIS MAY DEVELOP

PURVAROOPPURVAROOP : : Less expressed or Less expressed or intermittent expression of intermittent expression of pain or parasthesia along pain or parasthesia along one leg and lumbar Regionone leg and lumbar Region

• SAMPRAPTI : • Snaayvaaisqat: kuyaa-d\

gaRQa`syaayaamakubjata: ÈÈ• paiYNa-p`%ya=\gaulaInaaM tu kNDra yaa|

inalaaid-ta È• sa@qna: xaopM inagaRh\NaIyaat\ gaRQa`saIit ih

saa smaRta ÈÈ sau. ina. 1/74

Dosha – Vat (vyan) – Anubandha – KaphaDushya – Asthi, Majja, Snayu, KandaraSrotas – Asthivaha, MajjavahaAdhishthan – Lumbar region & lower limbNature – AcuteRogamarga - Madhyam

NIDAN SEVAN

VITATION OF VATA

STHANSANSHRAY AT KATI – SANDHI

REDUCES KAPHA

PRODUCES DEGENERATIVE CHANGES IN TARUNASTHI

FURTHER VITIATES VATA

ASAMYAK ASTHI DHATU VYUHAN

ASTHIVRUDDHI-(OSTEOPHYTE) – COMPRESSED NERVE ROOT

AFFECTS MAMSA, SIRA, SNAYU, KANDARAOF KATI & PADA

SANKHYA SAMPRAPTI 1) VATAJ 2) VATAJ KAPHAJ ROOP : Pain starts from Lumbar Region and spreads down-

wards- from Gluteal Region to Back side of Thigh, Knee, Leg and upto the Feet

Pain along the distribution of Sciatic Nerve or its branches

Severe pain while walking, sitting for long time Restricted movements or Complete loss of

movements of Leg and Lumbar Region Parasthesia May Develop

1) Dull Ache - Ruja 2) Penetrating Pain With Needle - Toda3) Complete Loss - Stambha4) Restricted Movement - Graha

Scoliosis may develop Vatkaphaja – Drowsiness, Heavyness Of Leg,

Anorexia

PROGNOSIS: Kashtasadhya

INVESTIGATION: 1] CBC 2] ESR RADIOLOGICAL INVESTIGATION : 1] X-RAY OF LUMBER SPINE 2] MRI

EXAMINATION

1. SLR-STRAIGHT LEG RAISING

2. CONFIRMATORY: LASEGUE’S SIGN

3. FLIP TEST

4. SITTING TEST

TREATMENTTREATMENT““gaRQa`syaat- narM samyak\ gaRQa`syaat- narM samyak\

rokoNavamanaona vaa ÈrokoNavamanaona vaa È

&a<vaa inaramaM dIP%aaignaM &a<vaa inaramaM dIP%aaignaM baistiBaÁ tM ]PaacarotbaistiBaÁ tM ]Paacarot\\ ÈÈ ÈÈ

naadaO baistivaiQa: kuyaa-t\ naadaO baistivaiQa: kuyaa-t\ yaavadyaavad\\ ]Qva- na SaudQyait È ]Qva- na SaudQyait È

snaohao inarqasnaohao inarqa--k: samyak\ k: samyak\ Basmaina eva kRtM yaqaa ÈÈBasmaina eva kRtM yaqaa ÈÈ

Baa.p`.À BaO.rBaa.p`.À BaO.r

TREATMENTTREATMENT

SHODHAN SHODHAN SHAMAN SHAMAN

1]1]SHODHAN SHODHAN VATAJ VATAKAPHAJ VATAJ VATAKAPHAJ 1.Vaman- Virechan Virechan-snigdha 1.Vaman- Virechan Virechan-snigdha

vaman&virechan vaman&virechan Castor oil,Gandharva Castor oil,Gandharva haritaki,Mishrak snehaharitaki,Mishrak sneha2.Basti Anuvasan,Matra,Yapan, 2.Basti Anuvasan,Matra,Yapan,

Niruha,ErandmooladiNiruha,Erandmooladi Tiktaksheer basti Tiktaksheer basti

• 2]EXTERNAL• VATAJ VATAJKAPHAJ1. SNEHAN OIL which nourishes Sahachar,

Dashmool,• dhatu –Mahanarayan Vishagarbha,• Bala, Ashwagandha,• Mahamash,

2. Swedan Snigdha,Nadi,Upanah Tapa,ruksha swed

Erand patra pottali,

Pinda swed

3. Dahan- at gluteal region or little finger of the affected foot

4. Raktamokshan – Siravedha –blood letting with IV SET at popliteal or saphenous vein

5. Katibasti-

3]INTERNAL3]INTERNAL VATAJ VATAKAPHAJVATAJ VATAKAPHAJ1.Dravyas of attribute Madhur,Amla,Lavan 1.Dravyas of attribute Madhur,Amla,Lavan

Tikta,Katu,UshnaTikta,Katu,Ushna Ushna,Madhur vipak Katu vipak Ushna,Madhur vipak Katu vipak Guru Laghu Guru Laghu Balya which clears Balya which clears obstructionobstruction

2.Dravya - Ashwagandha,Bala 2.Dravya - Ashwagandha,Bala Dashamool,RasnaDashamool,Rasna

For Example Vidari,Amruta,Masha Deodar,HinguFor Example Vidari,Amruta,Masha Deodar,Hingu Chaturbeej,Gokshur kupilu,RasonChaturbeej,Gokshur kupilu,Rason ErandamoolErandamool 3.Guti,Vati Mahayograj guggulu Rasnadi gugullu3.Guti,Vati Mahayograj guggulu Rasnadi gugullu Trayodashang guggulu Agnitundi vati Trayodashang guggulu Agnitundi vati Amapachak vati Amapachak vati

Sinhanad,EkangaveerSinhanad,Ekangaveer Mahavatavidhwansan Mahavatavidhwansan Ras Ras

44.c.choorna Ajamodadi,Chaturbeej Alambushadi,hoorna Ajamodadi,Chaturbeej Alambushadi, Hingwashtak Vaishwanar Hingwashtak Vaishwanar 5.Bhasma Abhrak Raupya 5.Bhasma Abhrak Raupya

Mandur,Shilajeet Mandur,Shilajeet Praval Praval 6.Rasakalpa Brihat vata chintamani 6.Rasakalpa Brihat vata chintamani

Rasaraj,Rasasindur Rasaraj,Rasasindur Yogendra rasa,Tapyadi Sameerpannag Yogendra rasa,Tapyadi Sameerpannag

7.Kashaya Dashamool,Baladi Sahacharadi,7.Kashaya Dashamool,Baladi Sahacharadi, RasnapanchakRasnapanchak Rasnasaptak,Rasnasaptak, 8.Asava,Arishta Ashwangandharishta 8.Asava,Arishta Ashwangandharishta

Bhallatakasava Bhallatakasava 9.Rasayan Bala,Narsinha Rason,bhallatak 9.Rasayan Bala,Narsinha Rason,bhallatak

Erand paka Kuchala paka Erand paka Kuchala paka 10.Anupan Milk,Ghrut Honey,Ardrak 10.Anupan Milk,Ghrut Honey,Ardrak

juicejuice Koshna jal Koshana jal Koshna jal Koshana jal 11.Aushadha sevan kal - Vyankal, Apankal 11.Aushadha sevan kal - Vyankal, Apankal

Special TreatmentSpecial Treatment

• 1.ADMINISTRATION:1)Castor oil + gomutra • 2)Castor oil + ardrak juice • +matulanga juice • 3)Castor oil + gomutra + • pippali churna• 2.KASHAY :1)Shephalika parna kashaya• +pippali churna

• 2)Panchamool kashay • 3)Erandamooladi kashay• 4)Sinhasyadi kashay • 5)Ashwagandhadi kashay• 6)Sahacharadi kashay

• 3.CHURNA :1)Turangandhadi churna •

MORDERN TREATMENTMORDERN TREATMENT

• IN ACUTE PAIN • 1.Complete bed rest

• 2.Inj. Voveron (NSAID-diclofenac) 2.c.c. IM × alternate ×

• 3days • 3.Tab. Voveron 50 1tds × after food × 7

• 4.Antacid- Cap.omez 10 mg OD• 5.S.W.D for lumbar spine - 5- 10 days• 6.Tranquiliser-Tab.Alprazolam-0.25 mg bd

• 7.Inj. Neurobion 2.c.c IM

• ONCE ACUTE PAIN SUBSIDES• 1.Tab.Voveron SR – 1daily × after food • 2.Cap. Neurobion forte 10D × 1 month• 3.Tab. Ostocalcium 2 bd × 1 month (calcium preparation)• 4.Back exercises – To increase back muscle tone• 5.Maintain straight back posture,avoid bending forward,

sleep on hard mattress,gentle massage with Rubefacient ointment

• 6.Use of Lumbosacral belt to support the spine.