Approach and Management Strategies for Radicular Low Back Pain in Ayurveda: The Classical and Emerging Methods
Life Sciences-Ayurveda
DOI:
https://doi.org/10.22376/ijlpr.2024.14.2.L1-L7Keywords:
Low Back Pain, Sciatica, Gridhrasi, Katishoola, Katigraha, Marma therapyAbstract
Radicular low back pain management in Ayurveda includes oral ayurveda formulations for local applications and systemicpanchakarma procedures. Several practitioners of Ayurveda are also practicing marma therapy. The lacunae in today's knowledgeare that very less clinical trial evidence can guide ayurveda practitioners in managing this complaint. Due to a lack of documentedevidence and research, these therapies and techniques are not used in mainstream management protocols in large public settings.It makes these therapies inaccessible to the general public. This study aims to review the management methods for radicular lowback pain or sciatica from published resources and to discuss its approach. For this review study, previous published research andarticles on ayurveda and low back pain, sciatica, Ghridhrasi, Katishoola, Katigraha, and Marma therapy have been searched fromstandard databases (PubMed and Science Direct) and relevant books. After a thorough search, 12 papers on standard databaseswere reviewed for this study and incorporated to build up the concept of radicular low back pain management through ayurveda.The study concluded that Ayurveda provides a holistic approach and encompasses various pharmacological and nonpharmacologicalmethods to manage pain and associated disability. Marma therapy can become long-term, cost-effective methodsto tackle this growing problem. Thus, public settings must be equipped rigorously with ayurveda therapy units for radicular lowback pain. Larger scale randomized controlled interventional trials and research needs to be done to evaluate the effect andlimitations of ayurveda therapies (ancient and emerging) for radicular low back pain and develop standard management protocols.
References
Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth. 2007;99(4):461-73. doi: 10.1093/bja/aem238, PMID 17704089.
Merskey H, Bokduk N. Classification of chronic pain. 2nd ed. Vol. 13. IASP Press; 1994.
Frymoyer JW. Lumbar disc disease: epidemiology. Instr Course Lect. 1992;41:217-23. PMID 1534104.
Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988;318(5):291-300. doi: 10.1056/NEJM198802043180506, PMID 2961994.
Bindra S, Sinha A, Benjamin AI. Epidemiology OF low back pain IN Indian population: a review. Population: a review. 2015;5:166-79.
Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. 2007;25(2):387-405. doi: 10.1016/j.ncl.2007.01.008, PMID 17445735.
Kumar D, Putti BB, Bindhu S, Manjula S. Prevalence of mechanical low back pain in school children of adolescent group- An observational study. J Adv Res Biol Sci. 2012;4:213-8.
Damayanthie Fernando KP, Thakar AB, Shukla VD. Clinical efficacy of Eranda Muladi Yapana Basti in managing Kati Graha (Lumbar spondylosis). Ayu. 2013;34(1):36-41. doi: 10.4103/0974-8520.115444, PMID 24049403.
Kumar S, Rampp T, Kessler C, Jeitler M, Dobos GJ, Lüdtke R, et al. Effectiveness of Ayurvedic massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: a Randomized Controlled Trial [sahacharadi Taila]. J Altern Complement Med. 2017;23(2):109-15. doi: 10.1089/acm.2015.0272, PMID 27704865.
Singh AK, Singh OP. A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica. Int J Yoga. 2013;6(1):71-5. doi: 10.4103/0973-6131.105950, PMID 23439799.
Sathavane GV, Pandya DH, Baghel MS. Effect of Vatari Guggulu in managing Gridhrasi (sciatica). Ayu. 2015;36(1):41-5. doi: 10.4103/0974-8520.169019, PMID 26730137.
Vaneet Kumar J, Dudhamal TS, Gupta SK, Mahanta V. A comparative clinical study of Siravedha and Agnikarma in management of Gridhrasi (sciatica). Ayu. 2014;35(3):270-6. doi: 10.4103/0974-8520.153743, PMID 26664236.
Deshpande SV, Deshpande VS, Bhosale A, Kadam M. Conservative management of acute prolapsed inter-vertebral disc with Ayurveda: A case report. J Ayurveda Integr Med. 2022;13(2):100561. doi: 10.1016/j.jaim.2022.100561, PMID 35661935.
Hariprasad K, Prabhu N, Acharya S, Nagappa AN, Naik V. A comparative clinical evaluation of trayodashanga guggulu and mustadiyapana yoga basti in gridhrasi. Value Health. 2014;17(7):A771. doi: 10.1016/j.jval.2014.08.319, PMID 27202843.
Kumar T, Sanapeti RV, Prasad BS. Evaluation of the effect of poultice (Upanaha Sweda) in low back pain (Katigraha): A randomized comparative clinical trial. Ayu. 2019;40(3):159-63. doi: 10.4103/ayu.AYU_71_18, PMID 33281392.
Mishra V, Shindhe PS, Killedar RS. Protocol based pain management by Ayurveda parasurgical procedures W.S.R to musculoskeletal pain and its critical appraisal – an open labeled clinical trial. J Ayurveda Integr Med. 2022;13(4):100665. doi: 10.1016/j.jaim.2022.100665, PMID 36436295.
Somasundaran A, Sasikumar VK. Reduction in score on Oswestry disability index in intra vertebral disc prolapse after an ayurvedic intervention – A case study. J Ayurveda Integr Med. 2018;9(2);Suppl 29. doi: 10.1016/j.jaim.2018.02.128.
Fox M, Dickens A, Greaves C, Dixon M, James M. Marma therapy for stroke rehabilitation -- a pilot study. J Rehabil Med. 2006;38(4):268-71. doi: 10.1080/16501970600630820, PMID 16801211.
Gautam AS, Verma P, Kumar Pathak A. Blood pressure normalizing effect of Talahridaya Marma therapy: A case report. J Ayurveda Integr Med. 2021;12(3):553-5. doi: 10.1016/j.jaim.2021.05.014, PMID 34275703.
Verma P, Kanaujia S, Pathak AK. Low back pain: the riveting history with unexplored ancient Indian knowledge; 2022. p. 256-64.
Aggarwal V, Jain A, Gupta A. A critical analysis on the ayurvedic aspect of katigraha (low back pain): a review. Int J Res Ayurveda Pharm. 2020;11(2):109-12. doi: 10.7897/2277-4343.110241.
Dr. Chavan SG. A critical review of Katishoola in Ayurvedic science. J Ayurveda Integr Sci. 2019Aug.31 [cited 2023Oct.7];4(04):251-7.
Pn J, Tekur DP. Vp N, sciatica VM. Gridhrasi - An Ayurveda. J Ayurveda Integr Sci. 2017;2.
Shastri KN, Chaturvedi G. Charaka Samhita of Agnivesha part I, Revised by Charaka and Dridhabala with Elaborated Hindi Vidyotini Commentary. eds-Shastri R, Upadhayaya Y, Pandey G, Gupta B, Mishra B, SutraSthana (13/52), Varanasi: Chaukhamba Bharti Academy; 2011. p. 269.
Shastri KN, Chaturvedi G. Charaka Samhita of Agnivesha part I, Revised by Charaka and Dridhabala with Elaborated Hindi Vidyotini Commentary. eds-Shastri R, Upadhayaya Y, Pandey G, Gupta B, Mishra B, SutraSthana (14/22), Varanasi: Chaukhamba Bharti Academy; 2011. p. 286.
Shastri KN, Chaturvedi G. Charaka Samhita of Agnivesha part II, Revised by Charaka and Dridhabala with Elaborated Hindi Vidyotini Commentary. eds-Shastri R, Upadhayaya Y, Pandey G, Gupta B, Mishra B, ChikitsaSthana (28/100-101), Varanasi: Chaukhamba Bharti Academy; 2011. p. 795.
Shastri KN, Chaturvedi G. Charaka Samhita of Agnivesha part II, Revised by Charaka and Dridhabala with Elaborated Hindi Vidyotini Commentary. eds-Shastri R, Upadhayaya Y, Pandey G, Gupta B, Mishra B, ChikitsaSthana (28/76-77), Varanasi: Chaukhamba Bharti Academy; 2011. p. 791.
Shastri AD; chapter 4. sloke 7. In: Ayurved-tatwa-sandipika commentary on Susruta Samhita part 1- ChikitsaSthan, Chaukhamba Sanskrit Sansthan, Varanasi. p. 34.
Shastri AD; chapter 8, sloke 16. Ayurved-tatwa-sandipika commentary on Susruta Samhita part 1- SharirSthan, Chaukhamba Sanskrit Sansthan, Varanasi. p. 88.
Lohith BA, Girish KJ. Clinical study to assess the effect of Yoga bastiin Gridhrasi. Int J Res Ayur Pharm. 2013;4(1):50-3. doi: 10.7897/2277-4343.04123.
Pathak AK, Verma P, Pandey A, Awasthi HH. Marma science. An Ancient Concept As Depicted In Ancient Ayurveda Literatures Of Charaka And Sushruta ISSN. 2021;10:1932-50.
Kumar JS. Marma science and principles of Marma therapy. New Delhi: Vani Publications; 2019, page-55.
Indrabasti K, Marma G. Therapy for Back and Leg pain; n.d. Pure Herbal Ayurved Clinic [cited Oct 7, 2023]. Available from: https://www.pureherbalayurved.com.au/kshipra-indrabasti-and-gulpha-marma-therapy-for-back-and-leg-pain.htm.
Published
How to Cite
Issue
Section
Copyright (c) 2024 Piyush Verma, Shiwangi Kanaujia, Sakshi Surve, Ashutosh Kumar Pathak

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

