E-ISSN:2456-3110

Review Article

Back pain

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 1 January
Publisherwww.maharshicharaka.in

A review article on Katrigraha vis-à-vis Mechanical low back pain and its management through Ayurveda

Shivashimpar P1*, Chavan SG2
DOI:10.21760/jaims.9.1.18

1* Pooja Shivashimpar, Post Graduate Scholar, Department of Kayachikitsa, Ayurveda Mahavidyalaya Hospital, Hubbali, Karnataka, India.

2 S G Chavan, Professor HOD, Department of Kayachikitsa, Ayurveda Mahavidyalaya Hospital, Hubbali, Karnataka, India.

In the present society, all age group people experience back pain, which is brought on by an unhealthy food and way of life. In Ayurveda, this ailment is compared to Katigraha, one of the Vataja Nanatmaja Vyadhi. It is a condition where pain and stiffness are brought on by Shuddha Vata or Sama Vata, which are concentrated in Kati Pradesha. Modern science says that actions like lifting heavy objects, bending, having poor posture, being sedentary, etc. cause Mechanical low back pain. It is usually limited to the lumbosacral region, buttock, or thigh and doesn't go past the knees. Modern medical treatments for low back pain have their own disadvantages and weren't effective over the long term. The Ayurvedic Chikitsa Sutra of Katigraha includes a description of Snehana, Swedana, Shamana, and Conventional Rasayana in addition to a healthy food and way of life. The breadth of Ayurvedic treatment for Katigraha shall be the main topic of the current paper.

Keywords: Katigraha, Shuddha Vata, Sama Vata, Mechanical low back pain

Corresponding Author How to Cite this Article To Browse
Pooja Shivashimpar, Post Graduate Scholar, Department of Kayachikitsa, Ayurveda Mahavidyalaya Hospital, Hubbali, Karnataka, India.
Email: 		Shivashimpar P, Chavan SG, A review article on Katrigraha vis-à-vis Mechanical low back pain and its management through Ayurveda. J Ayu Int Med Sci. 2024;9(1):132-136.
Available From
https://jaims.in/jaims/article/view/3024

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-11-16 2023-11-21 2023-11-25 2023-11-30 2023-12-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 21.98%

© 2024by Shivashimpar P, Chavan SGand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Shivashimpar P et al. A review article on Katrigraha vis-à-vis Mechanical low back pain

Introduction

Due to heavy industrialization and development advanced software technology the mankind running behind fast and furious life. Due to that every person indulging in improper sitting postures, Continuous long journeys, overexertion, jerky movements during travelling and sports, weight lifting, sitting for a prolonged time and other strainful activities etc, create an undue pressure to the spinal column and play an important role in producing low backache even in early decades of life. About 70%-90% of the population above 40 yrs of age suffers from this disease.[1] In

Ayurvedic Samhitas Katigraha has been mentioned as a very common problem, characterized by pain and restricted movements of Kati Pradesh (Lumbar region).

Nirukti

The term Katigraha is combination of 2 terms i.e., Kati and Graha. The etimology, definition & specific interpretation of these terms are given below.

Kati

The word ‘Kati’ is derived from the dhatu “kat + in” and Streelinga Pratyaya. It is considered as a ‘Shariraavayavavishesha’, a bodily part.[2]

According to Amarakosha, the word meaning of Kati is “Katau Vastra Varanau”, the part of the body which is covered with clothes[3] and Shroni, Kakundati are considered as synonyms of Kati. According to Monier Williams, Kati is the hollow space above the hip or the joints.[4]

Graha

The term ‘Graha’ is derived from the dhatus ‘Adant-Churam-Atmam-Saka-Set’. The term is explained as ‘Graho Grahanam’, by Durgadas, which means to collect or catch.[5]

“Graha” means holding. It is originated from Dhatu “Graha Upadane” - one which gives support.

Paribhasha

Katigraha is the condition where pain and stiffness in lumbar spine due to Kevala Vata or Sama Vata.[6] Sharangadhara has explained it as “Katisthambhena Vedanavishesha”, condition said as pain and stiffness in Katipradesha.[7]

Nidana

Mechanical low back pain can occur suddenly or gradually over time as a result of repetitive actions. The main causes of low back pain in today's lifestyle include stress, poor food, lack of exercise, and extended periods of sitting. For Katigraha, according to Ayurveda, Samanya Vatavyadhi Nidana includes eating dry, cold, inadequate, and light food; having too much sex and not getting enough sleep; receiving improper treatment; and engaging in excessive fasting, swimming, walking, exercising, and physical activity. It also includes worrying, grieving, and debilitating diseases; using uncomfortable beds or seats; getting angry; suppressing natural urges; experiencing trauma; not eating; indigestion and so on.

Poorvaroopa

Acharya Charaka has mentioned that Avyakta Lakshana is the Poorvaroopa of the Vatavyadhi.[8] Chakrapanidatta commenting on the word Avyakta mentions that few mild symptoms are to be considered as the Poorvaroopa.

Roopa

Katigraha being one among the Vatavyadhi mainly characterized by Shula and Stambha at Katipradesha, which is self-explanatory by its term Katigraha. This condition is such that it ceases the lumbar spine movements like flexion, extension, rotation and bi-lateral movements thus hampering the day-to-day activities.

Samprapti

Though separate Samprapti is not been described for Katigraha, the pathophysiology of Katigraha is mostly influenced by Vata and Kapha. Dhaatukshaya and Margavarodhajanya are the two types of Samprapti that, in the opinion of Acharya Charaka, might vitiate Vata. There will be a qualitative change in the joint in both types of Katigraha, which over time causes the disease to appear.

  • Dhatukshayajanya Katigraha

Continuously consuming foods that are Ruksha (dry), Sheet (cold), Laghu (light) in nature, Ratrijagarana (waking at night), and Vegadharana (holding urges) are all causes that result in the body developing Dhatu Kshaya and Vata Prakopa. Sandhi Bandhana Shithilata


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is caused by the diminution of Kapha in Sandhis caused by Rukshaguna of Vata, which also reduces the Snehansh of Kapha Dosha. The Kahavaigunyayukta Sandhi in Katipradesha is the location of the Prakopita Vata Stanasamshraya. All of them cause stiffness and pain in the Katipradesha, which in turn causes the illness Katigraha.

  • Margavarodhajanya Katigraha

Depends on Agnibala, one should consume food in the appropriate quantity. A person should only eat when the previous meal has been completely digested. If one eats while experiencing indigestion, the newly consumed food will contaminate all subsequent meals. Consuming too much Guru, Shita, Vishtambhi, Shushka, Vidahi, Ruksha, Pichhilha Guna Ahara, and leading a sedentary lifestyle contribute to the body's creation of Ama, which results in Dosha Prakopa, Agni disturbance, and a lack of Rasa Dhatu metabolism. There is Srotavarodha in the Adhishtana because Jatharagni and Dhatwagni are both deranged. Due to such Srotavarodha, Vata gets vitiated and produces symptoms like, Ruk (pain) and Stambha (stiffness) in Khavaigunyayukta Sandhi i.e., Kati Pradesha.

Samprapti Ghataka

Table 1: Showing Samprapti Ghataka of Katigraha

DoshaVataVyana, Samana, Apana
KaphaSheshaka
DhatuDhatuMamsa, Meda, Asthi
UpadhatuKhandara, Snayu
AgniJatharagni, Dhatvagni
AmaJataragni, Dhatvagnijanya
SrotasAsthivaha Mamsavaha
SrotodushtiSanga
UdbhavasthanaPakwashaya
VyaktasthanaKati
RogamargaMadhyama

Sadyasadyata

Katigraha is a Vatavyadhi, when associated with Kapha becomes little more easier to cure than in KevalaVataja condition but when patient comes earlier for treatment and if given proper treatment in appropriate manner then patient may likely to be cured and less likely to be suffer from further complications. Katigraha is Vata Nanatmaja Vyadhi affecting the Ashrayasthana of Vata, where the disease is of Madyama Roga Marga thus even at the initial stage it is Kricchra Sadhya and at later stage it may be Yapya or Asadhya

Upashaya - Anupashaya

Upashaya

Upashaya is much important; especially during the treatment usually all drugs, diet and regimen which give long lasting relief in Katigraha may be taken as Upashaya, having Snigdha & Ushna Gunas are prescribed to pacify the Vata Kopa. For example, Abhyanga, Swedana, Ushnaahara, Ushnaritu etc. This should be adopted in the Niramaavastha of Vatavyadhi (Katigraha) only. When the same drugs are prescribed in the Saamaavastha of Vatavyadhi the disease aggravates.

Anupashaya

All the drugs, diet and regimen which exaggerate the disease are taken for Anupashaya for Katigraha. Vatavyadhi Nidanas can also be taken as Anupashaya. During Samaavastha, even Upashaya method applied can also be included under Anupashaya. The diet having Laghu, Ruksha, Sheetagunas, Anashana, Alpashana, Sheetarithu can be considered as Anupashaya.

Chikitsa

1. Nidana Parivarjana

2. Samshodhana

3. Shamana.

  • Nidana Parivarjana

The first foremost treatment in all disease is Nidana Parivarjana.

  • Samshodhana - As Katigraha is dominant of Vata Dosha and also included under Vata Vyadhi, Mridu Samshodana is ideal one as per Vatasyopakrama.

Snehana:

Except for the criteria of Ama, Avrita Vata, Ajeerna, Aruchi, etc., Snehapana might be adopted in Katigraha. Langhana and Pachana are the first line of treatment before Snehapana to facilitate the Niraamaavasta in cases with accompanied Ama or Kapha Dosha. After achieving Niraamaavasta, Ghrita Paana and Taila Paana can both be successfully adopted based on the circumstances. Snehadhara, Abhyanga, Avagaha, Parisheka, Kati Basti, etc. are all examples of ways to practise Bahya Snehana.


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Swedana:

A Sweda Sadhya Vyadhi, Katigraha. Avagaha Sweda, Valuka Sweda, Nadi Sweda, Patra Pinda Sweda, Pinda Sweda, and Upanaha Sweda are some of the different Sweda methods that can be successfully carried out in Katigraha. Swedana is also helpful for easing pain and restricting movement in Kati Pradesha. It can be done in entire body or in affected part of the body alone.

Virechana:

Virechana plays a crucial part in Katigraha. Virechana's effects are not confined to a single spot; they extend throughout the entire body. Most authors in Vatavyadhi referred to Mridu Virechana. According to Vriddha Vagbhata, Virechana must be used to treat Vata ailments that are not relieved by Snehana and Swedana. For Nitya Virechana, Eranda Taila is advised.

Basti:

In Pakwashayagata Vyadhi, Basti is mentioned. Here, Basti is useful in reducing Vata, hence it is referred to as "Ardha Chikitsa" in Chikitsa. Taking all of these factors into account, Basti is a crucial step for Kati Graha, one of the Vata Vyadhis. It is possible to employ Vatakaphaja Vyadhi Niruha Basti such as Erandamooladi Niruha and Dashamooladi Niruha Basti.

  • Shamana

The Vatahara Shaman Aushadhi can be used in the treatment of Katigraha. If Sama Avastha of Katigraha is present, Deepan, Pachan, Rookshana Chikitsa will be helpful. Various Yogas have been described.

  • Churna - Rasnadi Churna, Ajamodadi Churna, Vaishwanara Churna.
  • Kalka/Lepa - Mahanimbakalka, Rasonakalka, Lepa -Vaataharapradesha.
  • Kashaya and Arishta - Rasnasaptakakashaya, Erandadikashaya, Dashamolakashaya, Sahacharadi Kashaya, Balarishta, Dashamularishta.
  • Grita and Taila - Eranda Taila, Vishagarba Taila, Prasarini Taila, Mashabaladi Taila, Narayana Taila, Vishnutaila
  • Guggulu - Trayodashanga Guggulu, Yogaraj Guggulu, Mahayogaraj Guggulu

Pathya-Apathya

Pathya - Godhuma, Raktashali, Shighru, Lashuna, Ghrita, Amla Dravya, Patola.

Apathya - Katu, Tikta, Kashaya Rasa Dravya, Jambu, Bhaya, Shrama, Yana, Sheeta Ahara etc.

Discussion

Katigraha is not mentioned in Brihatrayi, although Katigraha is one of the biggest health concerns these days, affecting around 60-85% of individuals at some time in their lives and interfering with their daily routine. The classics make it abundantly obvious that pain is caused by stiffness brought on by Sama or Niramavayu movement in the Kati (low back) area. Symptoms like Vedana and Cheshtastambha were aroused in Kati Pradesha (the lumbo-sacral region) as a result of Vata and Kapha Prakopa in Katigraha. It falls under the category of Vata Nanatmaja Vikara, however depending on the symptoms, it can also be categorised as Vataja and Vatakaphaja Katigraha

Sheetaguna of Vata and Kapha, as well as Stambaguna of Kapha, cause Lakshana like Shula and Sthambha. Ruja and Sthambha are the basic Lakshana in Katigraha that are manifested by the Gunatah and Karmatah Vaishamya of Vata and Kaphadosha. When it comes to the Chikitsa, first determine whether Kapha or Ama is involved. Langhana, Pachana, Swedana, Rukshana and Vatanashaka measures are the first line of treatment if Ama is implicated in the pathophysiology. Snehana, Swedana, Brumhana, Mruduvirechana and Basti are beneficial in Kevala Vataja type of Katigraha.

Conclusion

When doing a clinical examination, it is important to keep in mind that Katigraha can happen on its own or as a side effect of various disorders. According to the stage, such as Svatantra or Paratantra, Naveena or Purana, Saama or Niraama, the management differs. Katigraha can be successfully treated by using Panchakarma, Shamana, and adhering to a healthy diet and lifestyle.

References

1. Bailey H, Love MN. Chapter 41, Page no: 568.


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