E-ISSN:2456-3110

Case Report

Gridhasi w.s.r.

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 1 January
Publisherwww.maharshicharaka.in

A case study on Gridhasi w.s.r. to Sciatica

Minakshee C1*, Umesh T2, Kamini S3
DOI:10.21760/jaims.9.1.46

1* Chouhan Minakshee, Post Graduate, Department of Panchakarma, Pt Khushilal Sharma Govt Auto Ayurveda College Institute, Bhopal, Madhya Pradesh, India.

2 Tamrakar Umesh, Post Graduate Scholar, Department of Panchakarma, Pt Khushilal Sharma Govt Auto Ayurveda College Institute, Bhopal, Madhya Pradesh, India.

3 Soni Kamini, Reader, Department of Panchakarma, Pt Khushilal Sharma Govt Auto Ayurveda College Institute, Bhopal, Madhya Pradesh, India.

Gridhasi is one of the most common disease of Vata Vyadhi, which closely related with sciatica. This is characterised by low back pain and radiates towards posterior part of leg or discomfort associated with sciatic nerve. It has painful (Shoola Pradhan) condition which hampers the routine of life. In Gridhasi pain starts form Kati-Prushta (Pelvic & Lumbo-Sacral resion) radiating towards Jangha (Thigh), Pada (Legs) with impairment of lifting leg (Stiffness). The prevalence of sciatica varies considerably ranging from 3.8% in the working population to 7.9% in nonworking population. Contemporary medicine has limitations giving short term relief in pain or surgical intervention with side effect. The aim of this study was to access the effect of Ayurvedic management through Shodhan and Shaman Chikitsa. Here in this case study a 60 year female patient was suffering from sciatic pain (Low back Pain) radiating towards posterior part of leg due to herniation of L4-L5 and L5-S1 that is correlated with Gridhasi since 6 months approached to Ayurvedic Hospital and She was treated with Panchakarma treatment including Dashmooladi Niruha Basti, Merudand Basti, Patra Pinda Sweda and Raktmokshan along with Shaman Chikitsa. The treatment was continued for consecutive two months.

Keywords: Gridhasi, Sciatica, Vata Roga, Niruha Basti.

Corresponding Author How to Cite this Article To Browse
Chouhan Minakshee, Post Graduate, Department of Panchakarma, Pt Khushilal Sharma Govt Auto Ayurveda College Institute, Bhopal, Madhya Pradesh, India.
Email: 		Minakshee C, Umesh T, Kamini S, A case study on Gridhasi w.s.r. to Sciatica. J Ayu Int Med Sci. 2024;9(1):293-297.
Available From
https://jaims.in/jaims/article/view/3042

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-11-06 2023-11-17 2023-11-27 2023-12-07 2023-12-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared. NIL YES 12.76 NONE

© 2024by Minakshee C, Umesh T, Kamini Sand 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].

J Ayu Int Med Sci 2024;9(1)293
Umesh Tamrakar et al. A case study on Gridhasi w.s.r. to Sciatica

Introduction

In Ayurveda Sciatica is considered as Gridhasi which included under 80 type of Vataj Nanatmaja Vikara.[1] In this disease the gait of patient is typical patients leg become tense and slightly curved due to pain resembling walk to like vulture (Giddha).

Gridhasi is divided by into two types based on Dosha involvement in it. One is Kewal Vataja and other is Vata-Kaphaja. The sign and symptom of Kewal Vataja is Ruk (Pain) with Toda (Pricking sensation), Stambh (Stiffness) and repeated twitching in the Sphik, Kati, Uru, Janu, Jangha and Pada in order.

Sakthi Utkshepeni Graha (restriction in upword lifting of lower limb). In Vata-Kaphaja Gridhasi there is Tandra (Drowsiness), Gourava (Feeling of heaviness) and Aruchi (Anorexia) is present.

[2] Sciatica refer to pain that radiates along the course of sciatic nerve, which is associated with tingling numbness, pricking sensation and stiffness. According to Ayurveda Gridhasi is mentioned as Kricchrasadhya Vyadhi which is very difficult to cure.

The prevalence of sciatica varies considerably ranging from 3.8% in the working population to 7.9% in nonworking population. It is most prevalent in people during their 40s and 50s and men are more commonly affected than women.[3]

Low back pain has been reckoned as fifth most common cause for hospitalization and the third most repeated reason for a surgical procedure.[4]

The management provided by the immediate medicine for this condition is either conservative or surgical in nature. By taking that type of treatment more prevalence rate of Gridhasi and to overcome the above expensive therapeutics, so there is appreciable need to find out effective management of Gridhasi.

Case Report

A 60 years old female lady comes to OPD of Panchakarma Department of Pt. Khushilal Sharma Govt. Auto.

Ayurvedic Institute and Hospital, Bhopal. Patient was house wife by occupation. The Patients was apparently healthy before six month than she started following complaints.

Chief Complaints

On Vam Pada

1. Ruk (Pain)
2. Toda (Pricking sensation)
3. Stambh (Stiffness)
4. Sanchar Vedana (Radiating pain) in order Sphik, Uru, Kati, Janu, Pada
5. Chankraman and Aasan Kashtata (Pain while walk-in and sitting starts before 6 months.

History of Case Study

Patient had taken alternative treatment before came to our hospital as per need for her pain and she was not satisfied by it by having repeat episodes. Patient did not have history of any other illness.

Past History
History of Hypertention and Diabetes.
No any specific surgical History.

Family History
No any major illness.

On Examination

General Condition -
Moderate, Afebrile, and No pallor was present.

Ashtavidha Pariksha[5]

Nadi - 76 /mins    
Mutra - Samyak
Mala - Samyak  
Jivha - Sama   
Shabda - Spashtha   
Sparsha - Samshitoshna
Druka - Spashta
Akruti - Madhyam
Prakarti - Vata Kaphaja
Weight - 60 kg
Blood Pressure - 130/80
Temperature - 98.6°F

Systemic Examination

Inspection:

Gait - Antalgesic gait
Deformity - No any deformity

Palpation:

Tenderness: Positive at L4 and L5
Muscles tone: Both Upper limb and Lower limb is good


J Ayu Int Med Sci 2024;9(1)294
Umesh Tamrakar et al. A case study on Gridhasi w.s.r. to Sciatica

Range of movement of spine:[6]

Forward flexion: Limited to 30 cm above ground

Right lateral flexion: Limited to 400 with pain.

Left lateral flexion: Limited to 400 with pain.

Extension: Limited to 100 with pain.

Special Test:[7]

TestRight LegLeft Leg
SLR TestNegativePositive at 45°
Lessigue TestPositiveNegative

Assessment Criteria

Assessment of sign and symptoms of patient

1. Low back pain radiating towards thigh, calf and down to foot.

Pain in lumber region not radiated towards anywhereG0
Pain in lumber region radiates towards thighG1
Pain in lumber region radiates towards thighG2
Pain in lumber region radiates towards footG3

2. Stiffness In Lumbar Region

No stiffnessG0
Mild stiffnessG1
Moderate stiffnessG2
Severe siffnessG3

3. Pricking sensation

No pricking sensationG0
Mild pricking sensationG1
Moderate pricking sensationG2
Severe pricking sensationG3

4. Difficulty and pain while walking and sitting

No painG0
Mild pain +No difficulty in walking and sittingG1
Slight difficulty in walking and sittingG2
Much difficulty in walking and sittingG3

Overall assessment criteria:

Thus, the total effect of the therapies will be graded as follows 

Complete remission  100% relief

Marked improvement  <100% to ≥75% relief

Moderate improvement  <75% to ≥50% relief

Mild improvement  <50% to ≥25% relief

No improvement  < 25% relief

Treatment
1st Month

SNProcedureDrugsDuration
1.Merudanda BastiVata Shamak OilDaily at morning
2.Nadi SwedaDashmool KwathDaily After MB
3.Shodhan BastiTriphala Kwath, Mahanarayan Oil, Madhu, Saindhava, Satpushpa, Ajwain(750ml)1st - 3 days empty stomach
4.Karma Basti[8] (Alternate Niruha and Anuwasan Basti)Niruha Dashmool Kwath, Mahanarayan Oil, Madhu, Saindhava, Satpushpa, Ajwain (450ml)
Anuwasana- Bala Oil- 60ml		After Shodhan from 4th day of treatment
5.Raktmokshan[9] (Leech therapy)Every week

2nd Month

SNProcedureDrugsDuration
1.Merudanda BastiVata Shamak OilDaily morning
2.Patra Pinda SwedanaVata Shamak OilDaily morning after MB
3.Karma Basti (Alternate Niruha and Anuwasan Basti)Niruha - Dashmool Kwath, Mahanarayan Oil, Madhu, Saindhava, Satpushpa, Ajwain (450ml)
Anuwasana - Bala Oil - 60ml
4.Raktamokshan (Leech therapy)Every week

Observation

Assessment between before and after treatment

SNBefore treatmentAfter treatment
1.Low back pain radiating towards thigh calf
and down to foot		0300
2.Stiffness in lumber region0301
3.Pricking sensation0201
4.Difficulty and pain while walking and sitting 0301
5.Straight leg raise test (SLRT)+Ve at 45°+Ve at 70°

As observed in the above table, the patient score of symptoms of Gradhasi in left side was 11 and SLRT was +Ve at 45° respectively at the time of admission & was reduced to 03 and SLRT was +Ve at 70° at the time of discharge. It showed moderate improvement (72.7%) in left lower back & lower limb.

Conclusion

Sciatica is a major cause of morbidity makes a person unable to perform day to day activity. In this


J Ayu Int Med Sci 2024;9(1)295
Umesh Tamrakar et al. A case study on Gridhasi w.s.r. to Sciatica

case we treated the patient by Shodhan and Shamana Chikitsa and we found that these treatments were very effective in treatment of Gridhasi. It was proved by significant improvement of patient primary symptoms. The patient is doing well with his daily activities. In last we can conclude that Gridhasi can be successfully managed by proper Ayurvedic assessment and treatment without any side effect.

References

1. Shashtri K. Charaka Samhita of Agnivesa. Vol. 2. Varanasi: Chaukhamba Sanskrit Sansthan. Sutra Sthan (20/11); p. 348.

2. Shashtri K. Charaka Samhita of Agnivesa. Vol. 2. Varanasi: Chaukhamba Sanskrit Sansthan. Chikitsa Sthan (28/56); p. 716.

3. Kaila-Kangas L, Leino-Arjas P, Karppinen J, Viikari-Juntura E, Nykyri E, Heliovaara M. History of physical work exposures and clinically diagnosed sciatica among working and nonworking Finns aged 30-64. Spine (Phila Pa 1976). 2009;34:964-9.

4. Armstrong P, Wastie M, Rockall A. Diagnostic Imaging. 5th ed. Blackwall Publishing; 2004. Chapter 11; p. 362.

5. Laxmipati Shastri. Yogaratnakara. Purvardha, Pratham Adhyay. Varanasi: Chaukhambha Sanskrit Sansthan; 2002. p. 5-14.

6. Windle WF. The Spinal Cord and Its Reaction to Traumatic Injury: Anatomy, Physiology, Pharmacology, Therapeutics. New York, NY: M Dekker; 1980. p. xi, 384.

7. Vroomen PCAJ, Krom MCTFM de, Knottnerus JA. Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: a systematic review. J Neurol. 1999;246:899-906.

8. Shashtri K. Charaka Samhita of Agnivesa. Vol. 2. Varanasi: Chaukhamba Sanskrit Sansthan. Chikitsa Sthan (28/101); p. 723.

9. Shashtri K. Charaka Samhita of Agnivesa. Vol. 2. Varanasi: Chaukhamba Sanskrit Sansthan. Chikitsa Sthan (28/101); p. 723.


J Ayu Int Med Sci 2024;9(1)296