Journal of Ayurveda and Integrated Medical Sciences

Introduction

Despite not being life-threatening, this illness makes daily tasks more difficult. Katigraha is one of the eighty varieties of Vataja Nanatmaja Vyadhis as described by Acharya Sharangdhar.^[1] The term "Kati" and "Graham" combined to create the word Katigraha which refers to a back ailment marked by pain and stiffness in the joints as Kati itself is one of the seats of Vata Dosha.^[2] Katigraha is a condition where low back is afflicted either with Vata or Sama Vata (Vata involved with the toxins released due to altered digestion and metabolism) and present with symptoms such as pain with stiffness. Due to vitiated Dosha, the pain started in the joints of Prista Vam Asthi and Sphik Asthi. Katigraha as a distinct illness has been described in the classical text Gada Nigra.

Case Report

An OPD no. 33426 male patient, 43 years old, who worked as a welder, came to our hospital complaining of lower back discomfort that was radiating to his right lower limb, tingling in that limb, trouble in walking, loss of appetite, indigestion, and insomnia brought on by pain. The patient stated that he was doing well six months prior to the onset of symptoms, which included right leg pain emerging from the lumbar region. The patient experienced excruciating pain that was accompanied by tingling and restricted movement in the right hip. Prolonged standing made the pain worse, but it went away when the patient lay on his back with legs straight up. The patient saw an alteration in his gait as well. Symptoms were aggravated by cold climate, supine posture and during night hours and got relieved by warm weather. Progressively his problems aggravated and he approached for Ayurvedic treatment.

Table 1: Ashtavidha Pariksha

Result

We found that there was a marked improvement after the treatment. Painful and restricted movements of hip were reduced. Due to Maha Narayan Tail Matrabasti and Murivennam Tail Kati Basti Prayoga it was noticed that there was marked improvement in gait too.

Table 5: Assessment before and after treatment

Assessment of Subjective Parameters

Discussion

One of the Vata Vyadhis mentioned in Ayurvedic literature is Katigraha. It is generated by the Prakupita Vata, which leaves the Pakwashaya and settles in the Katipradesha. In Bruhatrayee particularly, Katigraha is not addressed as a separate condition. The state of Katigraha is caused by a vitiated Vata Dosha that settles in the Katipradesh and causes Stambha (stiffness) and Shoola (pain). There is discomfort, restricted movement, and stiffness in the lower back region in Katigraha. According to Acharya Sushruta, Shoola cannot be produced in the absence of Vata vitiation.^[3] According to Gada Nigraha, Nirama and Sama Vayu Movement into Kati (Lumbar region) causes Stambha, which is responsible for Shoola.

Katibasti was prescribed because it is a Bahya Sthanik Snehana (external local oleation) and Swedana (Sudation) technique that primarily acts against Vata's Ruksha Guna (dryness) and Sheeta Guna (coldness), respectively. Matra Basti rectifies vitiated vat at its source, which is Guda and Pakwashaya.