Introduction

Manyastambha, a clinically similar to cervical spondylosis, is classified among the Vataja Nanatmaja Vyadhis by Acharya Charaka. It manifests as stiffness or rigidity in the back of the neck, accompanied by impaired neck movements. Contributing factors include day sleep, improper postures while sitting or standing, excessive upward neck movements, overstretching and lifting heavy weights, all exacerbating Vata aggravation.^[1]

Additionally, Kapha involvement occurs alongside Vata in Manyastambha with vitiated elements lodging in Manyapradesha, thereby involving Kapha Dosha in its pathophysiology. Acharya Susruta suggests Vata-Slesma Hara and Vatahara management for Manyastambha, with Ruksa Sweda being directly indicated as a treatment modality.^[2]

Nasya and Snigdha Chikitsa are also mentioned as principles of therapy. Considering the views of both Charaka and Susrutha, a combination of Ruksha and Snigdha management approaches were undertaken in a patient of cervical spondylosis presenting Manyastambha symptoms.

Cervical spondylosis, also known as arthritis of the neck, is nearly ubiquitous in elderly individuals,^[3] characterised by disc degeneration, osteophyte formation and osteoarthritis of the spinal apophyseal joints.

Symptoms commonly include neck pain and restricted movement, typified by Ruk (pain) and Stambha (stiffness) in the neck region, which are cardinal features of Manyastambha.

Case Study

Chief Complaints:A 30-year-old male patient with complaints of:

• Pain and stiffness in the back of the neck region
• Difficulty in movement of the neck for the past 6 months.

History of Present Illness:Patient was asymptomatic before 6 months. Suddenly he developed pain in the neck region with restricted movement of neck after heavy weight lifting. He took analgesics and muscle relaxants to get relief from restricted movement but he got very minimal improvement.

Results

Table 1: Showing Range of Movement of cervical spine

Table 2: Showing Before and after treatment VAS Score of cervical Spine

Figure 1: Showing X-ray of Cervical spine before and After Treatment

Before Treatment

After Treatment

Thus cures the diseases affecting the Urdhva Jatru.^[12] Dehydration of intervertebral discs causes neck stiffness. Nasya with a nourishing drug can induce some nourishment to tissues and helps to reduce stiffness and pain. Brmhana Nasya helps to reduce the dehydration and helps to cure degenerations.

Greeva Vasti is a type of local Sweda. Greeva Vasti helps to break the pathogenesis of Manyasthamba. Tilatailam helps to reduce the Sita Guna of Vata and Kapha which are the main aggravated Doshas in Manyastambha. Greeva Vasti may help to increase blood circulation to the affected area which helps to release toxins and reduce Inflammation.^[13]

Long duration of contact enhances absorption of active principles helps in reducing pain and promotes strength of the muscles. Specific temperature, longer duration of contact surface and covering more contact surfaces are the factors making it more suitable to cure diseases.

Dasamoola Kasaya Vasti acts as Sothahara, Tridosha Hara, Ama Pachana,^[14] Vedanahara, Sthambahara etc. Some other Acharya like Vriddha Vagbhatta opined that Vasti is acting on 5 types of Vayu in chronological order like Apana, Samana, Vyana, Udana, Prana, later helps to maintenance of normalcy of Pitta and Kapha and lastly Poshana of Sarvasharira.^[15]

ENS of the gut brain is an independent integrative system with structural and functional properties that are similar to those CNS. System biology also plays an important role in the mode of action of Vasti. Vasti also helps in detoxification of colon and whole body before the autointoxication process.

Anuvasana Vasti is absorbed through the diffusion process. In this procedure molecules move from an area of higher concentration to the lower concentration. When Vasti Dravya enters the colon, the ANS also often operates by means of Visceral reflexes.

The gut sends signals to the spinal cord, brainstem and hypothalamus and cerebral cortex. Which in turn does Parasympathetic stimulation. As long as the Basti is retained in the body Parasympathetic tone remains dominant and the body feels relaxed and resting. Basti increases the Parasympathetic tone which nullifies the effect of increased sympathetic tone and brings it in homeostatic condition.^[16]