E-ISSN:2456-3110

Case Report

Modern Sciatica Care

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 12 DECEMBER
Publisherwww.maharshicharaka.in

Integrative approach to managing Gridhrasi - Unveiling the therapeutic synergy of Rasnadi Guggulu and Nirgundi Ghanavati in Modern Sciatica Care

Thipparapu V1*, Mohan GV2, Dharmannavar G3
DOI:10.21760/jaims.9.12.47

1* Vandana Thipparapu, Post Graduate Scholar, Dept of PG studies in Kayachikitsa, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

2 G Vinay Mohan, HOD and Guide, Dept of PG studies in Kayachikitsa, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

3 Girishkumar Dharmannavar, Assistant Professor and Co-Guide, Dept of PG studies in Kayachikitsa, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

Gridhrasi, described in Ayurvedic texts as a Vata-Kapha Vyadhi, manifests with symptoms resembling modern sciatica, including radiating pain, stiffness, and restricted movement. Rasnadi Guggulu and Nirgundi Ghanavati, traditional Ayurvedic formulations, have shown promising results in alleviating the symptoms of Gridhrasi. This article explores the pathophysiology of Gridhrasi in Ayurveda, pharmacological insights of these formulations, and their application in integrative care for sciatica.

Keywords: Gridhrasi, Sciatica, Rasnadi Guggulu, Nirgundi Ghanavati, Ayurveda, Integrative Care

Corresponding Author How to Cite this Article To Browse
Vandana Thipparapu, Post Graduate Scholar, Dept of PG studies in Kayachikitsa, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.
Email: 		Thipparapu V, Mohan GV, Dharmannavar G, Integrative approach to managing Gridhrasi - Unveiling the therapeutic synergy of Rasnadi Guggulu and Nirgundi Ghanavati in Modern Sciatica Care. J Ayu Int Med Sci. 2024;9(12):347-350.
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https://jaims.in/jaims/article/view/4140/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-11-09 2024-11-19 2024-11-29 2024-12-09 2024-11-23
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© 2024by Thipparapu V, Mohan GV, Dharmannavar Gand 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(12)347
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GV Mohan et al. Integrative approach to managing Gridhrasi

Introduction

Gridhrasi, often correlated with sciatica, is characterized by pain radiating along the sciatic nerve pathway. The term "Gridhrasi" is derived from the Gṛdhra (vulture), symbolizing the patient’s limping gait due to excruciating pain.[1]

Modern sciatica is primarily attributed to lumbar disc herniation, nerve compression, or degenerative changes. This article aims to bridge Ayurvedic wisdom with contemporary medical approaches for effective management.

Understanding Gridhrasi in Ayurveda

According to Ayurveda, Gridhrasi is a result of aggravated Vata Dosha, often combined with Kapha, leading to Srotorodha (channel obstruction).[2]

The symptoms, including pain, stiffness, and restricted movement, are closely aligned with those of sciatica. Nidana (causative factors) include:

Aharaja: Incompatible foods (Viruddha Ahara) and improper digestion.

Viharaja: Overexertion, long hours of sitting, and poor posture.

Manasika: Stress-induced Vata aggravated[3]

Therapeutic Synergy: Rasanadi Guggulu and Nirgundi Ghanavati

1. Rasnadi Guggulu

Ingredients: Rasna (Pluchea lanceolata), Guggulu (Commiphora mukul), and other Vata-Kapha pacifying herbs.
Pharmacological Actions: Anti-inflammatory and analgesic properties.
Deepana-Pachana (digestive and metabolic stimulation) to address Ama (toxins).[4]
Vata-Kapha Shamana, reducing pain and stiffness.

2. Nirgundi Ghanavati

Ingredients: Nirgundi (Vitex negundo) as the primary component.
Pharmacological Actions: Potent analgesic and muscle relaxant properties.
Sroto-shodhana (channel cleansing), aiding nerve function.[5]
Anti-spasmodic effects, reducing nerve compression.

Clinical Application and Case Insights

The combination of Rasnadi Guggulu and Nirgundi Ghanavati has demonstrated significant results in reducing pain, improving mobility, and enhancing quality of life.

Case Report

A 45-year-old female presented with classical symptoms of Gridhrasi, including radiating pain from the lumbar region to the left lower limb, stiffness, and difficulty in walking.

Rogi Pariksha (Patient Examination)

1. Darshana Pariksha

  • The patient exhibited an antalgic gait (limping due to pain)
  • Visible muscle stiffness in the lower back and affected limb.
  • Mild swelling was noted around the sacral region and thigh.
  • The patient frequently changed positions due to discomfort.

2. Sparshana Pariksha

  • Tenderness observed along the sciatic nerve pathway, especially in the gluteal region and posterior thigh.
  • Increased muscle tightness in the hamstrings and calf muscles.
  • Cold extremities, indicating Vata dominance.
  • Decreased sensation in the affected limb

3. Prashna Pariksha

  • Pradhana Vedana - Radiating pain from the lumbar region to the left lower limb.
  • Kaalaprabhava - Pain aggravated at night and early morning.
  • Vega - Sudden, sharp, shooting pain upon movement.
  • Upashaya - Warm fomentation and mild stretching provided temporary relief.
  • Anupashaya - Prolonged sitting, cold exposure, and excessive physical activity worsened symptoms.
  • Bowel Movements - Slight constipation, indicating Vata aggravation.

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GV Mohan et al. Integrative approach to managing Gridhrasi
  • Appetite & Digestion - Mild Agnimandya with bloating.
  • Sleep Pattern - Disturbed due to pain.

4. Nadi Pariksha

Nadi (Pulse): Vata-Kapha predominant, irregular, and slightly weak.

5. Mala Pariksha

Hard stools with occasional dryness, indicating Vata-Kopa.

6. Mutra Pariksha

Normal, with no significant abnormalities.

7. Jihva Pariksha

Slightly coated tongue, suggesting Ama (toxins) accumulation.

8. Shabda, Sparsha, Rupa, Rasa Pariksha

  • Shabda (Voice): Normal, no hoarseness.
  • Sparsha (Touch): Dry and rough skin, indicating Vata Prakopa.
  • Rupa (Appearance): Dull, tired look due to disturbed sleep.
  • Rasa (Taste Perception): Slight bitter taste, suggesting Vata-Kapha Dushti.

Clinical Findings & Management Approach

Based on these observations, a 6-week regimen of Rasnadi Guggulu (500 mg twice daily) and Nirgundi Ghanavati (500 mg thrice daily) was administered, along with Panchakarma therapies, including:

1. Abhyanga (Oil Massage) with Mahanarayana Taila.
2. Swedana (Sudation Therapy) using Nadi Sweda with Dashmoola
3. Kati Basti (Lumbar Oil Retention Therapy) with Sahacharadi Taila.
4. Mild Virechana (Purgation Therapy) to eliminate Ama and balance Vata.

Results

After 6 Weeks

  • 80% reduction in pain.
  • Improved mobility and flexibility.
  • Significant relief from stiffness.
  • Better sleep quality and digestion.
  • Decreased dependency on analgesics.

Integrative Approach in Modern Sciatica Care

While modern management relies on NSAIDs, physiotherapy, and surgery in severe cases, Ayurveda offers a non-invasive, root-cause approach[6] Integrating Ayurvedic principles with modern diagnostics can:

1. Reduce dependency on painkillers.
2. Offer sustainable pain relief.
3. Prevent recurrence by addressing Nidana

Discussion

Sciatica, known as Gridhrasi in Ayurveda, is a disorder primarily caused by the vitiation of Vata Dosha, sometimes accompanied by Kapha Dosha, leading to obstruction in the nerve pathways and resulting in characteristic radiating pain from the lower back to the lower limb. The term Gridhrasi is derived from Gṛdhra (vulture), signifying the limping gait that patients develop due to severe pain.

From a modern perspective, sciatica occurs due to compression or irritation of the sciatic nerve, commonly caused by lumbar disc herniation, spinal degenerative changes, trauma, or muscular entrapment, such as in piriformis syndrome.

The present study highlights the effectiveness of Ayurvedic interventions in managing Gridhrasi. The administration of Rasnadi Guggulu and Nirgundi Ghanavati provided significant symptomatic relief by addressing the root cause of the condition. Rasnadi Guggulu, with its key ingredients like Rasna, Guggulu, Eranda, Devadaru, and Shunthi, possesses anti-inflammatory, analgesic, and detoxifying properties, which help in reducing pain, stiffness, and nerve irritation. It acts as a Vata-Kapha pacifier, improving nerve function and circulation while also removing metabolic toxins (Ama) that contribute to nerve compression. Nirgundi Ghanavati, prepared from Nirgundi (Vitex negundo), is known for its Shothahara (anti-inflammatory), Vedanasthapana (analgesic), and Srotoshodhana (channel-clearing) properties, which help in reducing nerve swelling and muscle spasms.

The patient experienced significant pain relief, improved mobility, and better quality of life within six weeks of treatment.


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GV Mohan et al. Integrative approach to managing Gridhrasi

The holistic approach of Ayurveda, which focuses on Dosha balance, detoxification, and nerve rejuvenation, offers a promising alternative to conventional treatments, particularly for chronic cases of sciatica where long-term pain management is necessary.

Conclusion

The therapeutic synergy of Rasnadi Guggulu and Nirgundi Ghanavati exemplifies Ayurveda's potential in managing Gridhrasi (Sciatica)[7] with their multifaceted actions on Vata-Kapha imbalance, these formulations not only alleviate symptoms but also address the root cause. Gridhrasi is a Ruja Pradhaana Vatavyadhi. It is characterized with intense shooting pain that radiates from Sphika (gluteal region) to Pada (foot).[8] It disturbs both physical and mental status of a patient. On the basis of symptoms of Gridhrasi; it can be correlated with the disease sciatica in modern science which occurs due to spinal nerve irritation and is characterized by pain along the distribution of sciatic nerve.[9]

Integrating these Ayurvedic interventions with modern medicine can pave the way for holistic and effective sciatica care.

References

1. Susruta, Susruta Samhita, edited by Vaidya Jadavaji Trikamji Aacharya Narayan Ram Acharya ‘Kavyatirtha’. Sootrasthana. Ch.14, Ver.44. Reprint, 2019 edition, Varanasi: Choukhambha Sanskrit Sansthan, Kashi Sanskrit Series 316;2019.page no 66.

2. Cheppatt Achyutha Variyar, editor, (1st). Ashtanga Hrudaya of Vagbhata, Sootra Sthana; Chapter 27, Verse 48-50. Varanasi: Chowkhambha Sanskrit Series, 2006.page no 56

3. Astanga Hridaya With the commentaries, Sarvangasundara of Arundatta and Ayurveda rasayana Of Hemadri, edited by Pandit Hari Sadasiva Sastri Paradakara Bhisagacarya; Chaukhamba Orientalia, Varanasi, Ninth Edition, 2002 page no 32

4. Susruta, Susruta Samhita, edited by Vaidya Jadavaji Trikamji Aacharya Narayan Ram Acharya ‘Kavyatirtha’. Sootrasthana. Ch.13, Ver.22-23. Reprint, 2019 edition, Varanasi: Choukhambha Sanskrit Sansthan, Kashi Sanskrit Series 316;2019.p.58.

5. Chakradatta with vaidhya prabha Hindi commentary by Dr indradev Tripathi, edited By Prof Ramanath Dwividy, 1St edition Varanasi, Chaukhamba Sanskrit Sansthan, 1992.pg no 133

rd

6. Bannister, R. (Ed.). Pain Management: A Practical Guide for Clinicians, Springer; 3 edition, 2017.page no 32-33

7. Singh, VP., et al. Pharmacological and Therapeutic Studies on Vitex Negundo (Nirgundi): A Review, Indian Journal of Traditional Knowledge, 2011; 10(3): page no 569-577.

8. Patil, S., Deshmukh, A. A Clinical Study on the Effect of Rasnadi Guggulu in the Management of Gridhrasi, Journal of Ayurveda and Integrated Medical Sciences, 2017; 2(5): page no 45-50.

9. Gray, H., Standring, S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice, Elsevier; 41st edition, 2015.page no 1617-18

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