MANAGEMENT OF LUMBAR SPONDYLOSIS IN AYURVEDA

• LUMBAR SPONDYLOSIS
  DEFINITION- IT’S A DEGENERATIVE JOINT DISEASE AFFECTING LUMBAR VERTEBRAE AND INTERVERTEBRAL DISCS, CAUSING PAIN, STIFFNESS , SOMETIMES WITH SCIATIC RADIATION DUE TO NERVE ROOT PRESSURE BY ASSOCIATED PROTRUDING DISCS OR OSTEOPHYTES- DORLAND’S DICTIONARY



• CLINICAL FEATURES OF LUMBAR SPONDYLOSIS
  1. LOW BACK ACHE
  2. PAIN RADIATING TO BACK OF THIGH, BUTTOCKS.
  MAY BE SUPER IMPOSED WITH SCIATICA BECAUSE OF ROOT COMPRESSION.
  3. NUMBNESS OF LIMBS.
  4. LOSS OF TOUCH SENSATION.
  5. CONSTIPATION
  6. SOMETIMES HEADACHE
  7. MUSCLE WEAKNESS, TINGLING
  8. MORNING STIFFNESS MAY BE PRESENT
  9. PAIN INCREASES BY CHANGING POSTURES AND MOVEMENTS LIKE BENDING ETC
  
  INVESTIGATIONS & DIAGNOSTIC MEASURES
  1. RADIOLOGICAL- X-RAY
  2. MRI, CT IMAGING
  3. DISCOGRAPHY
  AYURVEDIC CONCEPT
  l KATI OR LUMBAR REGION IS VATA SITE ACC TO AYURVEDA’
  l AT THE SAME TIME JOINTS ARE SITE OF SLESHAKA SLESHMA(KAPHA).
  l BECAUSE OF NIDANAS( CAUSES) VATHA AGGRAVATION OCURS IN KAPHA STHANAM AND BECAUSE OF THE INCREASE IN RUKSHA GUNA(QUALITY OF DRYNESS) , THE DEHYDRATION OF THE DISC BEGINS, INITIATING THE SCLEROSIS AND WHEN UNINTERVENED THE CONDITION PROGRESSES TO OTHER LEVELS, SUCH AS BULGING, HERNIATION, PROLAPSE AND OSTEOPHYTE FORMATION ETC.
  TREATMENT PRINCIPLE
  l THE AIM OF THE TREATMENT IS TO REDUCE THE DRYNESS AND BRING BACK THE SNEHA GUNA, ELASTICITY AND TO REHYDRATE THE DISC , REMOVING THE OSTEOPHYTES, OR THE MALA ROOPA KAPHA.
  l IN SIMPLE TERMS , VATA HARAM AND KAPHA HARAM IN INITIAL STAGES AND BRMHANAM IN LATER STAGES TO NOURISH THE DISC.
  l ITS IMPORTANT TO MAINTAIN AGNI, IN THE PROCESS OF VATA HARAM , KAPHAM SHOULD NOT BE VITIATED. PROPER VATHA ANULOMANAM HAS TO BE ENSURED FOR EFFECTIVE RESULT.
  MANAGEMENT
  l AUSHADAM- MEDICINAL MANAGEMENT
  l STHANIKA CHIKITSA- LOCAL MEASURES
  1.ABHYANGAM-MASSAGE
  2.KATI VASTHI- SNEHANAM
  3. PATRA POTALI- SWEDANAM
  l PANCHA KARMA PROCEDURES
  1.SNEHA VASTI
  2.KASHAYA VASTHI
  l DIET AND YOGA ASANAS, PHYSICAL THERAPY, LIFE STYLE MODIFICATIONS.
  AUSHADHAM- MEDICINES
  l MAHAYOGA RAJA GUGGULU
  l LAKSHADI GUGGULU
  l ABHA GUGGULU
  l YOGA RAJA GUGGULU
  l TRAYODASANGA GUGGULU
  l MAHA RASNADHI KASHAYAM
  l RASNA SAPTHAKAM KASHAYAM
  l RASNA ERANDADI KASHAYAM
  l RASNADI KASHAYAM
  l DHANWANTHARAM KASHAYAM
  l ASHTA VARGAM KASHAYAM
  l VIDARYADI KASHAYAM
  l BALA ARISHTAM
  l ASHWA GANDHARISHTAM
  l VATA GAJANKUSA RASA
  l VAYU GULIKA
  l LASHUNA KSHEERA
  l PRAVALA PISHTI
  l KSHEERABALA 101
  l DHANWANTHARAM 101
  l GANDHA THAILAM
  POPULAR PATENT PRODUCTS
  l RUMALAYA- HIMALAYA
  l SHALLAKI- HIMALAYA
  l LUMBATON- AVN
  l DAZZLE- VASU
  l ARTAB-VASU
  l RHEUMAT 90-NAGARJUNA
  l ARTHOJITH- AVP
  l RHUE- BAN
  l R.PAIRYN- BAN
  l ARHIT FORTE- CAPRO
  l R.COMPOUND- ALARSIN
  l LOBAK- PENTA CARE
  l ARTIBAN FORTE- SANTHIGIRI
  l AUROYOG- ARYA AUSHADI
  l HERBOGESIC- ARYA AUSHADI
  l AYURFINE- BAL VEDICS
  l ORTHONERVIN- PANKAJA KASTHURI
  STHANIKA CHIKITSA
  l ABHYANGA
  USUALLY CARRIED OUT AFTER KATI VASTI PROCEDURE, CAN ALSO BE DONE SEPARATELY TOO.
  SPECIAL TYPE OF SPINAL MASSAGE HAS TO BE DONE WITH SPECIAL EMPHASIS ON THE LOWER BACK.
  ZIG ZAG STROKES, PARALLEL STROKES AND OTHER SPECIAL SPINAL STROKES WITH PROPER PRESSURE( TOO MUCH OF PRESSURE IS HARMFUL!) FOR A PERIOD OF 25 TO 30 MINUTES
  OILS USED
  SAHACHARADI THAILAM
  KARPASA ASTHYADI
  BALA THAILAM
  DHANWANTHARAM
  NARAYANA
  MAHA MASHA THAILAM
  KOTTANCHUKKADI
  KSHEERA BALA
  KARPURADI
  GANDHA THAILAM
  KATI VASTHI
  l REQUIREMENTS
  MASHA PISHTA ( BLACK GRAM FLOUR)
  MEDICATED THAILA
  COTTON
  VESSELS, AND
  OIL HEATING
  ACCESSORIES
  DHARA TABLE.
  
  PROCEDURE
  l PATIENT IS MADE TO LIE IN PRONE POSITION.
  l PISHTA OF MASHA IS MADE IN TO PASTE AND BUILT LIKE A WALL AROUND LUMBO SACRAL AREA.
  l OIL IS HEATED AND POURED SLOWLY INSIDE THE BOUNDARY WITH THE HELP OF COTTON.
  l WHEN OIL BECOMES COOL IT IS REPLACED WITH WARM OIL.
  l CONTINUED FOR A PERIOD OF TIME. APPROX- 30 TO 50 MINS, FOR 7 DAYS OR 14 DAYS.
  l AFTER THE DURATION , THE OIL IS DRAINED AND FLOUR IS REMOVED
  l ABHYANGAM OF THE BACK IS GIVEN USING SAME OIL.
  l ALWAYS SNEHANA MUST BE FOLLOWED WITH SWEDANA PROCEDURE
  
  PATRA POTALI OR ELA KIZHI
  l A TYPE OF PINDA SWEDAM. WHICH COMES UNDER USHMA SWEDA.
  l MATERIALS REQUIRED
  LEAVES OF VATA HARA LIKE ERANDA ,ARKA , CHINCHA,NIRGUNDI, SHIGRU, KARANJA DHATURA VATHAGNI SINDUVARA -500 gm
  CHOORNA OF SATAHVA AND METHIKA-25gm EACH
  SAINDHAVA-15gm
  LEMON -4 NOS
  NIMBA OR SAINDHAVA THAILA OR ERANDA THAILA (REQD QTY)
  CLOTH
  TWINE TOWEL. VESSEL, FRYING PAN, SPOON, STOVE
  l RASNADI CHOORNAM
  l MEDICATED OIL
  PATARA KIZHI PROCEDURE
  l ALL THE LEAVES ARE CUT IN TO SMALL PIECES, AND SLICES OF LEMON, CHURNAS, SAINDHAVA ARE ADDED AND FRIED IN THE CASTOR OR NEEM OR COCONUT OIL , TILL IT BECOMES ROASTED RED.
  l THEN THEY ARE MADE IN TO POTALI(USUALLY 4 IN NO)
  l AFTER ABHYANGA, THE POTALI IS APPLIED OVER THE BODY BY DIPPING IT IN TO THE HEATED OIL.
  l CIRCULAR MOVEMENTS ARE DONE.
  l PROCEDURE DONE FOR A PERIOD OF 25-45 MINS
  VASTI PRAYOGAM
  l SNEHA VASTI
  MATRA VASTI- MINIMUM DOSE OF SNEHA VASTI ( APP 60-75 ML)
  ANUVASANA VASTI.(APP 150 ML)
  SNEHA VASTI(250-300 ML)
  KSHEERA VASTI CAN BE ADVOCATED.
  KARMA VASTI, KALA VASTI, YOGA VASTI- 30, 15 , 8 DAYS OF VASTI ALTERNATELY KASHAYA AND SNEHA VASTHI. KALA VASTI IS IN PRACTICE.
  OIL USED FOR SNEHA VASTI
  TILA TAILAM
  GUGGULU TIKTAKA GHRTHAM
  MAHANARAYANA TAILAM
  MAHAMASHADI TAILAM
  SUDDHA BALATAILAM
  KSHEERABALA
  SATAHVADI TAILAM
  SUKUMARA GHRTAM
  LAKSHADI TAILAM
  SAHACHARADI TAILAM
  DHANWANTHARAM
  GANDHARVA HASTADI
  
  KASHAYA VASTI
  l DHANWANTHARAM
  l GANDHARVA HASTADI
  l SAHACHARADI
  l ERANDA MOOLA
  l ASTHAPANA GANA
  l DASAMOOLA
  l SATAHVADI



• ASANAS, EXERCISES, LIFE STYLE MODIFICATIONS
  l Pavanamuktha Asana, Bhujanga Asana, Shalabha Asana, Uttanpada Asana, Shava Asana and Rechka Purak Pranayama
  l Travelling in bumpy roads should be avoided, proper and full back support should be avoided, straining, lifting heavy weights, pressure jobs should be avoided. Proper posture has to be maintained.
  l Physical therapy measures can be adopted suitably.

PURUSHAM PURUSHAM VEEKSHYA AND PERSONALISED MEDICINE!!

Pranams to all, this time we shall try to discuss about some thing which is mentioned in ayurveda centuries back and has been recently understood by contemporary people as thier own discovery. ayurveda deals with the diseases not just the disease, i.e we believe in bringing the entire environment of the body in harmony and normalcy, health is not just absence of disease, its the complete psychological, social well being says w.h.o.in its definition of health. but ayurveda has understood this concept several centuries back, it has understood all thge parameters of health, sama dhoshaha, samagni , sama malaha- these are physical parameters, then comes prassnathma indriya manaha- these psychological and psycho social parameters are understood by our ancient seers. coming to the treatment concept, ayurveda doesnt believe in irrational treatment, i.e one cant just blindly administer any medicine, a aushada may not cure the same condition in all the people. a disease just cant be cured by the same medicine to all. it may work or may not work. ayurveda considers each and every individual as different and hence the medicine should be close to his own self. even in diagnosing we consider various things like prakrithi, kala, bala, ahara shakthi, vikrti, vyayama shakthi , satwa, etc. every individual need not respond to the same medicine. hence we have several preparations having similair properties and action but with subtle variations that has to bve appropriately selected according to the individual and his condition. unlike ayurveda , the contemporary system of medicine had the practice of administering drugs which are target specific or condition specific. these are nothing but poisons in low doses, they have antipyretics to relieve fever, anti spasmodics, anti inflamatory, ant helminthic etc. but the net result is the suppression of expression of the disease. the root cause and disease causing tendency remains un disturbed. but now a recent system of practice, a branch of medicine has evolved with advance ments in genetics, the branch called as personalized medicine, it believes that 400mg of paracetamol given at same time and for same temperature of 100 degree f, to two individuals say x and y, will not elicit the same response. the bio availability, action duration, solubility, cause etc all are independent , they are purely objective, and more over the genetic make up of individual and the environment also plzys an imporatant role. this is what our ancient seers have observed several centuries before. acharya charaka has wonderfully described as purusham purusham veekshya, every individual is different. now the modern system is looking in this field and tremendous scope is there in future for this field for sure, ayurveda and its concepts have once again proved its eternity.

PANCHA MAHA BHOOTHA 2

To continue our exploration, first we need to understand what is aakasha?
and how to understand aakasha? aakasha is said to exhibit shabda guna. shabda gunakam aakasham. but our range of hearing i.e what human ears can percieve is in the range of 20- 20000 decibels, so there is sound which may exixst above 20000 or below 20, the difficuilty is we cant percieve. absence of perception doesnt mean that the thing is not exixting. sound exists , but cant be percieved, thats it. one more sole property in defining aakasha is "aprathighathatvam" , the term aphrathighathatvam means not hindering, .i.e allowing to go through without any obstruction, e.g from water flowing in pipe, to electrons jumping in orbit, and so on. we have to understand that everywhere aakasha exists, even in the midst of solid substances aakasha exists. it is a medium through which displacement occurs. in human body how to understand aakasha? acharya charaka in vimana sthana 5th chapter srotho vimanam has described wonderfully about the srothas , in that he has said the entire body is made up of srothas, so what is srothas? sravanath srothamsi- in which something flows, he has given synonym of srothas as kha, kha means aakasha mahabhuta. and he has wonderfully explained that all diseases are due to the abnormalities in srothas, and he has given 4 types of dusthi of srothas. permeability in cell membrane to blood circulation everything falls in this category.
as i said earlier about evolution of mahabhuta from aakasha to prthvi, the disease manifestation or vyadhi awasthas also form similair pattern. every roga starts with kha vaigunyam or vitiation of aakasha, as times goes on it invades and involves subsequent mahabhutas and when prthvi the last mahabhutha is affected the disease or vyadhi is said to attain gambheera awastha, remember prthvi is manifested kapha, and remember the quotation " prakruthasthu sleshma balam " kapha in its natural state is bala or strength , bala is closely related to ojas, hence the final stage of a disease is oja kshayam. ayurveda is not merely a set of old stories, it tells about some great facts and uses logic. knowledge of pancha maha bhutas are very essential for all of us for good clinical practice.

pancha maha bhootha

ayurveda as it is known is science of life, it is more a life style rather than an alternate system of medicine, ayurveda the term is literally derived from the root "ayusho vedaha" i.e knowledge of life, hence ayurveda deals with the whole of life , it works on a person as a hole and not as fragments, it doesnt suppress your symptoms it works on a very different platform, ayurveda is more scientific that most traditional systems of medicines.

one of the most fundamental concepts of ayurveda is the pancha maha bhootha theory,

first what are these 5 mahabhoothas, they are

1. aakasha - compared to space, ether

2.vayu -compared to wind , air

3. agni -compared to fire, energy

4. jala or ap_ compared to water, liquidity

5. prthvi - compared to solid or earth

i feel that there is no exact or proper transalation to for these sanskrit terms exactly, let them be understood as they are. interstingly in sanskrit we call it as prapancham, which can be taken as universe. the name prapancham derives its name from the fact that it is formed of 5 maha bhootas. these mahabhootas doesnt exist as they are, but in mixed and sublime forms.

ANYONYANU PRAVESHA:

this theory tells about evolution of universe and mainly about the 5 maha bhootas. it says that maha bhootas are formed in succesive order from akasha to prthvi i.e aakasha ---vayu---agni---jala---prthvi.

one can cleanly relate that this order shows one striking feature, from emptiness or unstability of aakasha the travel ends in the most stable and solid prthvi. intersting do you see? also the states of matter solid, liquid and gas is also related. coming to human body now our human body is also made up of pancha maha bhoothas, a living person is said to be composed of 5mahabhootas and chetana or athma, and hence said to be shad dhatvatmaka purusha.

so how does these 5 maha bhootas in human body? yes it is in the form of 3 doshas...

vatha- aakasha+ vayu

pittha-teja+jala

kapha-jala+prthvi

its wonderful that u can find the same order from unstable to stability in 3 doshas too.

MAHABHOOTAS EVERY WHERE IN YOUR BODY:

again how to understand the presence of mahabhootas in your body? the answer to this is , to understand some thing which cant be percieved or understood directly as it is, one need to understan the guna- qualities and karma- action or effects, it goes like this

digestion, anabolism ,catabolism, glucose break down etc in all these processes there is transformation of something in to other which is the key , hence energy is involved and heat or ushna is felt or used up hence agni maha bhootha is there. think about solid organs composed of prthvi and jala mainly. thin about blood, lymph anything thats liquid composed of jala, think about respiration, neve conductio, motor and sensory activities, vayu is there. aakasha . how to understand this? all the other four combine in various proportions and undergoes various things within aakasha, any cavity, any space is aakasha. we will see more about clinical applications in next blog.