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.