SCIATICA - GRUDHRASI
GRUDHRASI DEFINATION:
gaRQa`vat\ calato yaismana ÈÈ MORDERN ASPECT : SCIA MORDERN SCIATICA TICA The gait of the patient is like a vulture. It is a disease of the sciatic nerve-the longest nerve in human body.
ORIGIN AND ROOT VALUE OF SCIATIC NERVE
COURSE OF NERVE
NIDAN PANCHAK NIDAN : CAUSATIVE FACTORS OF VATAVYADHI +
– LUMBAR DISC PROLAPSE – DIFFERENT DISEASES OF SPINAL COLUMN – TUMORS TUMORS OF SPINAN CORD – SOME DISORDERS OF HIP JNT LIKE FIBROSITIS – SOME PARTICUL PARTICULAR AR DISORDERS DISOR DERS OF PEL PELVIS VIS – TECHNICHAL TECHNICHAL JOBS LIKE LIFTING HEAVY WT – OCCUPATIONS – ASSAULT ON DIFFERENT MARMAS – MISTAKES DURING ADMINISTRATION OF INJECTABLES – DM-NEURITIS MAY DEVELOP
PURVAROOP : Less expressed or intermittent expression of pain or parasthesia along one leg and lumbar Region
• SAMPRAPTI :
• Snaayvaaisqat: kuyaa-d\gaRQa`syaayaamakubjata: ÈÈ • paiYNa-p`%ya=\gaulaInaaM tu kNDra yaa|inalaaid-ta È • sa@qna: xaopM inagaRh\NaIyaat\ gaRQa`saIit ih saa smaRta ÈÈ sau. ina. 1/74
Dosha – Vat (vyan) – Anubandha – Kapha Dushya – Asthi, Asthi, Majja, Snayu, Kandara Srotas – Asthivaha, Majjavaha Adhishthan – Lumbar region & lower limb Nature – Acute Rogamarga - Madhyam
NIDAN SEV SEVAN AN VITATION OF VATA STHANSANSHRAY AT KATI – SANDHI REDUCES KAPHA PRODUCES DEGENERATIVE CHANGES IN TARUNASTHI FURTHER FURTH ER VITI VITIA ATES VATA ASAMYAK ASAMY AK ASTHI DHA D HATU TU VYUHAN VYU HAN ASTHIVRUDDHI-(OSTEOPHYTE) ASTHIVRUDDHI-(OST EOPHYTE) – COMPRESSED NERVE ROOT AFFECTS MAMSA, SIRA, SNAYU, KANDARAOF KATI & PADA
SANKHYA SAMPRAPTI 1) VATAJ 2) VATAJ KAPHAJ
ROOP :
Pain starts from Lumbar Region and spreads downwards- from Gluteal Region to Back side of Thigh, Knee, Leg and upto the Feet Pain along the distribution of Sciatic Nerve or its branches Severe pain while walking, sitting for long time Restricted Restric ted movements or Complete loss of movements of Leg and Lumbar Region Parasthesia May Develop
1) 2) 3) 4)
Dull Ach Dull Ache e - Ruja Ruja Penetrating Penet rating Pain Pain With Needle Needle - Toda Toda Complete Com plete Los Loss s - Stam Stambha bha Restri Re stricted cted Move Movemen mentt - Graha Graha
Scoliosis may develop Vatkaphaja – Drowsiness, Heavyness Of Leg, Anorexia
PROGNOSIS: Kashtasadhya INVESTIGATION: 1] CBC 2] ESR RADIOLOGICAL INVESTI INVESTIGA GATION TION : 1] X-RAY OF LUMBER SPINE 2] MRI
EXAMINATION 1. SLR-STRAIGHT LEG RAISING 2. CONFIRMATORY: LASEGUE’S SIGN 3. FLIP TEST 4. SITTING TEST
TREATMENT “gaRQa`syaat- narM samyak\ rokoNavamanaona vaa È &a
TREATMENT TREATMENT SHODHAN
SHAMAN
1]SHODHAN VATAJ 1.Vaman- Virechan
2.Basti
Virechan-snigdha Virechan-snigdha Castor oil,Gandharva haritaki,Mishrak sneha Anuvasan,Matra,Yapan, Tiktaksheer Tiktaksheer basti
VATAKAPHAJ vaman&virechan
Niruha,Erandmooladi Niruha,Erandmooladi
• 2] 2]EXTERNAL EXTERNAL •
VATAJ
VATAJKAPHAJ
1. SNEHAN
OIL which nourishes
Sahachar, Dashmool,
•
dhatu –Mahanarayan
Vishagarbha,
•
Bala, Ashwagandha,
•
Mahamash,
2. Swedan
Snigdha,Nadi,Upanah
Tapa,ruksha swed
Erand patra pottali, Pinda swed 3. Dahan- at gluteal region or little finger of the affected foot 4. Raktamokshan – Siravedha –blood letting with IV SET at popliteal or saphenous vein 5. Katibasti-
3]INTERNAL
VATAJ
VATAKAPHAJ
1.Dravyas of attribute
Madhur,Amla,Lavan Ushna,Madhur vipak Guru Balya
2.Dravya For Example
Ashwagandha,Bala Vidari,Amruta,Masha Chaturbeej,Gokshur
Dashamool,Rasna Deodar,Hingu kupilu,Rason Erandamool
Mahayograj guggulu Trayodashang Trayodashangguggulu guggulu
Rasnadi gugullu Agnitundivati vati Agnitundi Amapachak vati Sinhanad,Ekangaveer
3.Guti,Vati
Mahavatavidhwansan
Ras
Tikta,Katu,Ushna Katu vipak Laghu which clears obstruction
4.choorna
5.Bhasma
6.Rasakalpa
7.Kashaya
8.Asava,Arishta 9.Rasayan
Ajamodadi,Chaturbeej Ajamodadi,Chaturbeej Alambushadi, Hingwashtak Vaishwanar Abhrak Raupya Mandur,Shilajeet Praval Brihat vata chintamani Rasaraj,Rasasindur Yogendra Yogendrarasa,Tapyadi rasa,Tapyadi Sameerpannag Sameerpannag Dashamool,Baladi
Sahacharadi, Rasnapanchak Rasnasaptak, Ashwangandharishta Bhallatakasava Bala,Narsinha Rason,bhallatak Erand paka Kuchala paka
10.Anupan
Milk,Ghrut Honey,Ardrak juice Koshna jal Koshana jal 11.Aushadha sevan kal kal - Vyankal, Vyankal, Apankal Apankal
Special Treatment • 1.ADMINISTRATION:1)Castor oil + gomutra • • • •
• 2.KASHAY
2)Castor oil + ardrak juice +matulanga juice 3)Castor oil + gomutra + pippali churna
•
:1)Shephalika parna kashaya +pippali churna
• • • • •
2)Panchamool kashay 3)Erandamooladi kashay 4)Sinhasyadi kashay 5)Ashwagandhadi kashay 6)Sahacharadi kashay
• 3.CHURNA •
1)Turangandhadi andhadi churna :1)Turang
MORDERN TREA MORDERN TR EATMEN TMENT T TREATMENT • IN ACUTE PAIN • 1.Complete bed rest • 2.Inj. Voveron Voveron (NSAID-dic (NSAID-diclofenac) lofenac) 2.c.c. IM × alternate × • 3days
• 3.Tab. Voveron 50 1tds × after food × 7 • 4.Antacid- Cap.omez 10 mg OD • 5.S.W.D for lumbar spine - 5- 10 days • 6.Tranquiliser-Tab.Alprazolam-0.25 mg bd • 7.Inj. Neurobion
2.c.c IM
• ONCE ACUTE PAIN PAIN SUBSIDE SUBSIDES S • 1.Tab.Voveron SR – 1daily × after food • 2.Cap. Neurobion forte 10D × 1 month • 3.Tab. Ostocalcium 2 bd × 1 month (calcium preparation) • 4.Back exercises – To increase back muscle tone • 5.Maintain straight back posture,avoid bending forward, sleep on hard mattress,gentle massage with Rubefacient ointment • 6.Use of Lumbosacral belt to support the spine.
