Abstract
Neurological disorders are one of the most common disorders that people suffer from these days. The nerve cells and nerves everywhere in the body lead to the sensation in the body. One of the largest nerves in the body is the sciatic nerve and is formed by the association of 5 nerve roots from the lower spine. It passes somewhere down in the butt cheek and down the rear of the thigh the whole way to the heel and underside of the foot. The sciatic nerve serves a crucial job in associating the spinal string with the skin and muscles of the thigh, leg, and foot. Any neurological pain and disorder originating from the nerve sciatica known as Sciatica. The pain is felt along the path of the sciatic nerve. In the text below, we shall discuss sciatica in detail and its management in the contemporary system of medicine and in the traditional Indian system of ayurveda medicine. Let’s discuss!!
Introduction
Sciatica is characterised by pain in the sciatica nerve and along the path of the sciatic nerve which is going down the leg from the lower back. The pain may go outside, the back or front of the leg. The pain is often said to be shooting in nature and it may occur gradually and suddenly as well. Usually the pain occurs on one side only, but in some conditions the pain can occur in the bilateral sides. In some cases lower back ache is present and numbness and weakness may occur in the affected side. In Ayurveda, the condition is correlated with gridhrasi. We shall see its Ayurvedic further in this text. Now let’s have a look at the causes, classifications, features and management.
Causes of Sciatica
Risk factors that can lead to the occurrence of sciatica include obesity, smoking, physical sports, and occupations in which heavy weights and back muscles are involved. Further the instances increase with the increase in age, being a male, history of back ache.
1. Spinal Disc Herniation
It is one of the main causes of sciatica as the herniated disc leads to the pressing of the sciatic nerve. It leads to 90 percent cases of sciatica. The cause of disc herniation is heavy weight lifting.
2. Piriformis Syndrome
Piriformis syndrome is a condition that leads to 8 percent of buttock or lower back pain. In around seventeen percent of the people the sciatic nerve runs through the piriformis muscle instead beneath it. Spasms and shortening the muscle due to overuse and trauma, it leads to the compression of the sciatic nerve. This syndrome is generally known as wallet sciatica as the wallet kept in the rear hip pocket compresses the hip muscle and sciatic nerve when the person sits.
3. Pregnancy
During the later stages of pregnancy due the weight of the foetus, the compression of the sciatic nerve occurs while sitting. This leads to numbness in the leg and imbalance during walking There is no management for the pregnancy induced sciatica.
4. Endometriosis
It is known as sciatic endometriosis, cyclic sciatica, catamenial sciatica. Incidence of sciatic endometriosis is unknown. Diagnosis is usually done by CT-myelography or MRI.
5. Spinal Stenosis
Some spinal issues also cause compression of the sciatic nerve. These causes include lumbar spinal stenosis in which the space in the spinal canal narrows and compresses the spinal cord, sciatic nerve roots or cauda equina. The narrowing of the canal can be caused due to bony spurs, inflammation, herniated disc, spondylolisthesis. All these decrease the space available for the spinal cord, which leads to irritation of the nerve.
Other causes include inflammation, cancer (spinal cancer/any growth in the pelvis region) and infection
Types of Sciatica
- Acute sciatica
- Chronic sciatica
- Altering sciatica
- Bilateral sciatica
1. Acute Sciatica
It has a recent onset having at least 4 to 8 week of duration of sciatic pain. It is usually self-managed and usually doesn’t need medical care.
2. Chronic Sciatica
It is persistent in nature and lasts longer than eight weeks and does not subside with self-management.
3. Alternating Sciatica
This is a type of sciatica that causes pain in both the legs alternatively. Usually this type of sciatica is rare and can be due to degenerative problems in the sacroiliac joint.
4. Bilateral Sciatica
This type of sciatica affects the both legs together though the condition is rarely found and it is also considered to have degenerative changes in the vertebrae or the disc at several levels in the spine and this can develop from the condition of cauda equina syndrome or it’s complicated.
Signs and Symptoms
Generalised Symptoms
- Nature of pain is shooting or electric shock-like, pulsating or throbbing pain, constant dull ache, on and off discomfort.
- Weakness in the muscle of thigh region
- Weakness in the foot and leg muscles of the affected side.
- Numbness
- Paresthesia.
- Change in posture may lead to aggravation of pain or relaxation.
- Altered sensation.
Symptoms of Sciatica for each nerve root
Sciatica symptoms from the L4 nerve root may lead to pain in the hip, inner areas of calf and knee and thigh. Further there can be loss of sensation over the inner calf, weakness in the muscles that helps pulling the legs together. Loss of tendon reflex (reduction in the knee-jerk reflex)
Sciatica symptoms from the L5 nerve root may cause pain in the back of the calf, side of the foot and in the buttock. Loss of sensation in the outer side of the foot including the 3rd, 4th and 5th toes. Further it causes hindrance in lifting up the great and second toe and also in the movement of the ankle.
Sciatica symptoms from the S1 nerve root is also known as classic sciatica and we have seen the symptoms of the same in the generalised symptoms.
Investigations
- Physical tests
Imaging of the spine such as
- X ray
- MRI
- Lumbar puncture
- Complete blood count
Differential diagnosis
- Cancer
- Spinal epidural abscess
Management of Sciatica
- Complete bed rest
- Analgesics
- Anti Inflammatory
- Local heat application
- Injection of 2 percent lignocaine to the sciatica nerve
- surgery
Ayurvedic Aspect and Management of Sciatica
As all the body movements and nerve conduction is governed by vata dosha. Any vitiation of the vata dosha leads to neurological issues or nervous issues. This can result in immobility, pain, tremors, and various other mobility problems and physiological issues as well.
Gridhrasi is best correlated with the modern disease namely sciatica. Ayurveda says that vata dosha leads to the irritation of the gridhrasi nerve (nadi) that is characterised by pain in the hip region, pain radiates from hip to thigh, knee, leg and foot posteriorly, stiffness in the leg, needling pain in the affected parts, pulsations, drowsiness, heaviness in body, anorexia. The condition is considered to be due to the compression of gridhrasi nadi. Rakta Vaha srotas, mamsvaha srotas, medovaha srotas and pranvaha srotas are vitiated in the condition of gridhrasi.
Causes according to Ayurveda include injuries, prolonged sitting and excessive walking, anger, dry food, less food and causes of vata vyadhi has also the same causes of gridhrasi.
Type of Gridhrasi
- Vataja gridhrasi
- Vata Kaphaja gridhrasi
Symptoms of vataja gridhrasi
Shooting type of pain, typical posture (curved) of the leg/body, stiffness and tingling sensation in the joint of waist, thigh and knee.
Symptoms of vata kaphaja gridhrasi
Poor appetite, drowsiness, excessive salivation and anorexia.
Chikitsa (Management)
- Nidana parivarjan
- Anuvasana vasti and niruha vasti
- Vein puncturing
- Electrocautery
- Vaman, virechamd followed by sneha vasti
- Massage with prasarini and mahanarayan taila and maha vishgarbha,
- Baluka sweda, saindhava ;avamna swedana
- Anuvasana vasti with saindhavadi taola, niruha vasti with erandamooladi taila
- In constipation, purgation therapy (virechana karma should be performed.
Following are Some of the Formulations That helps in Managing Sciatica
- Erandadi guggulu
- Agnitundi vati
- Sameer Pannag rasa
- Ajmodadi churna
- Shankh bhasma
- Ashwagandharishta
- Dashmoolarishta
- Rason ksheera paka
- Erand mool kwath
- Errand sneha
- Brahmi vati
- Brihat vata chintamani rasa
- Chintamani chaturmukh ras
- Mrig Shringa bhasma
Pathya (Beneficial)
- Mung
- Masoor
- Ginger
- CowMilk
- CowGhee (Clarified butter)
- Maamsrasa
- Yava
- Punarnava
- Draksha (Vitis vinifera)
- Pomegranate
- Following the daily regimen, seasonal regimen as mentioned in the Ayurvedic texts.
Apathya (Disease aggravating)
- Bitter, astringent food
- Chickpeas
- Peas
- Kodo
- Holding natural urges
- Sleeping during the day
- Stress and tension.
Herbal Remedies by Planet Ayurveda for Sciatica (Gridhrasi)
Planet Ayurveda is an eminent US-FDA registered, GMP certified and ISO 9001:2015 certified Ayurvedic Company, which adhered to the aim of manufacturing standard Ayurvedic medicines as given in the various ancient texts or scriptures of Ayurveda. Medicines are prepared without preservatives, synthesised material and additives which causes many ill effects on the body. Products manufactured at Planet Ayurveda are pure and do not contain any adulteration. Planet Ayurveda extends its herbal formulations that are helpful in management of sciatica.
Given below are some of the medicines that effectively manages the condition of Sciatica :
- HAKAM CHURNA
- BOSWELLIA CURCUMIN
- YOGRAJ GUGGUL
- ASHWAGANDHA CAPSULES
- VRIHAT VATCHINTAMANI RAS
- DHANWANTHARAM TAILAM
Product Description
1. HAKAM CHURNA
Hakam churna is a product of Planet Ayurveda and is blended with the herbs that maintain metabolic health. Further it aids the digestive health results in increased digestive fire. Thus beneficial in indigestion. It includes Kalonji (Nigella sativa),Methi (Trigonella foenum graecum), Ajwain (Trachyspermum ammi) etc. As it is an ama pachak thus is beneficial in sroto shuddhi (cleansing the micro channels) and helps in managing the condition of sciatica.
Dosage : One tsp. twice daily with warm water, after meals.
2. BOSWELLIA CURCUMIN
Boswellia Curcumin capsules, a product of Planet Ayurveda, are enriched with the herbs shallaki (Boswellia serrata) and haridra (Curcuma longa). Both the herbs possess antiinflammatory, analgesic and antipyretic properties. Boswellia Curcumin reduces the pain associated with sciatica and also helps in the healing process of the injury related to nerves and muscles. Therefore, Boswellia Curcumin is beneficial in the condition of Sciatica. This product of Planet Ayurveda is a gem in the condition of joint and effectively manages Sciatica.
Dosage : Two capsules twice daily with warm water, after meals.
3. YOGRAJ GUGGUL
Yograj Guggul is a classical Ayurvedic proprietary formulation. It is a beneficial formulation in the problems related to the musculoskeletal system and neurological system. Yograj Guggul is filled with the goodness of the herbs guggul (Commiphora mukul), amalaki (Emblica officinalis), bibhitaki (Terminalia bellirica), haritaki (Terminalia chebula), vidang (Embelia ribes), ela (Elettaria cardamomum), gokshur (Tribulus terrestris), shunthi (Zingiber officinale) etc. The herbs possess anti-inflammatory and detoxifying properties. As the formulation provides strength and support to the muscles and minimises the pain and numbness which makes it an excellent preparation for Sciatica.
Dosage : Two tablets twice daily with warm water, after meals.
4. ASHWAGANDHA CAPSULES
Ashwagandha capsules, is a product of Planet Ayurveda which are enriched with the properties of the herb ashwagandha (Withania somnifera) that possesses properties of rasayan. Ashwagandha capsules pacify the vata dosha. And benefits in maintaining the well neurological system. As ashwagandha possesses rasayanic properties thus helps in overall management of the bodily functions. In this condition of sciatica it helps by giving strength to the muscles that are supplied by the sciatic nerve. By pacifying the vata dosha it helps in the spasmodic condition of the leg muscle. By its above said actions, Ashwagandha capsules are of greater benefit in the condition of Sciatica.
Dosage : One capsule twice daily with warm water, after meals.
5. VRIHAT VATCHINTAMANI RAS
Vrihat Vatchintamani Ras is a classical Ayurvedic mineral formulation. The ingredients of the formulation are Swarna Bhasma (gold calx), Rajata Bhasma (silver calx), Abhrak Bhasma (mica ash), Loha Bhasma (iron ash), Suta Bhasma (compound of purified mercury and purified sulphur), Pravala Bhasma (coral calcium) and Mukta Bhasma (pearl calx). It contains the juice extract of Aloe vera (Aloe barbadensis). It helps in demyelinated nerves. It is helpful in all kind of neuropathies. It alleviates pain. And helps in the delayed reflexes and also benefits in the condition of muscle spasms. As the name of the formulation suggests it magnificently pacifies the vitiated vata dosha condition. With these wonderful actions, Vrihat Vatchintamani Ras is a tremendous formulation in managing Sciatica.
Dosage : One tablet twice daily with warm water, after meals.
6. DHANWANTHARAM TAILAM
Dhanwantharam tailam is used in the condition of weak muscular power. The oil possesses strengthening and power providing properties of the herbs bala (Sida cordifolia), kiulatha (Dolichos biflorus), agnimantha (Clerodendrum phlomidis), prasarini (Paederia foetida), brihati (Solanum indicum), manjistha (Rubia cordifolia), sariva (Hemidesmus indicus) and others. The oil provides energy to the weak muscles. Furthermore, the oil preparation alleviates pain and pacifies vata dosha. As Dhanwantharam thailam reduces pain and provides strength to the muscles, therefore it is useful in Sciatica.
Dosage : Massage externally after warming it up through a water bath method.
Conclusion
Sciatica is a troublesome condition that causes pain of radiating and shooting in the leg. This condition is irritating and makes the person angry and causes disturbance in daily life. As there is no proper and permanent solution for the condition is available in the contemporary system of medicine whereas Ayurveda presents its help in managing the condition of sciatica (gridhrasi) effectively. As we have discussed, some herbal medicines are available in the market that can well manage sciatica. Further some treatment procedures that are included in panchkarma are also beneficial as the basti karma (medicated enema) is considered best for vata vitiation as mentioned in the various ayurvedic texts. Above mentioned medicines of Planet Ayurveda effectively manages Sciatica. Choose Ayurveda and see the magical change in the problematic conditions.