Mr. Musammil, 45 year old male, married, resident of Mathottam, Calicut, employed in the construction field came to our Hospital in the month of October with severe lower back ache, radiating to right leg associated with difficulty in walking without support and unable to sit comfortably because of excruciating pain.
This patient was lying in front of the OPD as he was unable to sit because of pain at the time of admission. He was walking with the support of another person and the posture was completely leaned to his left side. When lying down in the bed also he couldn’t keep his body in a straight position as it was extremely painful.
The patient had been suffering from lower back pain for a period of three years. At the onset of the pain, it was non radiating and had began to radiate down into the right leg. He consulted an Allopathic physician and was receiving medication at the time. In the past month, the pain had become increasingly severe and accompanied by numbness. In the month of June, the patient was hospitalized for four days and received IV analgesics and supportive measures. These measures provided temporary relief, however, the pain returned. The doctor advised surgery, and to avoid the surgery, the patient contacted Sree Subramania Ayurvedic Nursing Home. After Ayurveda treatment, the patient was satisfied that he would not have to undergo surgery and could lead a normal life.
MRI:
- Sacralization of L5 vertebrae – Castell vi classification of LSTV – Type IIA (left)
- Posterior disc extrusion at L3-4 level with the disc material extending inferiorly behind the L4 vertebral body by 9mm, causing moderate spinal canal narrowing and bilateral lateral recesses narrowing.
- Annular fissure, posterior disc protrusion at L4-L5 level indenting anterior thecal sac causing moderate spinal canal narrowing, bilateral lateral recess narrowing.
TREATMENT COURSE
Internal medicine:
- Amritotharam kashayam+ kaishora guggulu
- Eranda taila 10ml bd
- Hinguvachadi choornam
- Vatarakshasa Bhasma
- Rasnamrutadi Kashaya+Amruta guggulu
Proceduers:
- Choornakizhi with kulatha and satapushpa powder – 14 days
- Dhanyamladhara – 7 days
- Choornavasthi with vaiswanara choorna – 3 days
- Kashayavasthi– 6 days
- Tailavasthi – 5
Advised diet recommendations
- Avoid excessive use of chana daal,green gram,Bengal gram,leafy vegetables etc.
- Include black gram,garlic,drum stick,lemon,grapes,milk,meat soup,coconut water etc.
- Avoid mental stress,excessive fasting,suppression of natural urges,night awakening,day sleep.
(Note* –
- Here are Some of the medications prescribed to address the patient’s accompanying symptoms.
- This is a specialized plan for a person, please do not try it at home without the supervision of an Ayurvedic Doctor)
Time line of Ayurveda treatment
The treatment was started with Choornakizhi (fomentation with a bolus of herbal powders) and choornavasti (with medicated dry powder). Within the 2 days of treatment, the inflammation had reduced, the intensity of pain was less, tenderness in the lumbar spine reduced and his walking posture slightly improved. After the first 7 days, the inflammation and pain reduced progressively and leg raising was still difficult. After an initial 7 days, Vasti treatment started, as it is considered a major treatment in such cases, which included a combination of 5 Tailavasti and 6 Kashayavasti. The leg raising and forward bending turned better after that. After these 14 days, treatment was changed to Dhanyamladhara as he started feeling tenderness in the Right SI joint. This treatment continued for another 7 days. All these treatments were done along with internal medication.
At the time of discharge:
- Pain reduced considerably.
- Inflammation reduced.
- Leg raising improved.
- Walking pattern improved.
- Posture becomes straight
- Improved mobility and flexibility.
WEEKLY PROGRESS REPORT
| WEEK | 1 | 2 | 3 |
| Pain | Grade 8 (Severe pain) – Interfere with basic needs. | 4 (Interfere with tasks) | 2 (Mild pain – can be ignored) |
| Tenderness (pain on touch) | +++ | ++ | + |
| Range of motion | Limited lumbar flexion mobility (10 degrees) | Improved lumbar flexion mobility (20 degrees) | Lumbar flexion mobility improved (45deg) |
| Body posture | Body posture leaned to the left side. | The posture of body considerably changed; slight leaning remained. | The posture of body became straight |
| SLR Test | 20 degrees (Right) | 30 degrees (Right) | 70 degrees (Right) |
Disk extrusion-scope of ayurveda
The intervertebral discs of the spine are located between the vertebral bodies. The discs are made of rubber or jelly and act as a cushion for the spine when it bends. The inner nucleus pulposus of the discs is gelatinous, while the outside annulus fibrosus is strong. Slipped disc is another term for a prolapsed intervertebral disc. A bulging out of the inner section of the disc would occur here. This is a spine disorder in which the outer fibrous ring of an intervertebral disc tears, causing the soft middle section to protrude.
Spondylosis is a term used to describe degenerative alterations in the intervertebral discs. Cervical spondylosis is caused by disc degeneration in the cervical region, and similar alterations in the lumbar region generate lumbar spondylosis. IVDP is characterized as intervertebral disc prolapse, which happens as a result of poor posture, trauma or degeneration.
The prevalence of these illnesses is increasing at an alarming rate, particularly among computer workers and those with sedentary jobs. Individuals suffering from cervical spondylosis will experience varying degrees of discomfort and numbness in the neck and arm. Lumbar spondylosis frequently manifests as low back pain. IVDP produces low back stiffness and soreness, which transmits pain and numbness down the leg. If these diseases persist, the individual will be severely disabled, forcing him to change his career several times.
Application of herbal lepa, Kati Basti, GreevaBasti, Pichu, Dhanyamladhara, Upanaha sweda ,choorna pinda sweda,choorna vasthi and yogavasthi etc. like therapies are employed to cure the disease. Depending on an individual’s condition, the quality or quantity may vary. In this case, after taking 3 weeks of proper treatment there was a significant change in the severity of pain(from grade 8 to grade 2) and flexibility in movement. During admission, he came here with a bent posture and now he walks straight.
