Jayaprakash,44 years old male patient, hailing from Chennai, was employed as a Chief Manager of an organisation. As part of his duties, he was required to remain seated for an extended period of time, almost 8-10 hours per day. The individual has been experiencing intense back pain for the past two to three years. The patient experienced a prolonged period of discomfort that extended from the hip to the toes of both legs. He experienced difficulty in standing up after prolonged periods of sitting, particularly from chairs, and was unable to ascend stairs due to discomfort. While walking, the patient experienced difficulty maintaining the initial step. Subsequently, the patient was able to walk normally. He found it difficult to bend forward. The pain was most predominant during the early morning hours and heaviness present in the lower back region while riding the bike.
The individual sought medical attention at an allopathic hospital and was advised to undergo an MRI, which revealed a protrusion of the L4 to L5 discs. In order to address this issue, he underwent Decompression and foraminotomy surgery in August 2022. Six months after his surgery, he experienced a recurrence of the pain, which was almost identical to the initial onset. He then started looking for the best Ayurvedic treatment centres in India. He heard about Sree Subhramania Ayurvedic Hospital from patients’ reviews, so he checked it out. Initially, he received treatment online, and then he was admitted for a period of three weeks. Upon examination, there was evidence of tenderness at the L4 to L5 levels and L5-S1 level along with lumbar spondylotic changes, and the patient’s hip joint movements were restricted and painful. Following a Panchakarma Treatment, combined with effective internal medication and physical activity, the patient’s pain level has decreased to 90-93%, potentially leading to a return to a normal, healthy lifestyle.
Treatment protocol
Internal medication:
- Rasnamrutadi kashaya
- Abhayarishta +punarnavasava
- Hinguvachadi choorna
- Tribhuvana Keerthi rasa
- Vatari ghrita
Panchakarma procedure
- Dhanyamladhara for 14 days
- Choorna Vasthi for 3 days
- Grihadhoomadi lepa for 9 days
- Agnikarma for 1 day
| Sl.No. | Date | Treatment given |
| 1. | 09/10/2023 | Dhanyamladhara+choorna vasthi |
| 2. | 10/10/2023 | Dhanyamladhara+choorna vasthi |
| 3. | 11/10/2023 | Dhanyamladhara+choorna vasthi |
| 4. | 12/10/2023 | Dhanyamladhara |
| 5. | 13/10/2023 | Dhanyamladhara |
| 6. | 14/10/2023-22/10/2023 | Dhanyamladhara+Theppu/Lepa (Grihadhoomadi) |
| 7. | 22/10/2023 | Agni karma |
Advised diet and lifestyle modifications:
- Include red shali rice, black gram, wheat in food
- Avoid taking chana, maize, and barley in excessive quantity
- Avoid taking cold, heavy, dry food materials
- Take milk, warm water, and coconut water in needed quantity.
- Avoid exposure to cold or air cooling etc.
- Free from excessive worries, fear, angry, excessive thinking, crying etc.
- Have fruits like mango, apple, black raisin, pomegranate etc.
Yoga Asanas
- Bhujangasana
- pawanamuktasana
- Shalabhasana
- Balasana
- Ardha chandrasana
- Setu bandha sarvangasana
(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)
MRI investigations report
- L5-S1 level: Diffuse disc bulge with posterior central disc protrusion &caudal migration ~ 1.5cm from superior endplate of S1 vertebra, intending on anterior thecal sac causing severe spinal canal stenosis, narrowing of bilateral lateral recess thereby compressing bilateral S1 traversing nerve roots.
- L4-L5 level. Mild diffuse disc bulge indenting on anterior thecal sac causing mild spinal canal stenosis, narrowing of bilateral lateral recess thereby impinging on bilateral L5 traversing nerve roots.
- Lumbar spondylotic changes are described.
Improvement Chart
| Sl.
No. |
Feature | Before treatment | After treatment |
| 1. | Lower back pain | Severe | 95% relief |
| 2. | Radiating pain in legs | Present from hip to toe | Nil |
| 3. | Standing up from sitting posture | Hard to get of chair due to pain | Not painful |
| 4. | Walking | Difficulty in initiating the first step | No difficulty in walking |
| 5. | Ascending stairs | Difficult due to pain | Within normal limit |
| 6. | Riding bike | Painful | Not painful |
| 7. | Morning hour aggravation | Present upto 1hr | Not present |
| 8. | Joint movements | Painful
Restricted |
Within normal limits |
| 9. | Tenderness in L4-L5 level | Present | Nil |
Ayurvedic Approach to Sciatica Pain
It is the lower back pain which is radiating down to both legs.it is caused due to the compression of the sciatica nerve. Depending on the severity of the sciatica, it can also cause weakness in the legs and changes in the bowel bladder that require surgery. The common causes include disc herniation, spondylolisthesis, piriformis syndrome etc. In ayurveda it is mentioned under vatavyadhi. There are different panchakarma treatment options such as dhyamladhara, abhyanga, kati vasthi, choorna vasthi, tailadhara,agnikarma and so on. The choice of the right treatment depends on the prakriti of the patient and the severity of the condition.
