Management of Katigata Vata by Ayurvedic Medicine

Abstract:

Lumber Spondylosis is a degenerative condition which affects the lower spine. In patient with Lumber Spondylosis, the spine is compressed by narrowing of the space between vertebrae, causing variety of health. Problems ranging from back pain to neurological issues. As per the modern management is concerned, there is no established treatment for it except surgical intervention; which causes complications and side effects. Hence Ayurvedic treatment is one of best for management of Lumber Spondylosis. The present case study has focus on effectiveness of Panchkarma combined with Shamana therapy.

Keywords : Lumber Spondylosis, Katigata Vata, Panchkarma, Shamana therapy

Introduction: Spondylosis (Cervical, Thorasic, Lumber) affects nearly 80% of population. If is most common cause of job related disability leading to missed work and second most common neurological ailments. As a result patient develops numbness, tingling and pain which seem to radiate out from the area.These symptoms are the result of pressure on nerves exit spinal cord. According to Ayurveda function of body with basic three humors (Doshas) i.e.Vata, Pitta and Kapha for a body to function in its optimum state these three doshas must function in equilibrium. At dis-equilibrium they causes disorders at these site. When the function of these three doshas are hampered at Lumber region it is called as Katigata Vata. Ayurvedic approach for treatment of Lumber Spondylosis is to maintain Vata, Pitta, Kapha at equilibrium.

Case Report

Case History:
Patint Name: ABC
Age: 29 years
Sex: Male
Residence: Prabhadevi, Mumbai.
Occupation: Policeman
D.O.A.-12/07/2013 D.O.D.-07/09/2013
C/O
-Severe lower backache since 15 days -Uvable to sit/stand/walk since 3 days

History of Present Illness:

Patient was apparently all right before 15 days, After that he had developed lower backache for that he took symptomatic treatment in spite of that he developed severe lower backache, So patient came to M.A.Podar Hospital for above said complaints.

Past History:

H/o Fall from height approx 10 feet before 10 years.
Medical: No H/O HTN/DM/PTB/BA/Epilepsy or any major medical illness.
Surgical: No H/O Any surgical illness.
Family History: NAD
Medication History:
1) Tab.Tramadol (50mg) BD For 10 days
2) Tab.Shelcal (500mg) OD
O/E
GC: Fair, Afebrile Pulse: 76/min BP :120/84 mm of Hg
S/E
RS: AEBE, Clear CVS: S1 S2 NAD CNS: Conscious ,Oriented Pupils : Rt. And Lt. NSRTL
RTVC , RTDS
Plantars: B/L Flexor

DTR:
Knee Jerk Ankle Jerk Biceps jerk Triceps Jerk Right 2+ 2+ 2+ 2+ Left 2+ 2+ 2+ 2+

MPG:
Right Left Upper Limb 4/5 3/5 Lower Limb 4/5 3/5

SLRT- RT.-45 degee Painfull
LT.-20 degree Painfull
P/A: Soft, NAD.
Urine and Stool : Passed.

Investigation: On Admission-

Hb-13.4gm%
RBC,WBC- WNL. ESR-50 mm/hour RA test- Negative
BSL- F:102 mg/dl PP:130 mg/dl
LFT and RFT: WNL Lipid Profile:WNL

MRI of L.S. Spine done on 12/07/2013 shows :

• Scoliosis of the lumbar spine,with convexity to left.
• Marginal osteophytes at multiple level.
• L3-L4 disk reveals diffuse posterior bulge compressing thecal sac without neural compression.
• L4-L5 dick reveals broad based posterocentral protrusion compressing thecal sac and bilateral L5 nerve root.Facetal arthropathy and ligamentum flavum thickening is noted at this level, contributing to central canal stenosis.

Nidan Panchaka:

Hetu: Aghataj
Poorvaroopa: Mild pain in Lumbar region.
Roopa: Severe pain in Lumbar region. -Unable to sit/stand/walk.
Smprapti: Vata Prakopak Aahar- Vihar and Kaal(Vardhakya)

Vitiation of Vata causes Asthikshaya &Diminuition of Sandhistha Shleshaka Kapha
Prakupit Vata gets accumulated in area with Khavaigunya at Katipradesh
Causes symptoms of Pain, Tenderness and Katigraha
Katigata Vata

Nidan: Katigatavata

Diagnosis According to Modern Pathophysiology of Lumbar Spondylosis.

Treatment Given:

Aabhyantar Chikitsa:

1) Lakshadi Guggulu 500 mg tds (Vyankali)
2) Trayodashang Guggulu 500mg tds (Vyankali)
3) Rasraj Ras 125mgm+ Padmakashtha Churna500mg tds (Apanakali)
4) Simhanada Guggulu 500mg tds (Vyankali)
5)Maharasnadi Kwatha 20ml ( Vyankali)

Panchakarma Chikitsa:

Sarvang snehana-Nadi swedana 15 days
Pindaswedana 15 days
Katibasti(By Murivenna Tail) 30 days
Panchtiktaksheerabasti 15 days

Pathya:

1) Aaharaj: Yava,Kultha,Vari,Nachani,Lasuna,Aardrak,Jangal Maansa,koshna Jala.
2)Viharaj: Aalpa Vyayam.

Apathya:

1) Aaharaja: Dadhi, Matsya, Dugdha, Masha.
2) Viharaja: Ratrajagaran, Divaswapan,Vegadharan.

Results:

1) Subjective:

Symptoms                        Before Treatment              After Treatment
Pain in Lumber region        +++(Severe)                       +(Mild)
Difficulty in walking       Unable to walk                  Can Walk
                                        with support also.              Without Support also.

2) Objective:

MPG

                       Right    Left     Right     Left
Upper Limb      4/5        3/5      5/5        5/5
Lower Limb     4/5        3/5      5/5        5/5

SLRT              Before Treatment           After Treatment
RT.                    45degree                        90degree
LT.                    20degree                        75 degree

Discussion:

Sr.No. Kalpa Contents Karma 1) Lakshadi Guggulu Shuddha Laksha, Asthi Shrunkhala, Ashwagandha,Nagabala, Shodhit Guggulu Asthisandhankar, 2) Trayodashanga Guggulu Babultawaka,Ashwagandha, Guduchi,Hapusha ,Shatavari, Ajamoda,Guggulu,Goghruta. Balya,Rasayana, Asthidhatwagnivardhana 3) Rasraj Rasa Rasasindoor, Abhraka Bhasma, SuvarnaBhasma,LohaBhasma Roupya Bhasma, Vanga Bhasma,Ksheerkalcoli. Reduces nervine irritation and inflammation, Helps in strengthning them. (as per modern terminology in comparision with Ayurveda) 4) Maharasnadi kwatha Rasna,Shatpushapa,Deodaru, Vacha,Aragvadha,Shunthi, Punarnava Haritaki,Musta, Guduchi Vataghna

References:

1) Charak Samhita Dr.Ravidutt Tripathi Chaukhamba Sanskrit Pratishthan 2002
2) AshtangHrudyam Dr. Brahamananda Tripathi Chaukhamba Sanskrit Pratishthan 2007
3) Sushruta Samhita Kaviraj Ambikadutta Shastri Chaukhamba Sanskrit Pratishthan 2002
4) Harrison’s Principles of Internal Medicine Dennis Kasper Medical Publishing Division 2006