Ayurvedic management of Spinal canal Stenosis:A single case study

Background: Lumbar spinal stenosis usually is a degenerative condition, it is localized to facets, joints, ligamentum flavum of vertebra. Herniated disc is common cause of stenosis in younger generation. In this condition patient experiences maximum pain in unilateral direction, which gets aggravated with prolong standing or lumbar extension. The distribution of pain in the lower extremities is dependent on area of stenosis but feels relief while at rest. According to Ayurveda, based on resembling clinical manifestation this condition can be co-related with Grudhrasi. Aim: To understand the efficacy of Ayurveda treatment protocol in the management of lumbar spinal cord stenosis (Grudhrasi). Materials and Method: A 33 years old female suffering from complaints of Katishool (lower back pain), radiating to right lower limb, which increased while sitting, over standing and walking since past 2 months, presented in the OPD. The above complaints exasperated over the last 15 days. On the basis of clinical presentation and MRI finding the condition was diagnosed as lumbar spinal canal stenosis (Grudhrasi). A multimodal therapeutic intervention as per Ayurveda with Snehan (Oleation/Massage), Swedan (sudation), Marma Chikitsa (vital point simulation therapy), Katibasti, Ksheer Basti (milk enema), Agnikarma (cautery) were prescribed for 10 days. Clinical assessment was done before, during and after treatment on the basis of Oswestry disability index questionnaire. Observation and Results: Before treatment Oswestry disability questionnaire was 26(52%) and after the complete treatment patient reported relief in symptoms of Ruk (pain), Stambha (stiffness), Muhuspandan (cramping), distribution of pain significantly reduced and score was only 4(8%). Conclusion: The present case study revealed that the multiple Ayurveda treatment modalities including Shaman and Shodhan Chikitsa (palliative and purification therapies) were effective in curing the lumbar spinal canal stenosis.