Conservative management of RTA induced chronic Low backache - A Case study
Introduction: A 49 yr old male patient with severe low backache (LBA) and unable to stand or walk was treated conservatively with ayurvedic medicine and Panchkarma therapies to avoid the advised laminectomy.
Case presentation: Patient presented with sustained LBA and weakness in left leg from last 1 year but the complaints got aggravated since last 10 days with symptoms like shooting pain in lower back; inability to sit, stand or walk and tenderness in lower back with numbness in left leg. SLR was positive being 0 degree on right leg and 20 degree on left leg. Patient had history of Road traffic accident (RTA) in 1993 with weak right upper and lower limb and short right lower limb. MRI LS suggestive of PIVD at L2-L3, L3-L4 and L4-L5 levels. More at L4-L5 level causing focal secondary canal stenosis and compression over the thecal sac with contained nerve roots. Management was done with Panchkarma treatment in IPD over three admissions and three months in total with medicines.
Management and Outcome: Panchkarma was done with Patrapinda sveda, Nadi sveda, Matra vasti for 7 days and shalishashtika pinda sveda for 21 days initially in which pain subsided. In second round shalishashtika pinda sveda and matra vasti was given for 15 days, in which patient was able to stand and walk with support for 40 – 50 steps. In third round snehadhara for 15 days, this increased the power in legs and resulted in sensory improvement in right upper limb and increased standing and walking capacity to more than four hundred meters. SLR improved to Rt – 60 degree, Lt 80 degree.
Materials and Methods: Ayurveda explains this disease under the title vatavyadhi as Katishula and katigatavata. The treatment available for the disease in modern medicine is not very satisfactory. The present study was aimed at establishing the holistic approach of management by Ayurveda. Therefore, abhyang, swedan – Patarapinda sveda and Shalishashtika pinda sveda, katibasti, Matra basti and Snehadhara were selected for the present case.
Discussion: The case was diagnosed as Vatavyadhi – Katigatavata following injuries sustained in RTA in past and recently as a result of fall when unbalanced which aggravated the symptoms. Snehana and svedana formed the first line of treatment to pacify the vitiated vata while shalishashtika pinda sveda worked as balya and poshana for mansa and asthi dhatu along with matra vasti. Snehadhara improves motor as well as sensory system thus resulting in improved sensory function in the right upper limb which had zero sensory function at the time of first admission.
*Head, Department of Panchkarma
**Clinical Registrar, Department of Panchkarma
***Assistant Professor, Department of Roga Nidana evem Vikriti Vigyana
Chaudhary Brahm Prakash Ayurved Charak Sansthan,Khera Dabar,Najafgarh,New Delhi.
Results: After treatment patient recovered symptomatically, the backache was very mild and intermittent. In addition, the patient was able to keep erect posture and to carry out the daily routine.
Conclusion: The treatment regimen given was effective and showed substantial improvement in the patient.
Lumbar spinal stenosis, Matra Vasti, Snehadhara
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