“Role of Sequential Administration of Ayurveda Protocol in the Management of Gridhrasi w.s.r. to Sciatica -A case Study”

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Correspondence Address

Government Ayurved College And Hospital Nagpur Sakkaradara Square Raje Raghuji Nagar 440024
Contact No. : 9527553065, Email : pragatidoye9@gmail.com

Date of Acceptance : 25 Dec 2025

Date of Publication : 31 Dec 2025

Article ID : SD-IJAY_154

How to cite this article : http://doi.org/10.55552/SDNJAY.2025.3405

Abstract

Sciatica is a prevalent neuromuscular disorder characterized by pain radiating along the course of the sciatic nerve, extending from the lower back through the buttock and down the lower limb. It significantly affects mobility, occupational performance, and overall quality of life. In Ayurveda, a clinical condition comparable to sciatica is described as Gridhrasi, which is classified as a Vata-dominant disorder in classical texts. Gridhrasi is characterized by symptoms such as pain (Ruk), stiffness (Stambha), pricking sensation (Toda), heaviness (Gaurava), and restricted movements of the affected limb. These symptoms are often exacerbated by improper posture, excessive physical activity, faulty dietary habits, and suppression of natural urges.

From a modern medical perspective, lumbar disc herniation causing nerve root compression is the most common etiology of low back pain associated with radiculopathy, resulting in radiating pain along the leg. Conventional management of sciatica primarily focuses on symptomatic relief using analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), with limited long-term benefits.

Ayurveda advocates a comprehensive therapeutic approach for the management of Gridhrasi, including Snehana (oleation), Swedana (sudation), Siravedha (bloodletting), Basti (medicated enema), and Agnikarma (therapeutic cauterization), administered in a systematic and sequential manner.

This case study reports the management of sciatica in a 52-year-old female patient treated with Viddhakarma, Basti karma, Agnikarma, and Shamana Chikitsa (internal medications). The patient demonstrated marked clinical improvement, with significant reduction in pain and functional disability, highlighting the potential effectiveness of Ayurvedic interventions in the management of sciatica (Gridhrasi).

KEY WORDS:-  Gridhrasi, Basti, Viddhakarma, Agnikarma, Shaman  

Introduction

Low back pain is a highly prevalent condition, with a lifetime incidence ranging from 50% to 70%, of which sciatica accounts for more than 40% of cases [1]. Sciatica is a common clinical entity, with reported lifetime prevalence varying between 13% and 40%. The annual incidence of sciatica episodes ranges from 1% to 5%. It is predominantly an age-related disorder, rarely observed before 20 years of age, with peak incidence occurring in the fifth decade of life, followed by a gradual decline thereafter [2].

From a modern medical standpoint, lumbar intervertebral disc herniation leading to nerve root compression is the most frequent cause of low back pain associated with radiculopathy. Sciatica commonly results from involvement of the L4, L5, or S1 nerve roots and is characterized by unilateral neuropathic pain originating in the gluteal region and radiating along the posterolateral aspect of the thigh, leg, and foot [3].

In Ayurvedic literature, sciatica is described under the disease entity Gridhrasi, wherein the patient’s gait resembles that of a Gridhra (vulture). This altered gait occurs due to severe pain affecting the lower back and lower limb, leading to limping toward the affected side [4]. Gridhrasi is classified into two types: Vataja and Vata-Kaphaja. Vataja Gridhrasi is characterized by symptoms such as stiffness (Stambha), pain (Ruk), pricking sensation (Toda), and frequent tingling (Spandana). In Vata-Kaphaja Gridhrasi, additional features such as loss of appetite (Aruchi), drowsiness (Tandra), and heaviness (Gaurava) are observed [5].

Ayurveda advocates a multimodal therapeutic approach for the management of Gridhrasi, including Snehana (oleation), Swedana (sudation), Basti (medicated enema), Siravedha (bloodletting), and Agnikarma (therapeutic cauterization), administered in a sequential manner. In addition to these procedures, the Shamana line of treatment, involving the oral administration of medicinal formulations, plays a significant role due to its ease of administration and therapeutic effectiveness [6].

Discussion

In Ayurveda, the management of Gridhrasi involves both Shodhana (bio-purificatory) and Shamana Chikitsa (palliative therapy), along with specialized procedures such as Siravedha, Basti, Viddhakarma, and Agnikarma. These interventions are considered relatively safe, require minimal infrastructure, are cost-effective, and are associated with fewer complications when performed appropriately. Among these, Shamana Chikitsa, which includes the oral administration of medicinal formulations, plays a crucial role by addressing the underlying pathophysiology of the disease through regulation of vitiated Doshas, rather than merely providing symptomatic relief. This approach also offers the advantage of better patient compliance and minimal adverse effects.

Probable Mode of Action of Snehana

External application of medicated oils through Snehana (oleation therapy) enhances local microcirculation and lymphatic drainage. This facilitates the removal of inflammatory mediators and metabolic by-products that sensitize peripheral nociceptors in neuropathic conditions, thereby contributing to pain reduction and improved tissue flexibility [12].

Probable Mode of Action of Swedana

Swedana (sudation therapy), whether localized or generalized, induces vasodilation and increases tissue metabolism. The resultant improvement in microcirculation aids in the clearance of inflammatory mediators and metabolic waste products, which are known to perpetuate peripheral nociceptor sensitization. This reduction in peripheral nociceptive input may help alleviate neuropathic pain [13].

Probable Mode of Action of Basti

Basti therapy is regarded as the most effective treatment for Vatavyadhi, as described by Charaka Acharya. In Ayurvedic philosophy, Basti directly pacifies vitiated Vata Dosha, which is primarily responsible for neurological and musculoskeletal disorders. From a modern perspective, Basti is believed to provide deep nourishment and lubrication to neuromuscular tissues, potentially supporting nerve function and reducing mechanical irritation at nerve roots [14].

Ehretia laevis (Khandu-chakka) contains flavonoids, phenolic compounds, and other bioactive constituents with proven analgesic, anti-inflammatory, and antioxidant properties in pharmacological studies. When administered as oil-based Basti (Anuvasana, Matra, or Snehika Basti), lipid-soluble components may be absorbed through the rectal mucosa into local tissues and systemic circulation, thereby exerting biochemical anti-inflammatory and analgesic effects [15].

Clinical Ayurvedic studies have demonstrated that Dashamoola Niruha Basti, administered as part of Kala Basti regimens, significantly reduces pain intensity, improves mobility, and alleviates neural irritation in patients with Gridhrasi. Notable improvements have been observed in symptoms such as Ruk (pain), Stambha (stiffness), and Straight Leg Raise (SLR) test outcomes, supporting its therapeutic efficacy in radicular pain conditions [16].

Probable Mode of Action of Viddhakarma

Viddhakarma, also known as Suchivedhana or dry needling, involves controlled puncturing at specific anatomical sites to relieve Avarana (obstruction), pacify vitiated Vata Dosha, and release locally accumulated Doshas along with minimal bloodletting. This intervention helps reduce pain and stiffness. From a neurophysiological standpoint, needle stimulation may induce the release of β-endorphins and other endogenous opioid peptides, which act on central and peripheral opioid receptors to inhibit pain transmission [17,18].

Probable Mode of Action of Agnikarma

According to Ayurvedic principles, Agnikarma utilizes the Ushna (hot), Tikshna (sharp), Sukshma (penetrating), and Ashukari (rapid-acting) properties of therapeutic heat, which counteract the cold, heavy, and obstructive qualities of aggravated Vata and Kapha Doshas. This procedure helps in relieving Srotovarodha (channel obstruction), restoring Dosha equilibrium, and reducing pain (Shoola), which is predominantly associated with Vata vitiation [19].

Probable Mode of Action of Shamana Aushadhi

Lasunadi Vati:

Lasunadi Vati was prescribed for its Deepana (digestive stimulant) and Amapachana (metabolic detoxification) actions, as the patient presented with Sama Mala Pravritti and Aruchi (loss of appetite). The formulation predominantly contains ingredients with Kapha-Vatahara, Shoolaghna, Ushna, and Tikshna properties, making it effective in enhancing digestion, correcting metabolic imbalance, and reducing pain.

Vatari Guggulu: 

The constituents of Vatari Guggulu collectively exhibit Vata-Shamaka, Kapha-Shamaka, Amapachana, Deepana, Vedana Sthapana, and Rasayana properties. Owing to its Ushna Virya and Vatanulomana actions, it helps normalize the functions of Apana and Vyana Vayu, thereby alleviating pain and improving mobility. Pharmacological studies indicate that Vatari Guggulu possesses anti-inflammatory and peripheral analgesic properties, which may reduce pressure on the sciatic nerve and enhance functional outcomes [20].

Shefalika Patra Kashaya (Nyctanthes arbor-tristis):

Shefalika Patra Kashaya has been specifically indicated for the treatment of Gridhrasi by Chakrapanidatta due to its pronounced Vata-Kapha Hara action [21]. The formulation possesses Tikta Rasa, Katu Vipaka, and Ushna Virya, which help counteract the vitiated Vata and Kapha Doshas responsible for the pathogenesis of Gridhrasi, thereby contributing to symptomatic relief and functional improvement [22].

Conclusion

The present case study highlights the effective role of Ayurvedic management in Gridhrasi (sciatica) through a comprehensive and individualized treatment approach. A multidimensional treatment protocol consisting of Shodhana therapies (such as Basti), Shamana chikitsa (internal medicines like Vata-shamaka and Vedana-sthapaka formulations), and appropriate external therapies (Snehan, Swedana, Agnikarma and Viddhakarma) resulted in significant reduction in pain intensity, stiffness, and improvement in mobility and daily activities. The therapeutic interventions worked synergistically to pacify aggravated Vata, improve circulation, reduce inflammation, and restore normal neuromuscular function. The outcomes observed in this case demonstrate that Ayurveda offers a safe, holistic, and cost-effective alternative in the management of Gridhrasi. Hence, the case study supports the efficacy of Ayurvedic modalities in the successful management of Gridhrasi and encourages further clinical studies with larger sample sizes to validate these findings scientifically.

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