Sciatica is the name given to the disease in which there is pain, tingling or numbness due to irritation of the nerve roots that form the sciatic nerve, which originates in the lower back and extends down into both the legs till the feet. Cervical Spondylosis is the name given to the disease in which there is pain, tingling or numbness due to irritation of the nerve roots that form the brachial nerve, which originates in the neck and extends down into both the arms till the hands.
Both diseases are discussed here together, since the causative factors, symptoms and the treatment required for both are very much similar, only the location of the pain is different. The pain of sciatica is in the lower back, radiating down to the leg and foot, whereas the pain of cervical spondylosis is in the neck and shoulder, radiating down to the arm and fingers. Sciatica pain has typically more of a dramatic onset, usually due to a ruptured or herniated disc which presses on the nerve roots and causes the pain. The pain can be severe enough to cause acute limitation of movement. This can happen in cervical spondylosis too, however, here it is more common to have a gradual onset of pain due to degeneration of the neck vertebrae.
In Ayurveda, sciatica is called as “Grudhraci” and cervical spondylosis is called as “Vishwachi”. Ayurvedic treatment of sciatica consists of the following procedures:
(i) “Snehan” ( use of local medicated lubricants)
(ii) “Swedan” (local fomentation)
(iii) “Basti” (Medicated enema)
(iv) “Anuloman” ( mild laxative treatment for prolonged periods)
(v) “Dahan” (local heat branding ) and
(vi) “Shaman” ( symptomatic oral treatment).
Vishgarbha oil in acute condition, and Mahanarayan oil ( containing mainly Asparagus racemosus) for chronic pain is used for local snehan procedure. Local fomentation can be done mainly in two ways. The first is “Naadi swedan” in which, a jet of medicated steam is directed at the back and affected leg, usually after the snehan procedure. A decoction of Nirgundi (Vitex negundo) is usually used for this procedure. The second procedure is called as “Awagah swedan”, in which the patient is made to recline in a tub filled with warm decoction of Nirgundi, Dashmool (Ten Roots) or ErandMool (Root of Ricinus communis).
Medicated enemas are given using Vishgarbha oil, Mahasahachar oil and Mahanarayan oil.
Castor oil and Haritaki (Terminalia chebula) treated with castor oil are used for mild, prolonged laxative treatment.
Local heat branding is used by some physicians to reduce severe pain in the leg. The branding is usually done at the site of maximum tenderness in the lower back or buttock.
Oral medications include Mahavat Vidhwans, Vata Gajankush, Maharasnadi decoction, Triphala Guggulu, and Yograj Guggulu. Guggulu (Commiphora mukul) compounds and other herbal combinations are given for prolonged periods depending upon the symptoms and severity of pain.
Most patients respond well to these medicines and are usually cured in a period of 1- 3 months. For degeneration of the cartilage or bones, prolonged treatment may be required. Though rare, it is important to rule out other cause of sciatica, like tumor. If there is gross structural damage to the back-bone, this may have to be first treated surgically. Ayurvedic herbal medicines, given later, may help in recovery of nerve damage.
The same treatment applies to cervical spondylosis, except that enema and laxative treatment may not be helpful here, and the heat branding is done on the shoulder blade. Fomentation is done using the “naadi swedan” procedure. A specialized form of enema, called “Tikta-ksheer basti” is used in severe cervical spondylosis, and the repeated use of this enema gives results where other treatments have failed.
It is advisable to avoid cold (refrigerated) food products, as also foods which may cause abdominal bloating. It is also better to refrain from very vigorous and heavy work or exercise.