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The name “sciatic” came via Latin from the Greek “ischiadikos” which means “subject to trouble in the hips or loins”.1 Sciatica is pain going down the leg from the lower back. The pain is along the sciatic nerve pathway.2 The sciatic nerve, also called the ischiadic nerve, is the longest and widest single nerve in the human body, going from the top of the leg to the foot on the posterior aspect. The nerve supplies sensation to the skin of the foot, as well as the entire lower leg (except for its inner side).3 The signs and symptoms of “Sciatica” are quiet similar to the condition called as “Gridhrasi”, where the name itself indicates the way of gait shown by the patient due to extreme pain, that is, “Gridhra” or Vulture.4

Sciatica is a relatively common condition with a lifetime incidence varying from 13% to 40%. The corresponding annual incidence of an episode of sciatica ranges from 1% to 5%.5 The condition is found most commonly in people aged 25 to 45 years. Men are more frequently affected than women.6 Sciatica Treatment in Ayurveda is a non-surgical approach to relieving sciatic pain with help of ayurvedic medicines and treatments. Sometimes one may need to undergo purificatory procedures to eliminate morbid doshas.

Sciatica Signs and symptoms7

  • Pain that radiates from your lower spine to your buttock and down the back of your leg 
  • The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain
  • Occasionally the pain is felt like a jolt or electric shock
  • Pain may be experienced when we move, sneeze, or cough
  • Some people also have numbness, tingling, or muscle weakness in the affected leg or foot
  • Pain may occur in one part of your leg and numbness in another part 

Causes for Sciatica

  • Herniated discs in the spine and bone spurs (bone overgrowth on the vertebrae) are age-related changes and the most common causes of sciatica.7
  • Obesity- excess body weight can contribute to the spinal changes that trigger sciatica.7
  • Spinal stenosis decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that become the sciatic nerve and is the most frequent cause after the age of 50 years.3
  • Pregnancy – Sciatica may also occur during pregnancy, especially during later stages, as a result of the weight of the fetus pressing on the sciatic nerve during sitting or during leg spasms.3
  • Piriformis syndrome is a rare neuromuscular disorder in which your piriformis muscle involuntarily contracts or tightens causing sciatica.8
  • Diabetes – this condition increases your risk of nerve damage.7

Tests advised in Sciatica

Physical examination

  • The patient may be asked to walk on toes or heels, and rise from a squatting position – pain resulting from sciatica worsens during these activities.9
  • Straight leg raise (SLR) test10 – This test includes the patient lying on his/her back and lifting one leg at a time with the other leg flat or bent at the knee. A pain encountered while lifting the affected leg usually indicates sciatica
  • Slump test10 – This test includes the patient seated upright with hands behind the back. The patient bends (slumps) forward at the hip. The neck is bent down with the chin touching the chest and one knee is extended to a degree possible. If the pain occurs in this position, sciatica may be present
  • X-Ray9 – X-Ray of the spine may reveal an outgrowth of bone that may be pressing on a nerve
  • CT and MRI9– produce detailed images of bone and soft tissues such as herniated disc

Ayurvedic view on Sciatica

Gridhrasi is one of the most common disorders of vata dosha which closely resembles sciatica.11

Two types of Gridhrasi have been mentioned in Ayurveda classics and those are vataja and vata-kaphaja. The common symptoms are stambha (stiffness), ruk (pain), toda (pricking kind of pain), muhurspandana (tingling sensation) in the hip region and gradually radiating to the waist, back, thigh, knee, and calf regions when there is only vata dosha. Tandra (numbness), gaurava (heaviness), and arochaka (anorexia) are the symptoms when kapha along with vata dosha is involved.12

Etiology for Gridhrasi is mainly due to an increase in vata dosha caused due to food habits such as intake of excess dry, cold, astringent, and pungent food; fasting for longer periods, and irregular intake of food. Lifestyle habits include staying awake during the night, carrying heavy weights over back, heavy physical exercise, excess walking for longer distances, suppression of natural urges, and incorrect posture while sleeping. Stress, fear, and anxiety are a few psychological factors leading to sciatica.

Sciatica Treatment in Ayurveda

  • Snehana (oleation) therapy such as abhyanga (massage), Kati basti (localized treatment for the back with medicated oil), and Kati Pichu can be advised
  • Abhyanga (massage) therapy –massage is ideal for sciatica. The oils that can be used are karpooradi taila, bala taila, mahanarayana taila, sahacharadi taila, etc.
  • Kati basti – is a localized treatment in the back region where a small well-like structure is made with the help of black gram flour and the indicated warm medicated oil (temperature of the oil is maintained) is poured into the structure made and allowed to hold by the patient and the procedure continues for a specified time. Medicated oils that can be used are karpooradi taila, bala taila, sahacharadi taila, etc. 
Kati Vasti
  • Kati Pichu (sponging) therapy – a piece of the sterile cotton pad is dipped in warm medicated oil and applied over the back. Oils that can be used in this therapy are dhanvantaram taila, mahanarayana taila, sahacharadi taila, etc.
  • Snehana (oleation) therapy can be avoided when there is the involvement of kapha dosha as it may aggravate the condition
  • Swedana (sudation) therapy such as Nadi swedana (where perspiration is induced by passing steam over the body parts by using a special instrument), Patra pinda swedana (inducing perspiration by using a heated pack of herbal leaves such as Nirgundi, Arka, Eranda, Shigru, Karpooradi taila), shashtika shali pinda swedana (inducing perspiration by using a heated pack of well-cooked red variety of rice and milk), etc. can be done when there is only vata dosha.
  • Valuka Sweda ((inducing perspiration by using a heated pack of sand) is ideal for the vata-kaphaja type of Gridhrasi.
  • Mrudu Virechana (mild purgation) therapy can be advised with the intake of eranda Sneha (castor oil) along with milk.  
  • Basti (medicated enema) therapy is beneficial in relieving vata dosha. A few preparations to mention are eranda muladi niruha basti, dashamuladi niruha basti, sahachara taila, ksheera bala taila, etc.
  • Raktamokshana (blood letting) therapy- various modes of blood letting therapy are explained in Ayurveda. Siravyadhana (venepuncture) is advised for Gridhrasi.
  • Agnikarma (thermal therapy) is advised for sciatica or Gridhrasi in Ayurveda.

Common Ayurvedic medicines for Sciatica

Various ayurvedic medicines are used to treat sciatica depending on the dosha predominance. Few commonly used ayurvedic medicines are

Diet and Lifestyle to be followed in Sciatica

  • Calcium: Calcium is an important support structure for our bones. Foods with high calcium content are essential in strengthening bones14

           Ex: Milk, dark green vegetables, spinach, peas and beans, soybean, etc.

  • Vitamin D: Vitamin D helps our bones to absorb calcium and maintain the health of the bones14

           Ex: Milk, egg yolk, mushroom, etc.

  • Foods with abundant omega 3 and vitamin E such as oil seeds, nuts, and fish are also helpful14
  • The red variety of rice, wheat, butter, and cow’s ghee can be included in a regular diet13
  • Regular light exercise 
  • Gentle stretching of the lumbar spine

When to see a doctor7

Consult a doctor if there is sudden pain and is severe in the low back region or leg, numbness, muscle weakness in the leg; or loss of bladder or bowel control.

Conclusion

Sciatica is the most common condition that causes intense pain in the lower back and hips and radiates to the back of the legs. Sciatica Treatment in Ayurveda is advised based on the dosha involved. Vata dosha being predominant, the treatment modalities are to pacify vata. Other than Panchakarma therapies, procedures like Agnikarma and Siravyadhana are also beneficial in treating sciatica as per Ayurveda classics. 

NOTE:
“This article does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on this WebSite. If you think you may have a medical emergency, immediately call or visit your doctor.”
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References and citations

  1. https://www.medicinenet.com/nerve_sciatic/definition.htm
  2. https://en.m.wikipedia.org/wiki/Sciatica
  3. https://en.m.wikipedia.org/wiki/Sciatica_nerve
  4. https://www.joinsysmed.com/article.asp?issn=2320-4419;year=2019;volume=7;issue=2;spage=131;epage=138;aulast=Mohan
  5. https://academic.oup.com/bja/article/99/4/461/305514
  6. https://www.omnicsonline.org/india/sciatica-peer-reviewed-pdf-ppt-articles/
  7. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
  8. https://www.healthline.com/health/sciatica
  9. https://www.mayoclinic.org/diseases-conditions/sciatica/diagnosis-treatment/drc-20377441
  10. https://www.spine-health.com/conditions/sciatica/diagnosing-cause-sciatica
  11. https://www.semanticscholar.org/paper/Ayurvedic-management-of-Gridhrasi-with-special-to-a-Mohan-Sawarkar/1ea2be9a254ae9cba6254ac1243a74ec0385e242
  12. https://www.ayurvedatreatments.co.in/ayurvedatreatments/– Downloads(Ayurveda E books) CharakSamhita Thika tritiya Khanda pg.1163
  13. 10roots.com/blogs/healing-with-kottakal-ayurveda/ayurvedic-management-of-cervical-spondylosis
  14. https://www.sureshotayurveda.com/blog/foods-to-eat-and-avoi-in-cervical-spondylosis/

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