An open single arm clinical trial to determine the effectiveness of Uloga Suttigai (Metal Cauterization) in the management of Vathathambam (Sciatica)

BACKGROUND

The Siddha system of medicine is based on a combination of ancient medical practices and spiritual disciplines In the text Yugi vaythiya chinthamani Yugimunivar classified the Vadha disease as 80 types and Vadathambam is one among them.In modern medicine Vathathambam may be correlated with Sciatica Sciatica pain is the most common musculo skeletal conditions that have life time prevalence of up to 70 percentage and this seems to be increasing in incidences Sciatica is condition in which the patient experience pain and or paresthesias in the sciatic nerve distribution or an associated lumbo sacral nerve root the sciatic nerve is made up of the L4 through S2 nerve roots which coalesce at the pelvis to form the sciatic nerve At upto 2cm in diameter the sciatic nerve is easily largest nerve in the body Sciatic pain often is worsened with flexion of the lumbar spine twisting bending or coughing The sciatic nerve provides direct motor function to the hamstrings lower extremity adductors and indirect motor function to the calf muscle anterior lower leg muscle and some intrinsic foot muscles Also indirectly through its terminal branches the sciatic nerve provides sensation to the posterior and lateral lower leg and the plantar aspect of the foot The straight leg raise test is a passive examination Typically pain that is reproduced between 30 to 70 degrees of hip flexion and experienced primarily in the back is likely due to a lumbar disc herniation In modern medicine the condition is managed by electro therapy hydrotherapy and exercise therapy to the patients Suttigai is one of the 32 external medicines found in Siddha literatures under the topic Puramarunthugal Vathathambam is caused by vitiated Vatham In chronic condition Kabam also added with vitiated Vatham and produce severe symptoms and signs In Suttigai procedure is mostly used in chronic and severe symptoms This Suttigai procedure act over cutaneous receptor and first cause sharp pain through ascending pathway and activate the descending pathway endogenous analgesic system Periaqueductal grey matter PAGdorsal raphe nucleus nucleus raphe Magnus and medial reticular column which involves the various chemicals

Suttigai therapy is non pharmocological cost effective economically non viable easy to perform even at remote areas for management of sciatica

OBJECTIVE

To study the therapeutic effectiveness of Uloga Suttigai (Metal cauterization) in reducing the clinical signs and symptoms of Vathathambam (Sciatica) through VAS scale and Oswestry low back Disability Index

STUDY DESIGN

An open single arm clinical trial with a total number of 30 diagnosed patient of Vathathambam Sciatica reporting at Ayothidoss Pandithar hospital National Institute of Siddha will be enrolled in the study patients having history of uncontrolled Diabetes Rheumatoid arthritis Chronic alcoholism Psychiatric illness Limb weakness Foot drop fracture infective arthiritis Pregnant and Lactating women will excluded The trial procedure suttigai will be given for 48 days