Comparative study on the management of lumbar spinal stenosis with neurogenic claudication between modern medicine and ayurveda treatment including marma chikitsa based on kevala vataja and urusthambha samprapthies A black box clinical trial

Spinal pain remains the leading cause of global disability.Lumbar spinal stenosis (LSS)  is a frequent cause of chronic low back and leg pain which is associated with significant disability and functional limitations.Symptomatic LSS typically described as neurogenic claudication (NC) characterised by unilateral or bilateral buttock,thigh or calf symptoms precipitated by prolonged standing or walking and relieved by sitting,lumbar flexion and lying down.The researchers of the present project find a lot of similarities in LSS causing NC and Urustambha as described by Acharya Charaka in chapter 27 chikitsa sthana sloga number 13,15,17 and 18.However till date there is no clear understanding of concept of Urustambha and its clinical application in the contemperory Ayurveda literature.To the best of our knowledge , the present study is the first to draw a parallel between Urustambha and LSS causing NC. This study is also the first of its kind where objectivization and stratification of Urustambha and LSS causing NC is proposed to be done on X ray,MRI and CT scan.According to samprapthi pathways 3 groups are considered.Group A – Kevala vataja ,group B-Urustambha group and group C with modern intervention. Sample size is considered to be 45 with 15 in each group as far as the paucity of Urustambha is considered.