Efficacy of Prasaranyadi taila Anuvasana basti in the Management of Gridhrasi (w.s.r. to Sciatica) – A Randomized controlled clinical trial

The most common musculoskeletal disorder affecting the movement of leg is low back pain. Among the affected patients, 40% have radicular pain and these cases can be classified under the umbrella term of sciatic syndrome. Low back pain is extraordinarily common, second only to the common cold.[1] The prevalence of Sciatica varies from 1.2% to 43% in different studies, and about 50% of working adults experience a back injury each year. Lifetime incidence is reported to be between 10% to 40% and an annual incidence of sciatica ranges from 1 to 5%. [2]

Sciatica is characterized by excruciating pain and paresthesias in sciatic nerve distribution associated lumbosacral nerve root which severely affects the quality of life of those affected.[3]

Physical activity during work and occupational workload, such as lifting heavy objects twisting the trunk while working, or being exposed to whole-body vibration (for example, machine operators or motor vehicle drivers), are all potential risk factors for Sciatica. These factors can create pressure on the spinal cord, leading to lower back pain and radiating pain.[4] In modern medicine, muscle relaxants, NSAIDs, corticosteroids, and other medications are often used to provide temporary pain relief. However, surgery may be required as a last resort, which can result in various complications and even permanent loss of working capabilities.[5]

In Ayurveda, sciatica seems to similar in signs and symptoms with Gridhrasi. Gridhrasi is a condition where the pain starts in the sphik pradesh area and radiates downwards to kati, prusta, uru, janu, jangha, and pada. Sciatica is a common cause of pain and disability and is more severe and persistent than low back pain

In this disease, mainly Vyana Vayu vitiation is observed, but Kapha is usually associated with Dosha.[6] So for the treatment of Gridhrasi, the drug of choice should have Vatashamaka, Kaphashamaka, Vatanulomaka, Dipana-Pachana(digestive-carminative), and Shulaprashamana properties.

Vasti is recommended as the best treatment for Vata because of how closely the Vata dosha and neurological system operate. It again validates the efficacy of Vasti karma on the nervous system. Charaka mentions that the administration of Anuvasana Vasti results in the nourishment of all pathways once it reaches Nabhipradesh, which is the central location of Sira(vessels) and Dhamani(channels).[7]

According to Bhaishyajya Ratnavali, in the Phalashruthi of Kubja Prasaranyadi Taila, Gridhrasi has been mentioned, Because it balances the vata and kapha doshas, Pratisarini taila is a useful taila for Anuvasna basti. The quality of Prasaranyadi taila is described as "Vatashleshmabhayan jayet" in Bhaishjya Ratnavali.[8]

The components of prasaranyadi taila consist of kaphavatahara, katu tikta, kashaya, rastmak dravya.

Sahacharadi taila has been proven effective and widely used for conditions involving Gridhrasi. Prasaranyadi taila has Vatahara and Kaphahara properties. Prasaranyadi taila also contains Saindhav, Bhallatak, Jatamansi, Dadhi, and Kanji. Therefore, this study aims to determine whether the property of Prasaranyadi taila will be more effective in treating Gridhrasi compared to Sahacharadi taila.