A Randomized controlled trail to evaluate the effect of Kulaththa kwatha vaitarana Basti and Madanaphala Vaitarana Basti in the management of Vata-Kaphaja Gridrasi (Sciatica)

Panchakarma is a unique approach of Ayurveda which is especially designed for internal purification of body via nearest possible route  Vamana Virechana Basti  Nasya and Raktamokshana are the Panchakarma

Changing Lifestyle of modern human being has created several disharmonies in the biological system of the body as the advancement of busy professional and social life improper sitting posture in office factories continuous and over exertion jerky movements during travelling and sports which are major cause for creating undue pressure over spinal cord by postural impairments which in turn leads to many pathological conditions like lower backache sciatica etc Now a days most common disorders which effects the movements of leg particular in middle age is low backache out of which 40 percent are radiating pain which comes under sciatica syndrome effecting greatly in day today routine work Exact data on the incidence and prevalence of sciatica are lacking In general an estimated 5 percent to10 percent of patients with low back pain have sciatica whereas the reported lifetime prevalence of low back pain ranges from 49 percent to 70 percent  The annual prevalence of disc related sciatica in the general population is estimated at 2.2 percentage

Gridhrasi is enumerated as one among the Vataja Nanatmaja and Samanyaja VataVikaras It is pain dominant lifestyle disorders in which the pain starts from spik Pradesh and radiates downwards to Kati Prusta Uru Janu Jangha and Pada Here piercing type of pain which restricts the movements of the affected leg make his or her gait like bird vulture and put them in disgraceful condition  Ayurveda categorized Gridrasi as one of the disease caused by vitiation of vata which is responsible for the movement and functions of the body Even Kapha vitiation along with Vata also causes Vata-Kaphaja Gridrasi This vyadi is characterised by sthamba Toda Ruk and spandana These lakshana in sphik and kati gradually involves jaanu janga uru and pada The classification of Vyadhi is done based on involvement of dosha either vata or kapha Acharyas have mentioned the lakshana based on these dosha pradhanata They are shoola supti stamba in vatapradhanjaand in kapha pradhanaja tandra,gourava and arochaka The treatment is based on dosha involvement Acharyas have explained that the chikitsa depends on vatavyadhi samprapti ie kevala vata and avaranajanaya   vata Vyadhi. Considering this as samprapti they had mentioned about the basti karma.

Basti is one among the Panchashodhana and is considered as half of all treatment modalities ArdhaChikitsaIt is most important constituent of Panchakarma due to its multifocal effects It eliminates Vata dosha along with other doshas by entering Mulasthana  Basti is the Ardha chikitsa for Vata dosha Niruha basti helps to eliminate Pitta and Kapha dosha and thereby brings down Vata to prime sthana and helps to attain VatanulomanaBy proper modulation Basti can perform multidimensional tasks It can act as Shodhana and Shamana as well as Brimhana based on different combination of drugs

Vaitaranabasti is a type of Niruha basti which is mentioned in Chakradatta Vangasena Samhitaand Vrunda Madhava It is Shodhaka and Kaphavata Shamaka in nature  Vaitarana basti can be administered in such patients in initial stage itself to relieve pain and inflammation immediately compared to other external therapies and internal oral medications

Saindhava lavana guda chinchakalka taila and gomutra are the ingredients of Vaitarana basti Guda is having sara guna and Sristha vinmutra Chincha kalka is anti-inflammatory and analgesic Since it is having Amla rasa it acts as a mudha vatanulomaka also Vaitarana basti acts as Anti-inflammatory and analgesic There are many treatment protocols for Gridrasi in its initial phase to reduce Aamavastha or anti-inflammatory phase like internal medication ruksha basti, ruksha sweda application of lepa etc Among these Vaitarana basti deserves the most important place

In present study Madanaphala kashaya   is replaced in the Vaitarana basti It is intended to take Madanaphala kashaya in place of gomutra as due to fear of unhygienic chances of infection from leptospirosis etc and also due to reduced availability of hygienic Gomutra Also the religious aspects binds the limitations in usage of Gomutra  Madanaphala kashaya being Tikta Madura rasa laghu ruksha guna kapha vatahara and Laghu ushnain nature and does the aamanirharana In the Vatakaphaja Gridrasi   the above said properties are helpful

Kulattha is one of the drugs in Niruha gana mentioned in Astanga HridayaSutrasthana 15thchapter Shodhanadi gana sangrahaniyamadhyayaThe peculiarity of this gana is that we can pick a single drug from gana and it is not mandatory that all the drugs of gana should be used as a whole Among the drugs in Niruha gana, Kulattha is the one which acts subsequently like gomutra due to its similarities in their properties  Kulatha kwatha yukta Vaitarana basti acts as Anti-inflammatory and analgesic Where Vaitarana is said to be Shodhaka and Kaphashamaka and amahara It is less expensive needs minimum man power as the route of administration is rectal route and there is no question of palatability So an attempt was made to evaluate the efficacy of Madanaphalakashaya Vaitarana basti in Gridrasi and to document it for future use this present study has been selected