Author: Dr. Vikram Chauhan

Ayurvedic Solutions for Sciatica Treatment and Prevention

Abstract

Sciatica is a debilitating condition in which a patient suffers pain and paresthesias in the sciatic nerve distribution. It is commonly referred to as any lower back pain or radicular leg pain. The pain is associated with the pathology of the sciatic nerve or sciatic nerve root pathology. The sciatic nerve is the largest nerve in the body. Pain due to the sciatic nerve will worsen with the flexion of the lumbar spine, twisting, and bending. Motor functioning of lower extremities adductors and hamstring is directed by the sciatic nerve. It also provides indirect motor functioning to the calf muscles and anterior lower leg muscles. The sciatic nerve provides sensation to the lower and posterior aspects of the legs and also the plantar aspect of the feet. Is due to the inflammatory changes in the nerve and causes irritation of the nerve. Direct compression of nerves leads to motor dysfunction. Let’s discuss this in detail!

Introduction

Sciatica is a painful condition in which the sciatic nerve of one or both legs is involved. It is much associated with lower back pain radiating to the legs and affects the movement of the legs. It is a neuromuscular disorder. As per the ayurvedic system of medicine it is known as Gridhrasi. The word Gridhrasi is derived from the word Gridhra which means Vulture ( a bird ). The gait of the patients resembles a vulture that’s why it is known as Gridhrasi. The gait is altered as the legs become tense and slightly curved due to pain. Sciatica is characterised by severe pain just like the pain felt by the prey of the vulture while being eaten up. This painful sensation is due to the vitiation of vata dosha.

Sciatica Pain

SYMPTOMS

  • Pain initiates from the hip area and radiates to the thigh, back, and sacral region.
  • Pain in calf muscles and feet.
  • Pricking sensation in the thigh region.
  • Altered gait.
  • Stiffness over the whole limb.
  • Weakness and numbness over legs and feet.
  • Hard to stand up.

CAUSES

  • Herniated or slipped disc:-   Pressure on the nerve root is caused by herniated or slipped disc. This is one of the most common causes of sciatica.
  • Spinal stenosis:-  It is the abnormal narrowing of the spinal canal. This leads to the narrowing of spaces for the passage of spinal nerves.
  • Spondylolisthesis:-  It is the slippage of one vertebra so that it is out of line one above it and narrows the nerve exit. The extended spinal cord pinches the sciatic nerve.
  • Osteoarthritis:-  Jagged edges of bones compresses the lower back nerves.
  • Trauma:-  Trauma injury to the lumbar spine and sciatic nerve.
  • Muscle Spasm:-  Small muscles that lie in the buttocks become tight and spasm. This can irritate the sciatic nerve.
  • Cauda Equina Syndrome:-  This condition affects the bundle of nerves at the end of the spinal cord. This causes pain down the leg and numbness around the anus.

DIAGNOSIS

1. Physical Examination

The physician will ask you to walk and notice how your spine carries your weight. Later you should be asked to walk on your toes to check the strength of your calf muscles.

1. Leg Raising Test

You have to lie on your back with straight legs. Then you have to slowly raise the legs and determine the point where the pain begins. This helps to identify the disc problems.

2. Radio imaging

  1. X- Rays:- To look for spinal fractures, disc problems, infections, and tumours.
  2. MRI:- MRI can show pressure on nerves, disc herniation, and any arthritic condition.
  3. Electromyography:- This is for examination of electrical impulses and how we’ll travel through the sciatic nerve.
  4. Myelogram:- To determine if a vertebra or bone is causing pain.

AYURVEDIC OVERVIEW OF GRIDHRASI  (SCIATICA )

Ayurveda is an ancient science that believes that a disease is caused due to the vitiation of doshas or by strotas dushti. When the pressure is exerted on the Gridhrasi Nadi ( sciatic nerve ) then there is a sensation of pain from the Kati Pradesh ( Lower back ) to the foot. In this disease, four strotas are being vitiated ( stroto dushti ).

  • Raktavaha strotas
  • Mansvaha strotas
  • Medovaha strotas
  • Pranvaha strotas

Gridhrasi is explained as among 80 types of vata imbalance disorders. It is a specific type of pain that travels from Stick Pradesh through the back of the Kati Pradesh and Urru till the foot.

COMMON CAUSES OF GRIDHRASI

  • Intake of vata aggravating foods like Bengal gram, Pigeon pea, Red lentils, and Flat beans.
  • Excessive intake of dry and cold food.
  • Suppression of mala ( urine and faeces)
  • Excess of walking
  • Trauma or injury

TYPES OF GRIDHRASI

There are two types of gridhrasi mentioned below:-

  • Vataj Gridhrasi
  • Vata kaphaja Gridhrasi

Symptoms of Vataj Gridhrasi

  • Shooting type pain
  • The curved posture of the leg and body
  • Stiffness and tingling sensation in the joints of the waist, thigh, and knee

Symptoms of Vata Kaphaja Gridhrasi

  • Poor appetite
  • Drowsiness
  • Excessive salivation
  • Anorexia

AYURVEDIC LINE OF TREATMENT

As this is the vata disorder, pacifying all vata measures should be undertaken.

Panchkarma

  1. Snehan:-  Application and pouring of oil over the affected area should be carried out.
  2. Swedana :-  Application of Poultice ( upnaha swed ) is effective.
  3. Anuvasan Basti:-  It is performed with saindhavadi oil.
  4. Virechan:-  In case of constipation virechan should be done.
  5. Agni karma:-  This is done in severe painful areas. It is done by using a metallic rod.

Herbs useful in sciatica

  1. Nirgundi
  2. Bala
  3. Punarnava
  4. Eranda
  5. Shigru
  6. Rasna
  7. Jambira
  8. Masha

HERBAL REMEDIES FOR SCIATICA BY PLANET AYURVEDA

Planet Ayurveda is a GMP-certified company offering products worldwide. All the products are prepared by following the ayurvedic texts under the guidance of MD Ayurveda experts. All the products are safe and devoid of all kinds of adverse effects. Let’s have a look at the formulations:-

SCIATICA CARE PACK

  1. HAKAM CHURNA
  2. BOSWELLIA CURCUMIN
  3. YOGRAJ GUGGUL
  4. ASHWAGANDHA CAPSULES
  5. VRIHAT VATCHINTAMANI RAS
  6. DHANWANTHRAM TAILAM

Herbal Remedies for SciaticaHerbal Supplements for Sciatica

PRODUCTS  DESCRIPTION

1. HAKAM CHURNA

It is a wonderful preparation by Planet Ayurveda. This is a classical herbal preparation that is very effective in sciatica and back pain disorders. This combination is also known as Tridoshic Rasayan. It affects all three doshas. Vata regulates the brain and nervous system, Pitta controls metabolism and Kapha maintains the body structure. Hakam Churna is a mixture of herbs like Chandershoor ( Lepidium sativum ), Kalonji ( Nigella sativaa ), Methi (Trigonella foenum graecum ), Ajwain ( Trachyspermum ammi ). All four herbs are present in equal quantity. It has the properties to bring vata in balance. It also improves digestion and decreases stiffness and pain.

Dosage:-  1 tsp. twice daily with warm water, after meals.

2. BOSWELLIA CURCUMIN

Boswellia curcumin capsules prepared by planet Ayurveda are the best preparation for inflammatory disorders. The results are long-lasting and the anti-inflammatory effect is permanent. This herb is effective and safe to consume as there are no side effects. The combination is very powerful for joint inflammation in vertebrae. Boswellia extract is generally made from tree gum. It contains at least 15 triterpene acids. Boswellia contains boswellic acid which is a very good anti-inflammatory and supports healthy joint functioning by inhibiting the leukotrienes. The addition of curcumin not only supports joint movements but is also a rich antioxidant. This combination provides comprehensive immune support.

Dosage:–  2 capsules twice daily with warm water, after meals.

3. YOGRAJ GUGGUL

Yograj Guggul is an ayurvedic preparation in tablet form which maintains the balance of vata in the body. It is a combination of various ingredients. It contains Chitraka (Plumbago zeylancia), Yavani (Trachyspermum ammi), Pippalimoola (Trachyspermum ammi), Karavi (Piper chaba), etc. All herbs are taken in fine powdered form. Guggul is melted and all the herbs are added to it. It is converted into tablet form in a uniform size of around 500 mg.

Dosage:-  2 tablets twice daily with warm water, after meals.

4. VRIHAT VATCHINTAMANI RAS

Vrihat Vatchintamani Ras is a classical preparation that is effective in balancing vata dosha. It is used in various nervous disorders. It contains ingredients like Swarna Bhasma, Abhrak Bhasma, Rajat Bhasma, Praval Bhasma, etc. It is enriched with antioxidants, anti-aging, nerve tonic, and many more properties.  It is excellent for increasing the strength of the body. It reduces the chances of age-related health issues. It is very effective in removing toxins from the body.

Dosage:-  1 tablet twice daily with warm water twice daily, after meals.

5. DHANWANTHARAM TAILAM

Dhanwanthram tailam is an ayurvedic oil preparation. It is effective in treating vata dosha disorders. This preparation is based on Kerala ayurvedic practice. It contains herbs like Balamool ( Sida cordifolia ), Agnimanth (Premna mucronate), Patala (Stereospermum suaveolens), Shyonaka (Oroxylum Indicum), etc. No side effects of this oil on external administration are noted.

Dosage:-  Massage externally after warming it up through a water bath method.

DIET AND LIFESTYLE CHANGES

DONOT’S

  • Avoid exercises that stretch your hamstring
  • Avoid sitting for longer times more than 20 minutes
  • Avoid the bed rest
  • Avoid bending over
  • Avoid twisting your spine
  • Avoid prolonged walking

DO’S

  •  Take a high-fibre diet
  • Maintain adequate body weight
  • Drink plenty of water
  • Mobilise and extend the lower back
  • Oil massages

CONCLUSION

Sciatica is a disease of the nervous system. It is characterised by radiating pain in the sciatic nerve. A person suffering from sciatica can have a great result by taking these formulations which have negligible side effects. This is far better than having painkillers that only act as symptomatic relief. Still, it is recommended that an expert’s advice should be taken before starting the treatment.

Understanding Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) – Symptoms, Causes, and Treatment

ABSTRACT

Arrhythmogenic right ventricular cardiomyopathy is a form of heart disease that usually appears in adulthood. Heart disease includes many heart problems which means it includes heart and blood vessel disease. The heart is a muscular organ which pumps blood through the blood vessels of the circulatory system. In humans, the size of the heart is approximately the size of a fist which is located between the lungs in the middle compartment of the chest. Usually, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles.

In a healthy heart, blood flows one way through the heart due to heart valves which prevent backflow. The walls of the heart are made up of three layers epicardium, myocardium and endocardium. The deoxygenated blood enters the heart through the right atrium from the superior and inferior vena cava and further passes to the right ventricle. Cardiovascular diseases are the most common cause of death. It is situated in the mediastinum at the level of T5-T8, a double membrane sc known as pericardium surrounds the heart and attaches to the mediastinum. An adult heart has a mass of 250-350 gm. The fibrous cardiac skeleton gives the structure to the heart and the cardiac skeleton provides the boundary in the heart’s electrical conduction system. In this article, we are going to discuss the causes, symptoms and ayurvedic management of ARVC (arrhythmogenic right ventricular cardiomyopathy).

INTRODUCTION

ARVC (Arrhythmogenic right ventricular cardiomyopathy) is a disorder of the myocardium which is the muscular layer of the heart. This condition causes the part of the myocardium to break down and increases the risk of abnormal heartbeat (arrhythmia) and causes sudden death. It is known as Arrhythmogenic cardiomyopathy (ACM), Arrhythmogenic right ventricular dysplasia (ARVD), which is inherited heart disease. It can be found in association with diffuse palmoplantar keratoderma and wooly hair which is an autosomal recessive condition known as Naxos disease. It is predominantly seen in males, 30-50% have familial distribution. The main clinical hallmark of this disease is ventricular arrhythmias which is arising from the right ventricle. The fatty fibrous tissue replaces the normal heart muscle which interrupts the normal signals in the heart and causes an irregular and life-threatening heart rhythm. Usually begins in the right ventricle (as the right ventricle stretches out and becomes thin and poorly contracts)  but after some time affects the left ventricle, so there is irregular heart pumping so blood backs up in the circulatory system which causes the fluid to build up in the soft tissues and sometimes in the lungs which further causes oedema and shortness of breath and results in heart failure. ARVC is a rare genetic disease which shows symptoms between the age of 10-50 years of age.

ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY

PATHOGENESIS

The cause is unknown, but apoptosis (cell death) plays an important role. This disease starts in the subepicardial region and moves towards the endocardial surface which leads to transmural involvement.  There are 2 pathological patterns which are seen in ACM/ARVC- Fatty infiltration and fibro-fatty filtration.

  1. Fatty infiltration-
  2. It is confined to the right ventricle and involves a partial and near complete substitution of the myocardium with fatty tissue without thinning of the walls.
  3. There is evidence of myocyte degeneration and death is seen in 50% of fatty infiltration.
  4. Fibro Fatty Infiltration-
  5. It is the replacement of myocytes with fibrofatty tissues.
  6. Myocardial atrophy is due to injury and apoptosis which leads to thinning of the RV free wall.
  7. These areas are prone to aneurysm formation

STAGES OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

There are 3 stages of ARVC (Arrhythmogenic right ventricular dysplasia)-

  1. Concealed Stage- There are no symptoms of abnormal heart rhythm while exercising.
  2. Electrical Stage- There is a high risk of ventricular arrhythmias and risk of sudden cardiac death, ECG shows abnormal heart rhythm issues.
  3. Structural Stage- They are at even higher risk of abnormal ventricular rhythm and sudden cardiac death.  

CAUSES

  1. It results from a genetic defect. 60% of people have genetic mutations. Due to mutations in the desmosomes, genes impair the functions of desmosomes, without normal desmosomes, cells of the myocardium detach and die so heart muscles come under pressure. The damaged myocardium gets replaced with fat and scar tissue. As the abnormal build-up walls of the ventricle get stretched out it prevents the flow and leads to changes in arrhythmia.
  2. There are 2 patterns of inheritance for ARVC-
  3. Autosomal Dominant- when one of the parents has a genetic mutation, it is more prevalent in Italy and other geographic areas
  4. Autosomal Recessive- When both the parents have genetic mutations but show no symptoms. It can be seen in Naxos disease which causes the thickening of the skin.
  5. Viral and inflammatory myocarditis
  6. Birth abnormalities which affect the right ventricle

SYMPTOMS

  1. ARVC causes chest pain which seems like a heart attack
  2. Ventricular arrhythmias- The irregular heart rhythms start in the ventricles or the lower chamber of the heart, the most common rhythm is ventricular tachycardia. Almost 77% of people are in this condition.  
  3. Supraventricular arrhythmias are most often in atrial fibrillation
  4. Heart Palpitations- that is the fluttering of the chest which forms abnormal rhythms of the heart.
  5. Chest pain
  6. Sudden cardiac death
  7. Shortness of breath
  8.  Swelling in the legs, ankles and abdomen
  9.  Fainting
  10. Lightheadedness

DIAGNOSIS

  1. Electrocardiogram (ECG/EKG)
  2. A Signal averaged ECG (SAECG)
  3. Cardiac MRI
  4. Holter monitor
  5. Cardiac magnetic resonance imaging (MRI)
  6. Biopsy
  7. Cardiac Computed Tomography
  8. Transthoracic echocardiogram

DIFFERENTIAL DIAGNOSIS

  1. Congenital heart disease-
  2. Partial anomalous venous return
  3. Atrial septal defect
  4. Repaired tetralogy of Fallot
  5. Acquired heart disease-
  6. Tricuspid valve disease
  7. Pulmonary hypertension
  8. Right ventricular infarction
  9. Miscellaneous-
  10. Sarcoidosis
  11. Idiopathic RVOT tachycardia  

TREATMENT

  1. Antiarrhythmic drugs (amiodarone
  2. Blood pressure medications such as Beta blockers and diuretics
  3. Anticoagulant (Warfarin)
  4. Radiofrequency (catheter ablation)
  5. Implantable cardioverter defibrillator (ICD)
  6. Heart Transplant

AYURVEDIC MANAGEMENT

In ARVC (Arrhythmogenic right ventricular cardiomyopathy) this is due to the consumption of causative agents, the doshas get vitiated. These doshas contaminate the rasa dhatus (nutritional fluid in the circulation) and then enter the hridya (heart). On entering the heart through rasa dhatus, the doshas get troubled and cause hrid roga.

  1.  Due to imbalance  Vata doshas cause irregular heartbeat.
  2. As the pitta doshas get aggravated that is responsible for an increased heartbeat.
  3.  As the Kapha dosha gets imbalanced it results in a slow down of heartbeat.

NIDANA

  1. Consumption of too hot foods
  2. Excessive consumption of sour, bitter foods
  3. Excessive thinking, stress
  4. Excessive physical activity
  5. Administration of a strong enema
  6. Excessive indulgence in sexual activity
  7. Frequent vomiting
  8. Excessive formation of ama (toxins)
  9. Forcibly withholding the natural urges
  10. Fear
  11. Panic
  12. Emaciation

TYPES OF HRID ROGAS

Hrid rogas is of 5 types

  1. Vataja Hrid Rogas- heart disease is caused by vitiation of Vata
  2. Pittaja Hrid Rogas- Heart disease is caused by vitiation of pitta
  3. Kaphaja Hrid Rogas- Heart disease due to vitiation of Kapha
  4. Tridoshaja Hrid Rogas- This is caused by the vitiation of three doshas (Vata, Pitta, Kapha)
  5. Krimija Hrid Rogas- Heart disease is caused by worms, bacteria (infections)

1. Vataja Hridrogas – It causes

  • Expansion of heart
  • Churning type of pain
  • Tearing type of pain
  • Cutting type of pain

2. Pittaja Hridrogas – It causes

  • Severe thirst, sucking pain
  • Excessive tiredness
  • Excessive sweating
  • Dryness in the oral cavity
  • Sucking pain

3. Kaphaja Hridrogas – It causes

  • Heaviness in the body
  • Loss of appetite
  • Stiffness
  • Rigidity
  • Excessive salivation

4. Tridosha HridRogas

Whole doshas will be seen in tridosha hridrogas

5. Krimija Hrid Rogas

This is seen in patients who consume apathya ahara vihara, which manifests kleda. Experience the toda (pricking type of pain) in the heart region.

  • Nausea
  • Vomiting
  • Tastelessness
  • Excessive dryness in the body     

HERBS USEFUL IN ARVC (Arrhythmogenic right ventricular cardiomyopathy)

1. ARJUNA

Arjuna (Terminalia arjuna) helps to balance pitta and Kapha doshas and has a great effect on cardiac diseases so known as a cardiac tonic (strengthens the heart and is useful in angina and in high blood pressure). It is used in the treatment of aconite poisoning. Because its kshaya ras is useful in the healing of fractures. Helps to reduce fat and cholesterol levels, useful in chest injuries and in many bleeding disorders./p>

2. BRAHMI

Brahmi (Bacopa monnieri) helps to improve intelligence, acts as an excellent anti-ageing herb and has antioxidant properties. It acts as a nerve tonic which promotes the growth of the brain and helps to improve the coordination between the tongue and limbs. Useful in many psychiatric disorders which improve the quality of life and in many spleen disorders. It is also good for heart disorders so known for its cardiac tone property.

3. SHANKHPUSHPI

Shankhpushpi (Convolvulus pluricaulis) helps to improve intelligence and memory.  It is known for its natural detoxification property, improves strength, induces sleep and helps to improve the quality of hair and promotes hair growth. Shankhpushpi is known for its rasayan property. It helps to improve the complexion of the skin and is used in many skin disorders.

4. VACHA

Vacha (Acorus calamus) helps to balance Vata and Kapha doshas. Vacha helps to relieve the ama dosha so helpful in the digestion process and useful against many psychological imbalances and disorders. It is extensively used in the treatment of obesity which relieves syphilis and in Vata doshas imbalances. Helps to induce uterine contraction so it is useful in dysmenorrhea. Improves speech, memory and intelligence.

HERBAL REMEDIES BY PLANET AYURVEDA FOR ARVC (Arrhythmogenic right ventricular cardiomyopathy)

Planet ayurveda is an ayurvedic manufacturing company that makes all the formulations from its natural resources. They have many branches overseas. Planet ayurveda is a GMP certified company, all products made are free from any preservatives, colors and additional resins. Ingredients are free from any adulterations. Products cause no side effects but provide many health benefits to patients.

PRODUCTS LIST

  1. ARJUNA CAPSULES
  2. ARJUN TEA
  3. TOTAL HEART SUPPORT
  4. HRIDAYARNAVA RASA
  5. BRAHMI VATI 

PRODUCTS DESCRIPTION

1. Arjuna Capsules

Arjuna Capsules are single herbal capsules which are made by planet ayurveda using a single standardized extract of Arjuna (Terminalia arjuna). These capsules help to balance the tridoshas in the body, Help to support the healthy circulation of the heartwhich maintains healthy blood cells and healthy metabolism. Taking these capsules supports the healthy cholesterol level in the body.

Dosage-2 capsules twice daily with plain water after meals

2. ARJUN TEA

Arjuna Tea is a herbal tea formulation which is made by planet ayurveda using various ingredients such as Arjuna (Terminalia arjuna), Dalchini (Cinnamomum zeylanicum), Chhoti Elaichi (Elettaria cardamomum) and many more. This herbal tea is an effective remedy for maintaining heart and blood pressure. It is also helpful in high cholesterol, congestive heart failure and many heart problems. This tea is rich in antioxidants and provides support to the vascular system.

Dosage– 2 cups twice daily

3. Total Heart Support

Total heart support are polyherbal capsules made by planet Ayurveda using ingredients such as Arjuna (Terminalia arjuna), Shankhpushpi (Convolvulus pluricaulis) and many more. This capsule is helpful in balancing Vata and pitta doshas. Helpful in heart disease in the treatment of high cholesterol levels and in congestive heart failure. Due to weakness in heart muscles, there is breathlessness so it is an effective remedy for heart disorders.

Dosage– 2 capsules twice daily with plain water after meals.

4. Hridayarnava Rasa

Hridayarnava Rasa is a tablet formulation which is prepared by planet Ayurveda using ingredients such as Shuddh Parad (Purified mercury), Tamra Bhasma, Shuddh Gandhak and many more. This tablet is helpful in cardiac disorders which further cause breathlessness. Heaviness in the chest and in many heart-related problems. This helps to balance Kapha doshas.

Dosage– 1 tablet twice daily.

5. Brahmi Vati

Brahmi Vati is a classical ayurvedic formulation which is made by planet ayurveda in the form of tablet using ingredients such as Brahmi (Bacopa monnieri), Vacha (Acorus calamus), Swarna Makshika bhasma and many more. These tablets are useful in panic attacks and in maintaining normal blood pressure. It is used in sleeplessness, in chronic fever and anxiety.

Dosage- 1 tablet twice daily with lukewarm water.

CONCLUSION

Arrhythmogenic right ventricular cardiomyopathy is a form of heart disease that usually appears in adulthood. ARVC (Arrhythmogenic right ventricular cardiomyopathy) is a disorder of the myocardium which is the muscular layer of the heart. This condition causes the part of the myocardium to break down and increases the risk of abnormal heartbeat (arrhythmia) and causes sudden death.   ARVC is a rare genetic disease which shows symptoms between the age of 10-50 years of age. On entering the heart through rasa dhatus, the doshas get troubled and cause hrid roga. We discussed many herbal remedies by planet ayurveda which are really effective and cause no side effects.