A 37 year old male came to my office with the following condition as observed after MRI: Loss of lumbar lordosisPartially desiccated L4-L5 intervertebral discsLigamentum flavum hypertrophy & facet joint arthropathy at multiple levelsDiffuse posterior bulge of intervertebral disc at L3-L4 level indenting the anterior thecal sacPosterior protrusion of the intervertebral discs at the level of L4-L5 compressing the canal(residual matter at this level 7.0mm in AP diameter)narrowing of bilateral recess & neural foramina & compressing the bilateral exiting nerve rootsModic type 2 changes seen involving the inferior part of body of L4 vertebral bodyVitals:Family history – NoneTraumatic history- NoneGestational history- NoneOn any medications-took 1 month of allopathy treatment ,not on any medications past 2 weeksDiet- Both veg and non vegBp- 128/84mm HgPulse- 86/minTemperature- WNLBowel- Soft and RegularSleep- Disturbed due to painSymptoms: Unable to walkPain in back radiating to right legMorning stiffness 1 hourNumbness -present when pain aggravates intermittently throughout the day towards right limb When the disc material protrudes beyond greater than 25% of the disc circumference it is called a disc bulge. When the nucleus pushes completely through the annulus and squeezes out of the disc, it is termed as protrusion. While canal stenosis/compression is a condition when the small spinal canal which contains the nerve root and the spinal cord is compressed.Patients present with all the above conditions find difficulties in their daily routine, while many other symptoms like back pain,numbness, improper posture, stiffness can be associated alongside. Most commonly, it may arise due to improper positioning while weight lifting, or Vit D3 deficiency or due to mismanaged posture .Ayurveda classifies it under vata disorder, though pitta and kapha can be associated signaling inflammation and heaviness along with the most painful condition.The more aggravated vata can result in numbness over the affected part.So vata pacifying actions like Patra Pinda swedana, abhyangam with oil and healing energy methodology via Marma therapy is performed to resolve the condition.
The role of Ayurvedic external therapies namely Abhyangam, Marma therapy along with Patrapinda Swedana was studied In a patient of disc bulge /protrusion at different levels of lumbar discs along with the presence of canal compression. Mahanarayana oil (Dabur) and Ksheerbala oil(Nagarjuna)were mixed together in equal quantities & used for spine abhyangam.
A different approach to abhyangam was followed which is given below:
Both the oils (Luke warm) mixed together were applied over the lumbar spine after which abhyangam i.e Ayurvedic massage was performed with both hands from lumbar to thoracic region.This action of spine abhyangam was performed to reduce the compression force on spine being an antigravity movement.
The second step of abhyangam was performed laterally on both sides from the mid portion of spine in both directions.
All the actions were performed 10 times for 5 repetitions daily for 6 weeks
Marma Therapy: Secondly the Marma therapy was performed after abhyangam which included the stimulation of Marma points of the leg and Lower Back namely Shipra/koorch/gulfa/talahridaya/Indravasti/kukunder/nitamba and katiktaruna etc marma points were stimulated 10 times for 0.8 seconds .Each Marma point was stimulated for 5 repetitions.
Also Patrapainda swedana was performed after both the above procedures for 15 minutes for lower back/lumbar region & also both the legs till the region of calf muscles
This special technique of Abhyangam, Swedana along with Marma therapy resulted in total reduction of pain as well as numbness over the affected area .Also the patient was able to walk with ease and was found returning to daily routine with precautions.
Patient was treated at Dr Tewari Ayurved Hospital located in Kichha ,district-Udham Singh nagar ,Uttarakhand,India for 6 weeks with the above mentioned procedure .Total therapy time involved per session was 1 hour .
The effects of special Abhyangam performed along with Marma therapy and Patrapinda swedana resulted in complete resolution of pain around the lumbar spine area and the right leg.Patient was able to walk after the second week of therapy which continuously improved in the following weeks. He was able to resume his work after 6 weeks of complete treatment. The lifestyle of the patient was seen to be highly improved (with precautions and optimal exercises advised ) after 3 months follow up.
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