- Pain on lower back radiating to both lower limbs
- Stiffness on low back region
- Numbness on both toes
Brief Relevant Medical History:
A male patient, aged 37yrs not a known DM / HTN came to AyurVAID hospital with severe pain and stiffness on lower back region since one month. The pain was radiating to both lower limbs. Pain usually aggrevate during activities and travelling long distances on bike. Pain relieves on rest. Pain was of shooting type. He had numbness on both toes. He took ayurvedic medicines internally but there was no relief. Advised MRI of lumbar spine. (Reports attatched).
History of past illness:
Patient explained a history of low back pain since three years, for which he is continously taking Inpatient treatments from this centre every year and got good results. Now the symptoms aggrevated again due to over strain and he came for further treatments.
Aggravating factor- Cold, Strenous activities
Relieving factors: Rest
Current medication: Nothing
Relevant systemic examinations:
Hip: Flexion and Extension painful
SLR - positive
Lassegues sign - positive
|Rogi Bala - Madhyama|
|Roga Bala - Balawan|
MRI of Lumbar Spine:(12/2/2015)
Mild osteophytes are seen at lower lumbar levels.
The IV disc at L4/5 shows loss of its normal signals.
Diffuse annular disc bulge is seen at L3/4 levels.
Postero-central IV disc protrusion at L4/5 levels levels causing bilateral nerve root compression and bilateral neural foraminal narrowing.
“Sphikpoorvakatiprushta ooru janujankha
Vatavardhakaaharavihara(rookshahara, atiadhwa, vishsmadhupachara, athivicheshtitha)
(lodges in jankha, Kati,Sphik)
leads to sthamba, Ruk, spandata
Differential Diagnosis with reaso ning
The patient was provisionally diagnosed with Sciatica with differential diagnosis of anklosing spondilitis and Spondylolisthesis.
Differential Diagnosis with reasoning
|Evidence Based Diagnosis with References
Report lead to the diagnosis of Mild Lumbar spondylosis with sciatica.
Evidence Based Diagnosis with References
Gridhrasi stambharuktodairgrahanati spandate muhur vatat”(Madhava nidana)
|Details of Allopathy medicine if continued
Gridhrasi vishesha chikithsa:>
“Gridrasyartham naram samyak pachanadair
visodhitamnjatva naram pradeepthagnim vasthibhir samupachareth”
”chakra dhatha vatha vyadhi chikithsa)
“Vasthi vatha haranam”
Objective of treatment:
Our goal was to reduce pain,stiffness and numbness.
Line of Treatment:
1.Reduce pain,stiffness and numbness by allevating vata with Marma kizhi.
2.Allevate vata with vaitarana vasthi.
3.Vatha harana-mathravasthi,Kati vasthi
4.Balya-shashtika shali pinda sweda.
(Once the inflammation and pain has been reduced, nourishing and strengthening the muscle tissue and surrounding area was done).
Type – IPT
Duration – two weeks.
Chikitsa Paddhati with details of dose of medicine.
Disc protrusion is most often the result of a gradual ageing related wear and tear called disc degeneration.As you age, spinal disc lose some ot their water content and makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist.Exercise for strengthening the trunk muscles helps stablilse and support the spine.Good posture reduces the pressure on spine and disk.Maintain a healthy weight because excess weight puts more pressure on the spine and disks.There should be prevention of affected joints from trauma,injuries and physical stress.
|Before treatment||Post treatment|
Patient’s Outcome Scale:
Poor(1); Fair(2); Good(3); Very Good(4); Excellent(5).
|#||Presenting Complaint||Weightage||Status_TSD||Status_TED||Status_1Week||Status_1 Month||Status_6 Months|
|1||Pain and stiffness of low back region.||40||1||3|
|2||Pain in right lower limb||20||1||3|
|3||Pain in left lower limb||20||2||4|
|4||Numbness on both toes||20||2||4|
After the course of treatment vitiation of vata and kapha is reduced.Pain and stiffness of low back region is significantly reduced.Numbness on both toes is reduced.He is advised to follow up after two weeks and continue oral medicines for these two weeks.