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MANAGEMENT OF CERVICAL SPONDYLOSIS THROUGH AYURVEDA: A CASE

STUDY

Article  in  International Journal of Research in Ayurveda and Pharmacy · June 2017

DOI: 10.7897/2277-4343.082109

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 Raman Kaushik et al / Int. J. Res. Ayurveda Pharm. 8 (Suppl 2), 2017

Research Article
www.ijrap.net

MANAGEMENT OF CERVICAL SPONDYLOSIS THROUGH AYURVEDA: A CASE STUDY

Raman Kaushik *1, Pragya Sharma 2, Om Prakash 3
1
Research Officer (Ayurveda), Regional Ayurveda Research Institute, C.C.R.A.S, Ministry of AYUSH, Ranikhet,
Uttarakhand, India
2
PG Scholar, All India Institute of Ayurveda, New Delhi, India
3
Assistant Director In-charge, Regional Ayurveda Research Institute, C.C.R.A.S, Ministry of AYUSH, Ranikhet,
Uttarakhand, India

Received on: 10/04/17 Accepted on: 17/05/17

*Corresponding author
E-mail: [email protected]

DOI: 10.7897/2277-4343.082109

ABSTRACT

Cervical spondylosis is a common spinal problem seen now a day. Though degeneration of cervical vertebrae is mostly seen in elderly people but its
prevalence is increasing in early or middle age also. In the present case study, a diagnosed case of cervical spondylosis has been included for its
ayurvedic management. Chief complains were pain and stiffness over the neck since 5 months and pain over the neck was radiating towards the right
arm. Degenerative changes with osteophytosis at C5-C6 vertebrae with nerve compression were reported in her MRI- cervical spine. Effect of Griva
basti (external therapy) and Nasya (Internal therapy) along with oral medication of Trayodashanga guggulu and Dashmoola Kwatha on cervical
spondylosis had been evaluated. Different parameters have been assessed during and after the treatment schedule. There is a complete relief in the
parameters like neck pain & stiffness whereas the parameters like pain in arm & vertigo has also shown significant improvement.

Keywords: Cervical spondylosis, Grivabasti, Nasya, Trayodashanga guggulu, Dashmoola Kwatha.

INTRODUCTION direction, leading to the vitiation of vata and kapha dosha. Such
condition may simulate with the condition of cervical
Continuous sitting or standing posture, working on computers spondylitis or acute stage of cervical spondylosis 7.
perpetually and lack of exercise are some of the atrocious
components of current lifestyle. The prevailing consequences of MATERIAL AND METHODS
such lifestyle appear in numerous problems like metabolic, Case study
musculoskeletal etc. Degenerative diseases which are mainly
seen in elderly persons are now becoming common in early or This study has been registered with ctri and under review
middle age persons also. Low backache and neck pain are the procedure with reference no. REF/2017/05/014262.
most common spinal problems and cervical spondylosis is a It is to mention that prior informed consent has been obtained
common in >30 age group 1. Recent studies depicted that from the patient and study has been carried out as per
cervical spondylosis increases with aging before age 50 years International conference of Harmonization-Good Clinical
and decreases with aging after age 50 years 2. Practices Guidelines (ICH-GCP) or as per Declaration of
Helsinki guidelines.
Disease review
A 41 years old female, security personnel by profession, has
Cervical spondylosis or osteoarthritis of the cervical spine visited OPD on 25.09.2016 with chief complains of pain and
produces neck pain radiating to the shoulders or arms with stiffness over the neck since 5 months. Pain over the neck is
headache (posterior occipital region). Narrowing of the spine radiating towards the right arm. She is also having tingling
canal by osteophytes, ossification of the posterior longitudinal sensation over the neck and arm, especially after waking up in
ligament or a large central disk may compress cervical spinal the morning. After standing or sitting for a long duration, she
cord 3. Age, gender and occupation are the main risk factors for also experiences giddiness or vertigo frequently. She is also
cervical spondylosis 4. suffering from incomplete evacuation of bowels. After
consulting an orthopedician for the same problem, she did her
In Ayurvedic perspective, grivastambha is one of the eighty MRI- cervical spine which reported degenerative changes with
types of vatavyadhi which is characterised by stambha osteophytosis at C5-C6 vertebrae with nerve compression. She
(stiffness) in the neck region 5, which is commonly seen in was diagnosed as a case of cervical spondylosis with
cervical spondylosis. Cervical spondylosis may also be radiculopathy. She is advised to take analgesics and anti-
considered as grivagata (neck region) sandhivata, especially in inflammatory medicine regularly for some initial time period,
degenerative condition. Pain during the flexion – extension of a followed by their occasional use (when needed). She had also
joint along with swelling and coarse crepitations on joint undergone physiotherapy session for about 15 days and got mild
movement is the typical clinical features of sandhivata6. relief in symptoms. As a known case of hypothyroidism, patient
Acharya sushruta has described manyastambha which is caused was taking tablet eltroxin, 25 mcg, once daily since one year.
by diwaswapna (sleeping during daytime), using pillows Other investigations like Haemogram, ESR, L.F.T, K.F.T, Lipid
inappropriately during sleeping and constant gazing in upward profile, Thyroid profile etc. are within normal limits.

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 Raman Kaushik et al / Int. J. Res. Ayurveda Pharm. 8 (Suppl 2), 2017

On examination, patient is having tenderness over the neck. upper back region, followed by nadi swedana (local
Neck pain is increasing with forward and backward movement fomentation) with dashmoola kwatha.
of shoulder but relieves on abduction. After thorough
examination, a diagnosis of grivagata vata vis-à-vis cervical Nasya
spondylosis has been established and patient is advised for griva
basti, nasya with oral ayurvedic medication. Nasya is one among the five chief purification procedures i.e.
Panchakarma. It includes instillation of medicine through nasal
Following materials were required in this case study - route 8 and it is mainly indicated for the diseases that affects the
• Masha (black gram) flour – 500 grams region above the clavicle bone 9. It pacifies vata and kapha
• Mahanarayana taila – 500ml dosha present in head region.
• Dashmoola kwath – 2 litres (for nadi swedana),
• Spatula – 01 Procedure for Nasya – After 10 minutes of griva basti, patient is
• Small piece of sponge – 01 asked to sit on a chair with slightly extended neck. A gentle
• Water – as per requirement massage over the forehead, cheeks and sides of nose (region of
• Nadi swedana yantra (Local steam apparatus) – 01 frontal and maxillary sinuses) is done for 10 minutes by using
sesame oil, followed by nadi swedana. Then 4-4 drops of anu
taila were instilled in each nostril. It is followed by luke warm
Treatment plan – A schedule has been planned with two
therapy sessions of griva basti and Nasya (6 days in each water gargles.
session) and 7 days gap in between each session. Along with Assessment parameters
this, patient is advised to take following ayurvedic medicines • Neck pain
throughout the treatment schedule: • Neck stiffness
• Pain radiating in arm
Name of the medicine Dose • Vertigo
Trayodashanga guggulu 500 mg, twice a day with lukewarm
water Table 1: Grading of parameters
Dashmoola kwatha 20 ml, twice a day, empty stomach
S.No Parameters Grading Observation
Griva basti 1. Neck pain 0 Absent
1 Mild and intermittent pain
Griva basti is a distinctively developed ayurvedic procedure 2 Moderate and bearable pain
which is done primarily to pacify aggravated doshas in the neck 3 Severe and unbearable pain
2. Neck 0 Absent
region, especially in chronic cases.
stiffness
1 Mild stiffness
Procedure for griva basti – Paste of Masha (Black gram flour) is 2 Moderate stiffness with
traditionally used to make circular boundary wall in griva partially restricted
basti. Whereas in the present case study, plastic griva basti movement
moulds has been used. These moulds are available in different 3 Severe stiffness with
sizes. Patient is asked to lie down in prone position on the table restricted movement
and a towel roll is placed under the chin to make neck region 3. Pain in arm 0 Absent
slightly flexed. After this, plastic mould is placed over the neck 1 Mild intermittent pain over
and its margins are sealed with the masha paste (paste of black arm
gram flour and water). Then it is kept for 5-10 minutes to settle. 2 Moderate pain with
occasional tingling sensation
Now, heated mahanarayana oil is poured in this griva basti
3 Severe pain radiating from
yantra by using a sponge piece. Precaution should be taken to neck with tingling sensation
maintain oil temperature as tolerated by patient and also for 4. Vertigo 0 Absent
leakage of oil for basti yantra. The oil in basti yantra has to be 1 Occasional
replaced with warm oil at regular interval. After doing this 2 1-3 times in a week
procedure for 30 minutes, oil is drained out and plastic mould is 3 > 3 times in a week
removed. After this, a gentle massage is done over the neck and

OBSERVATIONS AND RESULTS

Observations seen in different parameters before and after the course of treatment are as follows:

Table 2: Observation in different parameters

S.No Parameters Before treatment After Ist session After II nd session

1. Neck pain 2 1 0
2. Neck stiffness 3 1 0
3. Pain in arms 3 2 1
4. Vertigo 3 1 1

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 Raman Kaushik et al / Int. J. Res. Ayurveda Pharm. 8 (Suppl 2), 2017

Figure 1: Graphical presentation of changes in different parameters

DISCUSSION 3. Kasper, Fauci et al. Harrison’s Principle of Internal

Medicine, 19th edition, McGraw Hill; 2015. p.122.
In Ayurveda, the main etiological factor for the development of 4. Sudhir singh et al. Risk factors in cervical spondylosis,
manyastambha is considered as vitiated vata and kapha dosha. journal of clinical orthopaedics and trauma; December 2014,
In the present case study, a special schedule has been adopted to Volume 5, Issue 4, Pages 221–226.
manage cervical spondylosis with a prime focus to alleviate vata 5. Trikamji Yadavji Acharya. Agniveshakrita Charaka
and kapha dosha. Mahanarayana oil used for griva basti which Samhita,Chakrapani Commentary, Sutra sthan, Chapter 20,
has been indicated in different types of vatavyadhi 10 and it also Maharoga adhyaya, Verse no.11,Varanasi: Chaukhambha
provide strengthen to the local soft tissues. Nasya with anu taila Surbharti Prakashan; Reprint 2011. p. 113.
helps in elimination of vata- kapha dosha and clears obstruction 6. Trikamji Yadavji Acharya. Agniveshakrita Charaka
in the channels. Trayodashanga guggulu is a special ayurvedic Samhita,Chakrapani Commentary, Chikitsasthan, Chapter
formulation for vatavyadhi. It contains drugs like guggulu, 28, Vatavyadhi chikitsa, Verse no. 37, Varanasi:
rasna, ashwagandha etc which are having vata and kapha, Chaukhambha Surbharti Prakashan; Reprint 2011. p. 618.
shothhara properties11. Its significant effect has been evaluated 7. Shastri Ambika Dutt. Sushruta Samhita by Maharishi
in the condition of sandhivata in different studies12.Dashmoola Sushruta, Nidana sthana, Chapter 1, Vatavyadhi nidana,
kwatha is a well known ayurvedic medicine having anti- verse no. 67, Varanasi: Chaukhambha Sanskrit Sansthan;
inflammatory, analgesic effect 13. Reprint 2007. p. 234.
8. Tripathi Ravidutt. Ashtanga Samgraha by Vagbhatta,
A combination of trayodashanga guggulu and dashmoola kwatha Chapter 31, Nasyavidhi adhyaya, verse no. 3, Varanasi:
has vata-kapha alleviating, anti-inflammatory and analgesic Chaukhambha Bharati Sansthan; Reprint 2003. p. 528.
properties. In this study, the patient was having neck pain with 9. Trikamji Yadavji Acharya. Agniveshakrita Charaka
stiffness, which got significant relief after first session. Samhita,Chakrapani Commentary, Sutra sthan, Chapter 5,
Complete relief in the pain and stiffness has been observed after Matrashitiya adhyaya, Verse no. 62, Varanasi:
second session. Others parameters like pain in arms and vertigo Chaukhambha Surbharti Prakashan; Reprint 2011. p. 41.
has also shown a significant improvement and regularity in the 10. Shastri Ambikadutta. Bhaishajya ratnawali by Goving Das,
bowel habits has also been observed during the treatment. Chapter 26, Vatavyadhi chikitsita, Verse no. 343-354,
Varanasi: Chaukhamba prakashan; Reprint 2011. p.560.
CONCLUSION 11. Shastri Ambikadutta. Bhaishajya ratnawali by Goving Das,
Chapter 26, Vatavyadhi chikitsita, Verse no. 343-354,
It is to conclude that combination of ayurvedic therapies like Varanasi: Chaukhamba prakashan; Reprint 2011. p.539-
griva basti and nasya along with oral medication of 540.
trayodashanga guggulu & dashmoola kwatha has a significant 12. Biswal Debasis et al. A clinical study on efficacy of
role in the management of cervical spondylosis or osteoarthritis trayodashanga guggulu in the managementof sandhivata
of cervical spine. (osteoarthritis), Int. J. Res.Ayurveda Pharm, Sep-Oct 2015;
Vol 6, Issue5.
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2. Wang et al. The incidence of cervical spondylosis decreases Cite this article as:
with aging in the elderly, and increases with aging in the
young and adult population: a hospital- based clinical Raman Kaushik et al. Management of cervical spondylosis through
Ayurveda: A case study. Int. J. Res. Ayurveda Pharm. 2017;8(Suppl
analysis. Clinical Interventions in Aging 2016:11.
2):179-181 http://dx.doi.org/10.7897/2277-4343.082109

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