Back pain (Kati shoola) is one of the most common reasons people visit the doctor, and it is a leading cause of disability worldwide. In the life span of human life, most people have back pain at least once.
Ayurveda refers to this condition as ‘Kati Shoola’. In Ayurveda 'Kati' Refers to the lower back region and 'Shoola' refers to pain. This condition is also available in some other terms in Ayurveda books like Kati Graha, Prishta Graha etc. It is due to the Vitiated Vata Dosha.
Back pain can be categorised as:
Acute- Back Pain lasted less than 6 weeks.
Sub-acute Back pain lasted 6-12 weeks.
Chronic Back pain lasted more than 12 weeks
CAUSES
Trauma- Lower back pain that develops after a trauma, fall or accident.
Muscle or ligament strain- Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. This may lead to back pain.
Degenerative disc disease- It is a age-related condition that happens when one or more of the discs between the vertebrae of the spinal column deteriorates or breaks down that leads to pain.
Bulging or ruptured disc- Disc act as cushions between the bones (vertebrae) in the spine. The soft material inside a disc can bulge or rupture and press on a nerve.
Lumbar herniated disc. The disc wall is richly supplied by nerve fibers, and a tear through the wall can cause severe pain.
Spinal stenosis- This condition causes pain through narrowing of the spinal canal where the nerve roots are located.
Spondylolisthesis- This condition occurs when one vertebra slips over the adjacent one.
Sacroiliac joint dysfunction. The sacroiliac joint can become painful if it becomes inflamed (sacroiliitis).
Osteoarthritis. This condition results from wear and tear of the disc and facet joints.
Sciatica (Gradhrasi)- It is a condition in which pain radiates to the lower limb from the lower back region.
Skeletal irregularities. A condition in which the spine curves to the side.
MANAGEMENT
Most of the low back subsides on its own, within a few days, or possibly in a few weeks on proper rest.
On 'line of treatment' emphasis is given on arresting the process of degeneration & helps in regeneration of soft tissue damages, prevention of disc prolapse or disc rupture.
Panchakarma treatment and Ayurvedic medicines plays a major role in reducing or subsiding pain and in achieving homeostasis.
PANCHAKARMA TREATMENT
Snehana (oleation): Both internal and external Snehapana can be adopted. For internal Snehapana (internal oleation) various oils or ghrita can be used according to the condition.
Bahya Snehana (External oleation)- Snehadhara, Abhyanga, Avagaha, Parisheka, Kati basti etc.
Swedana (fomentation): Relief in low backache (Kati Shoola) can be adopted by Swedana (Fomentation). There are different kinds of swedana which can be used in backache (Kati Shoola) according to the condition and feasibility.
Kati Basti and Patra Pinda Swedana are the most used Swedana in Practice. Other forms of swedana which may be used are Pizichil, Upnaha Sweda, other forms of Pinda Sweda, Nadi Sweda etc.
Both Snehana (oleation) and Swedana (fomentation) are useful in relieving pain as well as helps in relieving the restricted movement of the back region (Kati Pradesha).
Mridu Samshodhana (mild form of purificatory process):
In chronic low back pain, Mridu Virechana (mild therapeutic purgation) has an important role. Eranda Taila can be used for Mridu or Nitya Virechana.
Basti (medicated enema):
Basti is known as ‘Ardha Chikitsa’ or half the treatment of all the treatments available.
Various types of Niruha (decoction based enema) and Anuvasana Basti (oil based enema) can be used in low backache which are mentioned in Ayurveda texts. These are:-
Niruha Basti (Decoction based enema)
Erandamuladi Niruha Basti
Dashmoola Niruha Basti
Rasna-eranadi Niruha Basti
Guduchyadi Niruha Basti
Sneha (herbal oil) for Niruha ( decoction based enema) and Anuvasana Basti based enema (oil based enema)
Gugglutiktaka Ghrita
Tiktaka Ghrita
Dhanwantaram Taila
Murivenna Taila
Sahacharadhi Taila
Mahamasha Taila
Prasarini Taila etc.
SHAMANA CHIKITSA (PALLIATIVE TREATMENT)
Kashaya (Decoction)
Gandharvahastadi Kasaya
Sahacharadi Kashaya
Dashamoola Kashaya
Rasna-erandadi Kashaya
Rasnadi Kashaya
Maharasnadi Kashaya etc
Guggulu
Mahayogaraj Guggulu
Simhnad Guggulu
Trayodashanga Guggulu
Lakshadi Guggulu etc
Choorna
Ashvagandhadi Churna
Ajamodadi Choorna
Hingwastak Choorna etc
Oils for external application
Vishgarbha oil
Narayan oil
Murivenna oil
Prasarani oil etc
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