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Department of Kayachikista, Sri Dharmasthala Manjunatheswara Ayurveda College And Hospital Hassan.
Background: Gridhrasi is one among the eighty Nanatmaja Vata Vyadhis described in Ayurveda and is characterized by pain originating from the Sphik region and radiating to Kati, Pristha, Uru, Janu, Jangha and Pada. The clinical presentation closely resembles sciatica described in modern medicine5.7. Owing to increasing sedentary lifestyle, occupational stress and degenerative spinal disorders, the incidence of sciatica has increased considerably2.3. Ayurveda advocates Basti as the prime treatment for Vata Vyadhi and recommends Sneha-based interventions for Vata predominant disorders. Aim: To evaluate the combined effect of Prasarini Capsule and Prasarini Taila Matra Basti in the management of Gridhrasi (Sciatica). Materials and Methods: An open label single arm clinical study was conducted on 30 patients diagnosed with Gridhrasi attending the Outpatient and Inpatient Departments of Sri Dharmasthala Manjunatheshwara Hospital, Hassan. Patients received Prasarini Capsules orally along with Prasarini Taila Matra Basti. Assessments were performed on Day 1, Day 9 and Day 25 using Visual Analogue Scale (VAS), lumbar range of motion, Straight Leg Raising Test (SLR), Oswestry Disability Index (ODI) and associated symptoms of Gridhrasi. Results: Statistically significant improvement was observed in Ruk, Toda, Stambha, lumbar extension, left lumbar rotation, SLR test and ODI scores (p<0.05). Significant reduction in pain and disability with improvement in spinal mobility was observed following intervention. Spandana demonstrated an improvement trend whereas Gourava and Arochaka did not show statistically significant changes. Conclusion: Prasarini Capsule combined with Prasarini Taila Matra Basti was found to be safe and effective in reducing pain, improving spinal mobility and enhancing quality of life in patients suffering from Gridhrasi.
Gridhrasi is one among the Vataja Nanatmaja Vyadhis described by Acharya Charaka and is considered one of the common disorders affecting the locomotor system5. The disease derives its name from the peculiar gait of the patient resembling that of a vulture (Gridhra) due to severe pain and restriction of movements. Classical Ayurvedic texts describe the disease as beginning from Sphik and radiating successively to Kati, Pristha, Uru, Janu, Jangha and Pada7.
According to Ayurveda, Gridhrasi results from vitiation of Vata Dosha either independently or in association with Kapha Dosha. Vataja Gridhrasi manifests predominantly with Ruk, Toda, Stambha and Spandana, whereas Vata-Kaphaja Gridhrasi additionally presents with Tandra, Gourava and Arochaka6. The pathological process involves Dosha-Dushya Sammurchana affecting Asthi, Majja and Snayu Dhatus along with Asthivaha and Majjavaha Srotas.
The clinical features of Gridhrasi closely resemble sciatica described in contemporary medicine. Sciatica is characterized by radiating pain along the course of the sciatic nerve due to nerve root compression or irritation, commonly resulting from lumbar disc prolapse, spinal canal stenosis and degenerative disc disease. Patients frequently present with pain, tingling sensation, numbness, restricted movement and disability affecting their quality of life.
Modern management mainly includes analgesics, non-steroidal anti-inflammatory drugs, physiotherapy and surgery in severe cases1,4. Although these modalities provide symptomatic relief, recurrence and residual disability are common. Long-term use of analgesics may also produce adverse effects.
Ayurveda offers a holistic approach through Nidana Parivarjana, Shamana and Shodhana therapies. Among Panchakarma procedures, Basti is considered Ardha Chikitsa and is regarded as the most effective treatment for Vata disorders6,11. Matra Basti, being a Sneha Basti, is particularly beneficial in Vata disorders due to its nourishing and Vata-pacifying properties11.
Prasarini is traditionally indicated in disorders involving pain, stiffness and restricted movements and possesses Vata-Kaphahara, Vedanasthapana and Shothahara properties13,17,18. Therefore, the present study was undertaken to evaluate the combined effect of Prasarini Capsule and Prasarini Taila Matra Basti in Gridhrasi.
AIM AND OBJECTIVES
Aim
To evaluate the combined effect of Prasarini Capsule and Prasarini Taila Matra Basti in the management of Gridhrasi (Sciatica).
Objectives
MATERIALS AND METHODS
Source of Data
Patients were selected from the Outpatient and Inpatient Departments of Sri Dharmasthala Manjunatheshwara Hospital, Hassan.
Study Design
Screening and Diagnosis
A screening proforma containing history, signs and symptoms of Gridhrasi was prepared.
Diagnostic Criteria
Inclusion Criteria
Exclusion Criteria
Ethical Clearance and Trial Registration
The study protocol was approved by the Institutional Ethics Committee of Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan vide approval number SDM/IEC/109/2024.
The clinical study was prospectively registered under the Clinical Trials Registry–India with registration number CTRI/2025/03/083740.
Written informed consent was obtained from all participants before enrolment.
INTERVENTION
Prasarini Capsule
Prasarini Taila Matra Basti
METHOD OF ADMINISTRATION OF MATRA BASTI
Purva Karma
Sthanika Abhyanga using Tila Taila followed by Nadi Sweda was performed over lower abdomen, back and thighs.
Pradhana Karma
Patients were instructed to lie in left lateral position with the left leg extended and the right leg flexed at the knee and hip. The anal orifice was lubricated and indirectly heated Prasarini Taila was administered using a rubber catheter attached to an enema syringe.
Paschat Karma
Patients were advised to remain in supine position for five minutes and Basti retention time was recorded.
ASSESSMENT CRITERIA
Primary Outcome Measures
Secondary Outcome Measures
Statistical Analysis
Data were analysed using SPSS software version 23. Friedman Test was used for repeated non-parametric variables, Wilcoxon Signed Rank Test for pairwise comparison, Cochran's Q Test for dichotomous repeated variables and McNemar Test for post hoc comparison. Statistical significance was considered at p<0.05.
OBSERVATIONS
Among 86 screened subjects, 31 fulfilled the eligibility criteria and were enrolled. One patient discontinued treatment and 30 patients completed the study.
The majority of patients belonged to the age group of 41–50 years indicating increased susceptibility due to degenerative changes and progressive Vata predominance with advancing age.
Male predominance was observed in the study. Farmers and homemakers constituted the majority of participants, suggesting the role of repetitive bending, prolonged standing and heavy physical work in the pathogenesis of Gridhrasi.
Right-sided involvement was observed in most patients. Vataja Gridhrasi constituted the majority of cases followed by Vata-Kaphaja Gridhrasi.
RESULTS
Significant clinical improvement was observed in most assessment parameters.
|
Outcome Measure |
D1 Mean Rank |
D9 Mean Rank |
D25 Mean Rank |
χ² Value |
p-value |
Remrks |
|
RUK |
3.23 |
1.73 |
2.56 |
49.24 |
0.001 |
S |
|
TODA |
2.80 |
1.33 |
1.87 |
45.091 |
0.001 |
S |
|
Tandra |
1.26 |
1.13 |
1.06 |
2.000 |
0.009 |
S |
|
Gourava |
2.03 |
1.98 |
1.98 |
2.000 |
0.360 |
NS |
|
Arochaka |
2.00 |
2.00 |
2.00 |
45.091 |
0.120 |
NS |
Table 01-result of Friedman’s test on subjective parameters
|
Outcome Measure |
D1 Mean Rank |
D9 Mean Rank |
D25 Mean Rank |
χ² Value |
p-value |
Remrks |
|
Lumbar ROM – Extension |
2.85 |
2.02 |
1.13 |
51.515 |
<0.05 |
S |
|
Lumbar ROM – Flexion |
1.12 |
1.98 |
2.90 |
51.125 |
<0.005 |
S |
|
Lumbar ROM – Right Rotation |
2.43 |
1.88 |
1.68 |
14.480 |
<0.05 |
S |
|
Lumbar ROM – Left Rotation |
1.68 |
2.12 |
2.20 |
7.013 |
<0.05 |
S |
Table 02-Reasult of Friedman’s test on ROM of lumbar spine
|
Outcome Measure |
D1 Mean Rank |
D9 Mean Rank |
D25 Mean Rank |
χ² Value |
p-value |
Remrks |
|
SLR |
2.78 |
1.38 |
1.83 |
43.780 |
<0.001 |
S |
Table 03-Result of Friedman’s test on SLR
|
Outcome Measure |
D1 Mean Rank |
D9 Mean Rank |
D25 Mean Rank |
χ² Value |
p-value |
Remrks |
|
ODI (Quality of Life) |
3.00 |
1.00 |
2.00 |
60.000 |
<0.05 |
S |
Table 04-Result of Friedman’s test on ODI
|
Outcome Measure |
D9–D1 (Z value) |
D9–D1 (p-value) |
D25–D9 (Z value) |
D25–D9 (p-value) |
D25–D1 (Z value) |
D25–D1 (p-value) |
Remarks |
|
RUK |
-4.264 |
<0.05 |
-4.630 |
<0.05 |
-4.736 |
<0.05 |
S |
|
TODA |
-4.456 |
<0.005 |
-3.557 |
<0.005 |
-4.565 |
<0.005 |
S |
|
Gourava |
- |
>0.05 |
- |
>0.05 |
- |
>0.05 |
NS |
|
Arochaka |
0.000 |
1.000 |
0.000 |
1.000 |
0.000 |
1.000 |
NS |
Table 05. Wilcoxon Signed Rank Test on Subjective Parameters
|
Outcome Measure |
D9–D1 (Z value) |
D9–D1 (p-value) |
D25–D9 (Z value) |
D25–D9 (p-value) |
D25–D1 (Z value) |
D25–D1 (p-value) |
Remarks |
|
Lumbar ROM – Extension |
-3.174 |
<0.016 |
-2.558 |
<0.016 |
-3.559 |
<0.016 |
S |
|
Lumbar ROM – Flexion |
-2.257 |
>0.016 |
-0.622 |
>0.016 |
-2.268 |
>0.016 |
NS |
|
Lumbar ROM – Right Rotation |
-0.808 |
>0.016 |
-2.668 |
>0.016 |
-1.833 |
>0.016 |
NS |
|
Lumbar ROM – Left Rotation |
-2.837 |
0.005 |
-0.801 |
0.420 |
-2.410 |
0.016 |
S |
Table 06. Wilcoxon Signed Rank Test on Lumbar ROM
|
Outcome Measure |
D9–D1 (p-value) |
D25–D9 (p-value) |
D25–D1 (p-value) |
Remarks |
|
SLR |
<0.001 |
0.004 |
<0.001 |
S |
Table 08. Wilcoxon Signed Rank Test on ODI (Quality of Life)
|
Outcome Measure |
D9–D1 (Z value) |
D9–D1 (p-value) |
D25–D9 (Z value) |
D25–D9 (p-value) |
D25–D1 (Z value) |
D25–D1 (p-value) |
Remarks |
|
ODI (QOL) |
-3.127 |
0.001 |
-3.357 |
0.002 |
-3.963 |
0.000 |
S |
Table 07. McNemar Test on SLR
DISCUSSION
Gridhrasi is predominantly a Vata Vyadhi involving Asthi, Majja and Snayu structures. The disease develops due to aggravation of Vata by factors such as excessive physical exertion, prolonged standing, irregular dietary habits, suppression of natural urges and exposure to cold.
The present study demonstrated statistically significant improvement in Ruk, Toda, Stambha, lumbar extension, left rotation, SLR and ODI scores following administration of Prasarini Capsule and Prasarini Taila Matra Basti.
The reduction in Ruk can be attributed to the Vedanasthapana and Vatahara properties of Prasarini. The Ushna Veerya and Snigdha Guna of the Taila oppose the Sheeta and Ruksha qualities of aggravated Vata thereby reducing pain and improving mobility.
Toda, representing sharp pricking pain due to nerve root involvement, also showed significant improvement. This may be due to the anti-inflammatory and analgesic activities of the formulation.
Improvement in Stambha can be attributed to the lubricating and nourishing action of Sneha Basti which reduces muscle spasm and enhances flexibility.
Although Spandana showed an overall trend towards improvement, pairwise comparisons did not demonstrate statistical significance. This may be due to the low baseline prevalence of the symptom and small sample size.
Similarly, Gourava and Arochaka did not show significant improvement as these symptoms were present only in a small number of participants and were predominantly associated with Vata-Kaphaja Gridhrasi.
The significant improvement observed in lumbar extension and rotation indicates restoration of spinal flexibility and reduction in paraspinal muscle spasm.
SLR demonstrated significant improvement throughout the study period suggesting reduction in nerve root tension and restoration of functional mobility.
The Oswestry Disability Index also showed statistically significant improvement indicating enhancement in daily activities, occupational performance and overall quality of life.
The probable mode of action of Matra Basti can be explained through both Ayurvedic and modern principles. Pakwashaya is considered the principal seat of Vata Dosha and administration of Sneha through the rectal route facilitates direct Vata pacification.
Rectal administration permits absorption of lipid soluble phytoconstituents through the rectal venous plexus resulting in systemic action. Prasarini Taila exerts Vatahara, Shoolaghna and Shothahara effects while nourishing Asthi, Majja and Snayu Dhatus.
The combined use of oral medication and Matra Basti provided both systemic and local therapeutic effects and may explain the significant improvement observed in the majority of clinical parameters.
LIMITATIONS
FUTURE SCOPE
CONCLUSION
The present study demonstrated that Prasarini Capsule administered orally in combination with Prasarini Taila Matra Basti produced significant clinical improvement in patients suffering from Gridhrasi (Sciatica).
The intervention effectively reduced radiating pain, pricking pain and stiffness while improving lumbar mobility, Straight Leg Raising Test and quality of life scores.
The findings support the Ayurvedic principle that Basti is the treatment of choice for Vata Vyadhi and highlight the therapeutic importance of Sneha-based interventions in disorders involving Asthi, Majja and Snayu Dhatus6,11.
The treatment was found to be safe and well tolerated with no major adverse events reported during the study period. Although the study was limited by a small sample size and absence of a control group, the results indicate considerable clinical benefit and justify further evaluation through larger randomized controlled studies.
Based on the findings of the present study, Prasarini Capsule and Prasarini Taila Matra Basti may be considered an effective Ayurvedic therapeutic approach for the management of
Gridhrasi and can be incorporated into routine clinical practice for appropriately selected patients.
REFERENCES
Shweta Sajjan*, Muttappa Totad, Vasantha B., Effect Of Prasarini Capsule And Prasarini Taila Matra Basti In The Management Of Gridhrasi (Sciatica): An Open Label Single Arm Clinical Study, Int. J. Sci. R. Tech., 2026, 3 (7), 764-770. https://doi.org/10.5281/zenodo.21508736
10.5281/zenodo.21508736