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Back pain, also known as katishula in Ayurveda, is usually associated with swelling and stiffness in the lower back and it occurs due to the vitiation of vata in lower back region.

Ayurvedic texts describe ancient treatment methods to treat back pain, which include udwartana (powder massage), swedana (sudation or sweat therapy), abhyanga (oil massage), basti karma (enema therapy), virechana karma (purgation therapy), lepa (coating the affected body part with medications) and agni karma (thermal cauterisation). Herbs that are effective for the treatment of back pain are shunthi (dried ginger), rasna (Indian camphorweed), rasonam (garlic) and eranda (castor). Ayurvedic medicines used to treat back pain include yogaraja guggulu, simhanada guggulu, dashmoola kashaya and balarishtha.

  1. Ayurvedic view of back pain
  2. Ayurvedic treatment for back pain
  3. Ayurvedic herbs and medicines for back pain
  4. Dietary and lifestyle changes for back pain patient as per ayurveda
  5. How effective are ayurvedic medicines and treatments for back pain
  6. Side effects and risks of ayurvedic medicine and treatments for back pain
  7. Takeaway
Doctors for Ayurvedic medicine, treatment and remedies for Back Pain

As per Ayurveda, katishula is caused by upastambhi vata (vata diseases caused by the aggravation of vata due to its obstruction by other doshas) or anupastambhi vata (vata diseases caused by wasting of the dhatus). Back pain is associated with a number of disease conditions. These include: :

  • Mutra and purisha vega dharana (suppression of the natural urge to clear the bladder and bowel): Nervous system controls the process of emptying of bowels and bladder. Controlling and suppressing such natural urges leads to accumulation of this waste and toxic products in body, which also includes the nervous system. This toxin then leads to various symptoms, back pain being one of them.
  • Shweta pradara (leucorrhea): It is a common problem that involves excessive vaginal discharge leading to itching and infection in the vulva along with back pain. (Read more: Ayurvedic treatment of leucorrhoea)
  • Amavata (rheumatoid arthritis): It causes vitiation of vata dosha and accumulation of ama (toxins) in joints. When this ama is located in the joints of the back, it causes pain, stiffness, swelling and tenderness in the back.
  • Gridhrasi (sciatica): It is a condition characterised by vitiated vata causing severe pain in the lower limbs. This pain originates in the lower back region and radiates towards the legs.
  • Other conditions that can cause back pain include polycystic ovary syndrome, certain types of fevers, disorders of the uterus and vagina, ankylosing spondylitis, etc.

Treatment is usually based on the clinical presentation of the individual.

  • Udwartana
    • It is a specialised therapeutic powder massage that is performed using the powder of a herb or a combination of herbs. It balances the vitiated dosha of the individual.
    • The powder is warmed before the treatment, and deep tissue massage is performed by giving upwards strokes on the affected area.
    • The whole procedure lasts for about 45- to 60-minutes, after which the individual is advised to rest for about 30 minutes and then take a shower with warm water.
    • It treats back pain by improving the mobility of the joints, strengthening and toning the muscles, improving blood circulation, and rejuvenating and refreshing the body.
  • Swedana
    • Sudation therapy using medicated oils and steam works by liquefying and dislodging toxins and promote the flow of ama from the tissues back into the gastrointestinal tract. This ama later gets eliminated from the gastrointestinal tract.
    • It restores the balance between vata and kapha and helps in the management of back pain. It is mainly used for vata diseases, and the intensity of swedana varies depending on the strength of the individual.
    • Swedana can be performed using various methods like- tapa (fomentation), in which a heated cloth is placed on the affected body part; upanaha, in which a hot poultice made from a combination of herbs is applied on the body; ushma, in which steam made by boiling the suitable herbs is used; and dhara, in which a warm medicated liquid or oil is poured over the body.
  • Abhyanga
    • Abhyanga involves massaging the affected body part with oil infused with the properties of herbs.
    • It helps in the treatment of disorders of the joints. After pouring the oil,  joints are rubbed in a circular motion, which enhances blood circulation.
    • Mahanarayana taila is useful for performing abhyanga in individuals with back pain.
    • Abhyanga is useful in healing and preventing disorders of nervous system, removing fatigue, nourishing the body and strengthening the immune system.
  • Basti karma
    • Basti is an ayurvedic form of enema; however, unlike the modern enema, it is prepared fresh just before use.
    • It is made from a combination of various herbs, which are decided on the base of the clinical status of the individual. It can be used in the form of a decoction, oil or ghee.
    • Basti therapy is used in the treatment of various vata diseases to balance out the vitiated vata. It cleanses toxins and excess doshas accumulated in the body to provides relief from diseases.
    • It is helpful in the treatment of cervical spondylosis, sciatica, back pain, constipation, digestive disorders, etc.
    • For effective treatment, basti is usually given for a period of 8 to 30 days.
  • Virechana karma
    • In virechana therapy, various herbs and their combinations are used to induce purgation and eliminate the toxins from the body.
    • It is considered to be the best treatment for diseases caused by pitta dosha as it clears the excess pitta from the liver, gall bladder and small intestine. It is also used for kapha diseases as it helps to eliminate excess phlegm. Virechana is not recommended in case of disorders caused due to vata dosha.
  • Lepa
    • Lepa is a semisolid formulation of herbs applied topically on the skin and is commonly used to treat pain, inflammation and swelling in the body.
    • A dashmool (10 roots) and milk plaster is helpful in treating acute pain.
    • Various lepas that are used to treat back pain are dashanga lepa, gandhabiroja lepa, maidalakdi lepa, etc.
  • Agni karma
    • Typically, agni karma is done on the most painful areas of the joint with a special instrument. To relieve pain, the heated instrument is applied directly on the affected part of the body.
    • Agni karma is used to treat back pain when it cannot be relieved by any other therapy.

Ayurvedic herbs for back pain

  • Shunthi
    • Shunthi acts on the digestive and respiratory systems and has numerous therapeutic activities including digestive, expectorant (expels phlegm), pain-relieving, nervine (soothes nerves) and carminative (relieves flatulence).
    • It is a universal medicine and can be considered as a wonder drug as it is useful in the management of diseases caused due to all the three doshas. Shunti reduces vata when taken with rock salt, pitta when taken with mishri (rock sugar) and kapha when taken with honey.
    • It is useful in the management of pain in the back and other parts of the body caused due to arthritis. It is also helpful in treating constipation, which may be one of the causes of back pain. Shunti aids in balancing the vitiated vata and reducing kapha.
    • It can be used in the form of fresh juice, decoction, powder, infusion, paste and pill.
  • Rasna
    • Rasna contains multiple phytoconstituents such as flavonoids, triterpenoids, sterols and lactones. These constituents make it useful in the treatment of various clinical conditions.
    • The plant is known to have anti-arthritic and anti-inflammatory properties, which is effective in improving the symptoms of inflammatory diseases and bone-related conditions that cause back pain.
  • Rasonam
    • Rasonam or garlic acts on the digestive, reproductive, nervous, respiratory, circulatory and digestive systems.
    • It clears ama, rejuvenates nerves and bone tissue, and relieves pain, inflammation and swelling. Therefore, it can be used in the treatment of back pain. Besides, this herb also treats cough, flu, heart disease, hypertension and asthma.
    • It can be used in the form of juice, infusion, powder and medicated oil.
  • Eranda
    • Eranda acts on the excretory, nervous, female reproductive, digestive and urinary systems and has a marked pain-relieving effect.
    • It is one of the most common herbs that are used for inducing purgation and in the treatment of swelling. It is also effective in treating lower back pain, sciatica, organ inflammation, rectal disorders, piles and rheumatism.

Ayurvedic medicines for back pain

  • Yogaraja guggulu
    • Yogaraja guggulu consists of chitraka (leadwort), rasna (Indian camphorweed), gokshura (small caltrops), twak (cinnamon), pippalimoola (long pepper roots), parsika yavani (stinking nightshade), guduchi (heart-leaved moonseed), guggulu (Indian bdellium-tree), vidanga (false black pepper), shatavari (hundred roots), etc.
    • It is useful in all vata diseases, especially arthritis, as it relieves pain and inflammation.
    • It is also helpful in the management of gouty arthritis where an imbalanced vata vitiates rakta, leading to swelling and pain.
    • Yogaraja guggulu balances vata dosha and eliminates ama, thereby, relieving pain in the affected bones and joints.
  • Simhanada guggulu
    • This formulation consists of many ingredients including shuddha guggulu (pure Indian bdellium-tree), vibhitaki (belleric myrobalan), haritaki (chebulic myrobalan), amalaki (Indian gooseberry), shuddha gandhak (pure brimstone) and eranda moola (castor roots).
    • It improves the digestive power, increasing the digestion of ama. It also reduces the production of excessive kapha and removes obstructions from the circulatory channels. It is effective in the management of numerous diseases that cause back pain.
    • Also, simhanada guggulu prevents ama from sticking around at the site of the disease.
  • Balarishta
    • Balarishta consists of bala (country mallow) roots, ashwagandha (Indian ginseng) roots, old cane jaggery, roots of eranda, cardamom, cloves, small caltrops, and various other ingredients.
    • It has rejuvenating properties and can be used in treating pain, swelling and inflammation of the joints. 
  • Dashmoola kashaya
    • It is a decoction prepared using the roots of 10 herbs, which include prishniparni (kalshi), brihati (bari katheri), bilwa (golden apple), shyonaka (Indian caper), agnimantha (headache tree), kantakari (chhoti katheri), gambhari (beechwood), and gokshura (small caltrops).
    • This medicine is effective in the management of many diseases caused by aggravated vata such as arthritis. Thus, it can also be used in treating back pain caused due to arthritic conditions.
    • Other conditions that can be managed with dashamoola kashaya are asthma and cough caused due to vata. It can also treat diseases of the bones associated with fever as well as degenerative diseases of the bones like osteoarthritis.

As treatments vary according to numerous factors such as an individual’s prakriti (constitution) and the affected doshas, consult a qualified Ayurveda doctor for the appropriate medications and treatment for your specific complaints.

Do’s

  • Consume easily digestible, nutritious and anti-flatulent foods. (Read more: Balanced diet chart)
  • Add fibre rich foods such as fresh fruits, barley, leafy vegetables and green salads in your diet to prevent constipation.
  • Include food items like udada (black gram), shigru (drumstick), brinjal, etc., prepared in ghee or any suitable oil. These food items help in alleviating vata dosha.
  • Include patola (pointed gourd), rasonam and draksha (grapes) in your regular meals.
  • Include vegetable soup and food items like kulattha (horsegram) and wheat products in your meals.
  • Exercise regularly   
  • Take enough sleep and try to keep a consistent sleep pattern.
  • Use hot water for drinking and bathing.
  • Use comfortable seats and bed.
  • Adopt a healthy posture.

Don’ts

  • Do not consume food items like chana (Bengal gram), kalaya (yellow pea) and kordusha (millets).
  • Do not drink cold water.
  • Do not eat pungent or astringent foods like red chillies and excessive spices.
  • Do not eat food items with low water content in it, e.g., wafers and biscuits.
  • Do not suppress natural urges like bowel and bladder movements.
  • Avoid over thinking, improper sleep and excessive physical work like over-exercise.
  • Avoid sponge-like mattresses.

A clinical study involving 20 participants with back pain, indicated that yapana basti (a type of basti using erandadimoola taila) is useful in the treatment of lumbar spondylosis and its symptoms, which include back pain, back stiffness, tenderness, sciatic pain, tingling sensation in the feet and heaviness in the feet. The frequency of administration of painkillers was also reduced to a significant extent.

Another clinical study, which was done for assessing the effectiveness of Ayurvedic therapy in lumbar canal stenosis, reported that yogaraja guggulu, dashmoola rasnadi kwatha, shatavari, ashwagandha, and gandharva haritaki, along with sarvanga abhyanga with tila taila (sesame oil), bashpa sweda and basti karma produced a significantly positive result in back pain symptoms. Not only was the pain relieved, but also the clinical condition of the participants was found to be considerably improved.

Even though natural remedies are safe and efficient, some precautions are always needed to get a better result and to avoid any adverse events. For example, virechana karma and basti karma are effective treatments for back pain, but these treatments should not be used in pregnant women, weak and elderly individuals, and in individuals with rectal ulcers and bleeding. Shunthi aggravates pitta and, thus, should be used with caution in individuals with skin diseases, fever, bleeding, ulcers, etc. Rasonam should be taken with caution in individuals with excess pitta and hyperacidity.

Back pain is a common problem that can occur due to an excessively sedentary lifestyle as well as extreme or repetitive physical work. A balance between work and rest needs to be maintained to have a healthy life. Exercise is known to make you healthier and stronger, but excessive exercise is not good for health.

Although mild back pain doesn’t hamper regular activity, ignoring it can aggravate the condition. Using ancient Ayurvedic techniques to treat back pain can help you live an active life.

Ayurveda describes various treatment procedures, medicines and herbs along with a healthy lifestyle for the treatment of back pain. Ayurevdic therapy involves the elimination of toxins and balancing the vitiated doshas to achieve relief from a condition. 

Dr. Gurpreet Virmani

Dr. Gurpreet Virmani

Ayurveda
1 Years of Experience

Dr. Sunil Kilaniya

Dr. Sunil Kilaniya

Ayurveda
3 Years of Experience

Dr. Tanushri Yeole

Dr. Tanushri Yeole

Ayurveda

Dr. Verender Singh Chaudhary

Dr. Verender Singh Chaudhary

Ayurveda
3 Years of Experience

References

  1. Central Council Of Indian Medicine. Standard Treatment Guidelines in Ayurveda.. New Delhi, India [Internet].
  2. National Institute of Indian Medical Heritage (NIIMH). Kaṭi-Śūla. Central Council for Research in Ayurvedic Sciences (CCRAS); Ministry of AYUSH, Government of India.
  3. Ministry of AYUSH, Govt. of India. Essential Drug List - Ayurveda . [Internet]
  4. Ashvin Bagd, Ranjeet Sawant. [link]. Ayurpharm - International Journal of Ayurveda and Allied Sciences, Vol.2, No.11 (2013) Pages 332 - 340.
  5. Kamini Dhiman. Leucorrhoea In Ayurvedic Literature - A Review. Ayurpharm - International Journal of Ayurveda and Allied Sciences, Vol.3, No.3 (2014) Pages 73 - 78.
  6. Sanjay Kumar Gupta, Anup B Thakar, Tukaram S Dudhamal, Aditya Nema. Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma. An International Quarterly Journal of Research in Ayurveda, 2015;36:413-5.
  7. Shweta A. Pandey, Nayan P. Joshi, Dilip M. Pandya. Clinical efficacy of Shiva Guggulu and Simhanada Guggulu in Amavata (Rheumatoid Arthritis). Ayu. 2012 Apr-Jun; 33(2): 247–254, PMID: 23559798.
  8. The Indian Medical Practitioners' Co- operative Pharmacy and stores Ltd. Vaidya Yoga Ratnavali . Adyar, Madras-20.
  9. K. P. Damayanthie Fernando. Clinical efficacy of Eranda Muladi Yapana Basti in the management of Kati Graha (Lumbar spondylosis). Ayu. 2013 Jan-Mar; 34(1): 36–41, PMID: 24049403.
  10. Deshpande Vaishali Shailesh. Effect Of Ayurvedic And Panchakarma Treatment In Grudhrasi (Lumbar Canal Stenosis): A Case Study. European Journal Of Pharmaceutical And Medical Research, 2018,5(2), 480-483.

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