Dr Ambika Nayak Presented PIVD Management at International Ayurveda Congress 2017 London

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Addressing Low back pain w.s.r. to PIVD through
Ayurveda Panchakarma

• DR A P Nayak,
• Chief Physician
• Astang Ayurveda
• Email drapnayak_at_gmail.com
• Website www.astangayurveda.com
• Mob 919437055021

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Why Low Back?

• Low back is the site of strength that keeps the
  human being errect.
• Low back is the sight of Muladhara chakra (earth)
  , Swadhisthana Chakra (water), Manipura chakra
  (fire).
• Low back is the site of sacral
• nerve plexus.
• Low back is the site of Vayu.
• (Pakwashaya, kati, sakthi
• srotrasthi sparshanendriyam)
• Vayu is powerful, unlike kapha
• and pitta.
• Sciatica, the largest nerve is
• originated from the lumbar plexus.

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Reasons of Low back pain

• Common reasons- Lumbar strain, Nerve irritation,
  Lumar radiculopathy, bony encroachment.
• Non arthropathic reasosns- Kidney, Ovary,
  Pregnancy, Tumour.
• Uncommon reasons- Infection in pelvis, cartilage,
  bone, herpes etc.
• All reasons do have good solution, and the
  absence of the reason will relieve the pain.
• But for PIVD (a common reason for LBA), no
  popular solution is available world wide other
  than spinal surgery and physiotherapy.
• Spinal surgery- The Risk is well known world
  wide.
• Physiotherapy- No medicine exercise is like
• exercise without food.

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What is PIVD?

• Prolapsed inter vertebral disc comes under the
  group of Low back pain or lumbo sacral disorder
  where the inter vertebral mass is prolapsed.
• The patient may complain of
• Dull pain in waist area.
• Sciatica Pain.
• Muscle weakness.
• Pain increasing with walking, decreasing at night
  
• temporarily relieve by bed rest.
• Trunk tilted towards or away from
• affected side.
• Lumber scoliosis
• Paraspinal muscle spasm.
• Extremities sensory aberrations , parasthesia
• numbness.

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What happens in PIVD?
ABOUT PIVD

• It is protrusion of pulpy inner material of an
  intervertebral disc through the fibrous outer
  coat causing pressure on adjoining nerve roots ,
  ligaments etc.
• This may result sudden twisting of backbone,
  sciatica etc.

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Modern Medical Science

• Modern medical science suggests-
• pain killer,
• muscle relaxant,
• calcium,
• B12,
• bed rest,
• exercise
• and finally
• neurosurgery to remove
• the herniated part which
• is not free from risk.

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Ayurveda

• Ayurveda understands, the
• herniation or prolapse or
• protrusion of intervertebral
• disc takes place due to
• compression of vertebrae.
• Compression takes place
• either due to trauma
• (due to external factors
• e.g. accident) or loss of
• tonicity of muscle, ligaments, nerves etc.

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Line of treatment

• Indoor admission- To support panchakarma
  treatment guidelines.
• Bed rest- To align the vertebral column and
  minimize manipulation. To recreate (samsarjana)
  the tone of muscles and ligaments after every
  treatment.
• Whole body treatment with snehana, kayasheka,
  pinda sweda etc. Ayurveda handles the patient not
  the disease.
• Localized treatment with pristha basti, pinda
  sweda, upanaha etc.
• Mrudu virechana, Anuvasana and Asthapana.

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A flow chart
Indoor Admission
Bed Rest
Generalized Treatment
Internal Medicine
Localized Treatment
Mrudu Virechana, Anuvasana Asthapana
Bed rest for Samsarjana of the body
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Group-1 Pain
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Group-1 Stiffness
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Group-1 Numbness
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Group-1 Radiation
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Group-2 Pain
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Group-2 Stiffness
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Group-2 Numbness
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Group-2 Radiation
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Group-1 Functional Ability
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Group-1 Laseagues sign in degree
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Group-2 Functional Ability
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Group-2 Laseagues sign in degree
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Why not Spinal surgery

• Spinal surgery may remove the herniated part of
  the disc over the spinal cord.
• But it does nothing to tone up the muscles,
  nerves, ligaments.
• Say, spinal surgery may
• remove compression from
• the spinal chord, but it
• does nothing to prevent
• the process compression
• of vertebral column.

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A failure case of spinal surgery

• The patient came
• to us after two
• consecutive
• spinal surgery
• for the same
• problem.

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Ayurveda Panchakarma prevents compression

• Ayurveda pancha karma rehabilitates the pain and
• the herniated mass,
• tones up the muscles,
• nerves, ligaments and
• prevents further
• compression of the
• vertebrae and prolapse
• of the intervertebral disc.

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What we do at Astang Ayurveda?

• Follow guide lines of Ayurveda
• management of PIVD.
• Patient admission into IPD.
• Ayurveda clinical methodology
• Modern investigations like MRI, X-ray etc.

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Treatment at Astang Ayurveda

• Personal care,
• strong practice of traditional
• specialized pancha karma
• treatment for PIVD,
• expertiztion over the particular
• treatment of PIVD,
• strict guidelines,
• diet regimen,
• need based clinical and para
• clinical consultation

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A question to all

• If Panchakarma treatment fails, then there is a
  scope of spinal surgery,
• if spinal surgery fails then

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Thanks