Katigraha

To Know more about Katigraha - Low Back Ache

1. welcome
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2. KATI GRAHA VIS –A –VIS BACK PAIN
and
ITS MANAGEMENT PROTOCOL
By
Dr. ABDUL SUKKUR M
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3. PAIN
Subjective factor.
a discomfort or uneasiness.
Ayurvedaas Rujarelated to Roga; Dukha–Misery ( Mind and Body, Both ).
Attachment to Worldly affairs ( Upadha) –cause for Dukha.
Katigraha–pain in Kati region causing difficulty in movement.
Back Pain –LBA; pain in lower part of the back of body .
INTRODUCTION
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4. •Epidemic in most industrial countries.
•upto65% of the population have
Back pain.
•most common cause is mechanical
-soft tissue injury,facetjoint damage,
disc protrusion.
•Ageing is also relevant cause.
•In Young majority ( 90% ) resolve
with analgesia & rapid progressive
return to normal active is better.
•Bed rest, Physiotherapy –last option.
BACK PAIN
occurence
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5. INगदनिग्रहःBYश्रीमद्वैद्यसोढल
वाय ःकट्यानश्रतःश द्धःसामोवाजियेद्र जम्।
कनटग्रहःसनवज्ञेयःपङ्ग सनथिद्वयानश्रतः॥
-वातरोगानिकारः19/160
Pain in Kati region –low back.
KATIGRAHA
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6. स्फिक्पूर्वा कटिपृष्िोरुजवनुजङ्घवपदं क्रमवत्
गृध्रसी फथम्भरुक्तोदैगृाह्णवतत फपन्दतेमुहुुः ॥
र्वतवद्र्वतकिवत् तन्रवगौरर्वरोचकवस्न्र्तव ॥
-र्वतरोगवधिकवरुः 19/62,63
•Pain in different parts in a continuous manner in lower extremity
•According to chronicity, starting from Low Back to Buttocks -> leg
•Types –वातात्; वातकफात्.
GRIDHRASI
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7. CAUSES
HERNIATED INTERVERTEBRAL DISCS
SPINA BIFIDA
SPONDYLOSIS
RELATIONS WITH DISEASES
BACK PAIN
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8. •Herniation of an Inter vertebral Disc is common and its accurate diagnosis and
treatment has financial and social as well as medical implications.
•The material from the central portion of the disc (Nucleus pulposus) may herniate
through the annulus in two directions –1) Lateral to the posterior longitudinal ligament,
to compress the spinal roots or 2) Posteriorly, to compress the cord or Cauda Equina.
•The acute protrusion may follow trauma, abnormal movement or weight bearing, but
other factors such as degeneration of disc, spondylosis or congenital abnormalities of
the vertebrae also may be relevant.
•The common sites afffected are the cervical and lumbar spine, the signs and symptoms
depend on the sites and extent of disc protrusion.
•In cervical spine the most common sites are between C5 / C6 & C6 / C7
•In lumbar spine the common sites affected are between L4 / L5 & L5 / S1
•Thoracic disc herniations are not common.
HERNIATED INTERVERTIBRAL DISCS
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9. •Local Pain is common and may be exacerbated by movement, coughing or sneezing.
There is usually associated local spasm and the patient resists all movements.
•Compression of the associated nerve results in pain referred along its distribution.
Stretching of the nerve root exacerbates the pain and this forms the basis of the Straight
Leg Raising ( SLR ) Test.
•Herniationof the disc into the cord may produce in the patient with symptoms and signs
of cord compression like muscle weakness, sensory loss and upper motor neuron signs.
•The diagnosis of the disease is usually made on Clinical examination and
Straight X-ray of the Spine; CT and MRI may help to identify more accurately the size
and site of herniation.
CONTD….
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10. •Spina bifida results from the defective fusion of the Vertebral arches.
•The most common site is in the lumbar region.
•Spina bifida occulta may be found in asymptomatic people who are X-rayed for
some other reasons.
•In some patients, there may be associated tuft of hair over the lower back or
tethering of the cord with a dimple in the skin.
•Spina bifida occulta is often a benign complaint that requires no treatment, but
occassionally may lead to progressive motor and sensory deficits.
•Diastematomyelia is a congenital anomaly in which the spinal cord is split in two by a
long, cartilaginous or fibrous band arising from the posterior surface of a vertebral body
in the thoracic or lumbar spine.
SPINA BIFIDA
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11. •In Spina bifida, there is often a progressive lower motor neuron deficit involving bowel,
bladder and lower limbs .
•The common cutaneous sign is a tuft of hair over the lower back or a dimple,
haemangioma, lipoma, sinus or skin tag .
•The symptoms start when the child starts to walk and gait may be abnormal due to
weakness or pain. Neuropathic changes may subsequently appear in the feet.
•In the severe form of Spina bifida, the meninges may protrude through the bony defect (
meningocoele ) and may include neural elements ( meningomyelocoele ). These
abnormalities are often associated with hydrocephalus and usually there is impairment of
leg and bladder function.
•Surgery is required to cover the defect and shunting is necessary for hydrocephalus.
CONTD....
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12. •Spondylosis is the term applied to chronic degenerative changes that occur with
ageing in the intervertebral discs and the associated changes in the adjacent
ligaments and vertebral bodies, including the out growth of osteophytes .
•Here the symptoms and signs are usually slow progressive, in contradistinction to
those of a disc protrusion, which are acute .
•Radicular compression produces pain, which may be referred, and there may be
associated with muscle spasm .
•Lower motor neuron weakness and wasting may occur.
•Spinal movement may be reduced and movement may exacerbate pain.
SPONDYLOSIS
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13. •गृध्रस्यादौदशमूलानदयोगः -ग. नि. 19/142
•गृध्रस्यादौपञ्चमूलीयोगः -ग. नि. 19/144,145
•गृध्रस्याांरास्िाग ग्ग ल ः -ग. नि. 19/146
•कनटशूलग्र ध्रस्योरेरण्डबीजपायसः –ग. नि. 19/143
•कनटशूलगृध्रस्योःश ण्ट्याद्यःपायसः–ग. नि.19/147
•कनटग्रहादौत्रयोदशाङ्गोग ग्ग ल ः -ग. नि. 19/149
MANAGEMENT
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14. MANAGEMENT
•गृध्रस्यातंिरांसम्यग्यावकाद्यैनविशोनितम्।
( यावकनविादूिवालेयवागूआनद)
•ज्ञात्वानिरामांदीप्तानग्िबनस्तन ःसम पाचरेत्॥
-ग. नि. 19/148
•िादौबनस्तनवनिक यािद्यावदूर्ध्वंिश र्ध्यनत।
स्िेहोनिरििकस्तत्र स्ममन्येवाहुनतयििा॥
–ग. नि.19/149
•In जङ्घाregion–स्िेहि, स्वेदि
MANAGEMENT
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15. CONCLUSION
•Katigraha can be related with Back Pain.
•In Katigraha pain is in the lower back region, in due course of time difficulty in
walking will be seen due to the pain radiating to the lower limbs.
•Back Pain explained in contemporary medical science is similar to the signs and
symptoms of Katigraha explained in Ayurveda.
•In chronicity of the disease it may manifest with severe radiating pain starting
from the buttocks to the back part of the leg; thus can be related with the
disease Gridhrasi explained in Ayurveda.
•The Management protocol has to be planned according to the necessity
considering the general health of the patient and the severity of the condition.
CONCLUSION
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16. •CLINICAL MEDICINE By Charles D. Forbes, William F. Jackson
•CHARAKA SAMHITA –SHAREERA STHANA
•GADA NIGRAHA By Shrimad Vaidya Shodala
LIST OF REFERENCES
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17. thank you
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सर्े सन्तु तनरवमयवुः