Ayurvedic Management of Lumbar Canal Stenosis with Hip Joint Inflammation in a Diabetic Farmer: A Successful Panchakarma-Based Case Report

Abstract

Intervertebral disc bulge is a fairly prevalent musculoskeletal condition associated with chronic pain in the lower back, radiculopathy, mobility dysfunction and disability, and may overlap with the diagnosis of lumbar spinal stenosis. But with diabetes mellitus, the tendency for healing may be delayed, the inflammatory reactions and side effects of steroids and surgery may increase, making management more difficult. Case report on treatment of a farmer man aged 39 years had been diagnosed as lumbar stenosis with diffuse bulges at L3-L4 and L4-L5 levels with foraminal narrowing, mild thecal sac compression and traumatic hip joint inflammation of right hip joint as a case illustration of successful treatment through the Ayurvedic medicine. The patient had severe pain in the lower back (Katishul), disturbed sleep, inability to walk without the support of a walker and right lower limb radiating pain and tingling sensation (Shoth). All clinical findings persisted and were still associated with significant functional impairment despite surgical (traditional orthopedic) and steroid therapy. The treatment modality was given in Panchakarma format in various stages like Lep Chikitsa, Sarvang Snehan with Til Tail, Dashamul Bashpa Swedan, Sthanik Taildhara with Murivenna and Kottamchukkadi Taila, Shashtika Shali Pinda Sweda processed with Bala and Ashwagandha. The internal medicines such as Kaishor Guggul, Lakshadi Guggul, Aampachak Vati, Mahamanjistadi Kashay were also given. Post treatment, there was appreciable clinical improvement which involved reduction in intensity of pain, abolition of hip swelling, and improvement in gait, mobility, neurological symptoms and improved quality of sleep. The patient slowly began to move about without any much help and started functioning independently. In insulin dependent diabetes, in monitoring blood glucose level due attention was taken and there is personalization in Panchakarma schedule. The present case thus shows that not only the conservative and integrative measures like Panchakarma in medically complicated diabetes, but the same is effective in the case of Lumbar stenosis with radiculopathy along with traumatic inflammatory condition also.