The upright posture of human beings has always provided functional advantages, but it has also led to musculoskeletal conditions such as low back pain (LBP). Statistics show today one in three individuals experience pain, stiffness, spasms or restricted movement in the region, especially after age 40. Not just this, according to the World Health Organization, LBP is the single leading cause of disability worldwide.
Low back pain can stem from degenerative factors like ageing, stress, inflammation, or mechanical causes such as sudden weight lifting or falls. It may result in spinal disc issues such as bulges or protrusions and that’s why identifying the cause is crucial for effective treatment.
Cause and remedies Ayurveda recognises the condition as Kateegraham, where katee refers to the low back region. The term grdrasi is used to describe sciatica, the pain in the region that radiates down to both limbs due to a protruded disc. In ayurveda, the condition is assessed on the basis of which dosha is dominant. Typically, pain and inflammation are associated with vata, and stiffness with kapha.
The entire low back and pelvic region is considered the domain of vata. Any disturbance here, even beyond musculoskeletal causes like constipation, pelvic inflammatory disease, inguinal hernia, or a history of caesarean sections, can affect the normal functioning of vata. Internal medicines are prescribed based on assessment.
For example, Rasnasaptakam kwatham is given for musculoskeletal issues, while Gandharvahastadi kwatham is prescribed for functional issues, along with pain relief tablets. At the inpatient (IP) level, lepanam (medicated paste) is applied to alleviate inflammation, and bandhanam (medicated bandages) are used to provide support and rest for soft tissues. Additionally, oil application in the form of massages, irrigation procedures and local holding is performed to strengthen the affected area.
Role of panchakarma In the management of acute low back aches, vasthi (therapeutic enema) plays a major role. Its different types, such as vaitarana vasthi, kshara vasthi, madhutailika vasthi, are prescribed based on the individual’s condition. Various external therapies, including patrapotala sweda, jambeera pinda sweda, choorna pinda sweda (sudation using different materials like leaves, lemon and powders), kati vasthi and kati dhara are also performed. In some cases, panchakarma can even help avoid surgeries for disc protrusion.
Prevention better than cure To prevent LBP, be mindful about postures, take breaks to stretch if you have a sedentary job, use ergonomic chairs, and avoid prolonged periods of standing. Other measures include avoiding head baths during noon and late night, having an early and light dinner, not sleeping on the stomach, maintaining meal timings, walking regularly, and ensuring a two-hour gap between dinner and sleep. You should also use even-surfaced beds that provide adequate back support, rather than spring beds. Regular application of oil, as advised by a practitioner based on age, body constitution, work pattern and disease, can be a game-changer in preventing low back ache.
The author is a Professor at the Department of Panchakarma, Ashtamgam Ayurveda Medical College, Kerala
