Dr. Ambika Prasad Nayak, the chief physician at Astang Ayurveda, presented a paper presentation on PIVD management in International Ayurveda congress, 2017, London.

1. DR A P Nayak,
Chief Physician
Astang Ayurveda
Email: drapnayak@gmail.com
Website: www.astangayurveda.com
Mob: +919437055021

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. A flow chart
Indoor
Admission
Bed Rest
Generalized
Treatment
Internal
Medicine
Localized
Treatment
Mrudu Virechana, Anuvasana & Asthapana
Bed rest for Samsarjana of the
body

10. Group-1: Pain

11. Group-1: Stiffness

12. Group-1: Numbness

13. Group-1: Radiation

14. Group-2: Pain

15. Group-2: Stiffness

16. Group-2: Numbness

17. Group-2: Radiation

18. Group-1: Functional Ability

19. Group-1: Laseague’s sign in degree

20. Group-2: Functional Ability

21. Group-2: Laseague’s sign in degree

22. 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.

23. A failure case of spinal surgery
 The patient came
to us after two
consecutive
spinal surgery
for the same
problem.

24. 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.

25. 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.

26. 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

27. A question to all
 If Panchakarma treatment fails, then there is a scope
of spinal surgery,
 if spinal surgery fails then…

28. Thanks