April 25, 2013


                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

What is Vertebral Disc? :

The disc (or intervetebral disc) is a structure that is found in between the spinal vertebral bodies from the neck to the sacrum (tailbone). It serves as a cushion and helps the spine to move.
Each disc is composed of two parts, the nucleus pulposus (the central part) and the annulus fibrosis (the outer part). The nucleus pulposus provides the padding and it is surrounded by the annulus fibrosis which forms a ring around the nucleus pulposus. This pulposus also attaches to the vertebral bodies above and below.

The diseases frequently associated with the disc :
The diseases frequently associated with the disc are usually 2 in number, disc herniations (abnormal protrusions of a portion of the disc material) and disc degeneration (changes in the disc seen in normal aging and also in injury) respectively.

The sites usually affected by disc herniation in neck :

The most common levels for disc problems are in descending order C6-C7 (C refers to cervical and the number refers to the number of the vertebral body counting from the top), C5-C6, C7-T1 (here the T refers to the thoracic spine, the part that the ribs attach to), C4-C5 and very rarely C3-C4.

Why and how disc protrusions cause pain? :
Herniation of the contents of the disc into the spinal canal often occurs when the front side (stomach side) of the disc is compressed while sitting or bending forward, and the contents (nucleus pulposus) get pressed against the tightly stretched and thinned membrane (annulus fibrosis) on the rear (back side) of the disc. The combination of membrane thinning from stretching and increased internal pressure (200 to 300 psi) results in the rupture of the confining membrane. The jelly-like contents of the disc then move into the spinal canal, pressing against the spinal nerves, thus producing intense and usually disabling pain and other symptoms.

Symptoms caused by the herniation :
Pressure on a nerve root is referred to as cervical radiculopathy.Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathyThe most common symptom of a cervical disc herniation is neck pain that radiates (spreads) down to the arm in various locations. The specific location of the arm pain depends on which disc is involved. There can also be associated paresthesias (pain as if pricked with pins and needles) and in some cases weakness of some of the arm muscles. Patients find that turning their head away from the painful side helps. Extending the head makes the pain worse so that looking up is avoided. Bending the head down usually gives some relief.
Severe neck pain radiating to the back of head and down between the shoulder blades may be present with an acute disc prolapse. There may also be an associated muscle spasm aimed at limiting the movement and relieving the pain. How ever in certain occasions the spasm itself may cause generalised neck pain.

Cervical Disc Herniation Treatment :

The treatment of cervical disc herniation can be divided into two categories, conservative and Pancha karma with Marma Chikitsa.
In general, conservative management consists of maneuvers to reduce pressure on the nerve root. Immobilization with the neck in a flexed forward position may be helpful. Straining should be avoided. Medication in the form of anti vatic or anti vata-kaphaik like Maha Rasnadi, Prasaranyadi, Gulgulu thiktam etc., may be prescribed. As these medications are selected based on the Prakruti (Constitution) of the patient, patients should consult their doctor if taking any medications for longer than a few days. Ayurveda medicines of course do not cause any side effects, only when proper medicine is selected for proper Prakruti. Other wise it may aggravate the agony, there by giving an impression like that of a side effect. Say for example a person with Pitta Prakruti suffering from Bleeding Piles if consumes a preparation with Bhallataka (Semecarpus ancardium) as it’s ingredient, he can be rest assured that his symptoms are going to get worsened, sometime leading to hospitalization. It is because Bhallataka increases the Pitta and hence will drastically increase the flow of already existing venous blood loss in the bleeding piles. Physical therapy may be prescribed. This can consist of traction, mild stretching, exercise, heat, massage etc.
Pancha karma and Marma Chikitsa :

Forty five persons suffering from cervical disc prolapse were considered for the clinical evaluation of Marma Chikitsa and Panchakarma either done separately or in combination. The details are being listed beneath for better understanding.

List - 1
No of patients with cervical disc prolapse – 45
No of Males – 33
No of Females _ 12
Protrusion in C6-7 (Inclusive for both genders) -42
Protrusion in C5-6-7(Inclusive for both genders) – 03
Patients with Neck pain alone- 28
Patients with  Neck pain radiating up to fingers of both hands – 11
Neck pain radiating to nape, chest and up to fingers of both hand - 06

List– 2
The other tenderful marmas other than the C 5, 6, 7 are listed below.
Krikatika        -06 patients
Siramatrka     -03   ‘’
Kshipra Marm Manipulation
Amsa              -16    ‘’
Amsaphalaka – 06 ‘’
Apalapa          -06   ‘’
Kakshadhara – 02   ‘’
Sthanarohita – 06   ‘’
Kurpara         -13     ‘’
Indrabasti     - 09     ‘’
Manibandha – 09     ‘’
Kurcha         - 05     ‘’
Talahrdaya   - 06     ‘’
Ksipra          - 09     ‘’
List – 3 Mode of treatment selected
In Males for M/C alone 28 patients were selected and for M/C & P/K 05 was selected.
In Females 09 of the patients were selected for M/C and 03 for M/C & P/K.
Please Note: - M/C indicates (Marma Chikitsa) &P/K (Pancha karma)

Course of treatment:
A course of 10 days or 14 days of Marma Chikitsa alone or in combination with Panchakarma was done.

Improvements observed during the course of treatment.
Amongst the 45 cases, in almost 36 patients the symptoms started receding from 3rd day onwards. In 6 of them pain relief happened from 5th day onwards and the remaining 3 cases felt the difference from either 6th or 7th day. However all the 45 subjects (patients) felt completely relived from the pain caused by cervical disc prolapse on completing their course of treatment of 10 or 14 days, subjected to. Periodical evaluations for the next 1 year revealed that the re-occurrence of pain never happened in their case.

The year long study of the above 45 cases indicates that when persons suffering from the cervical disc prolapse, when subjected to Marma Chikitsa in combination or without that of Panchakarma, depending on the discretion of the physician, yields very good result in controlling and eradicating the annoy some pain, from which the patients had been suffering with. I hope this research of mine enlightens the readers with a wider and deeper knowledge of the subject dealt with.

The above work  had been uploaded at articlesbase.com erstwhile by me.
It is being re-shared in my blog, in want of adding necessary and appropriate images.
The original work @ articlesbase can be viewed @ http://www.articlesbase.com/alternative-medicine-articles/management-of-cervical-disc-herniation-with-marma-chikitsa-1239113.html

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