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क्रॉनिक लोअर बैक पेन विद लेग रेडिएशन - #45456
मरीज की रिपोर्ट: लम्बर स्पाइन और लक्षण मरीज का नाम: جی جمیل مینگل जन्म तिथि: 5 सितंबर 1985 मुख्य शिकायत: लंबे समय से निचले हिस्से में दर्द जो दाहिनी टांग तक फैलता है --- वर्तमान बीमारी का इतिहास (दर्द की कहानी) मरीज ने बताया कि उसे पिछले 1 साल से निचले हिस्से में दर्द है, जो धीरे-धीरे बढ़ता गया है। दर्द मुख्य रूप से निचले लम्बर क्षेत्र (L4-S1) में होता है और दाहिनी टांग तक फैलता है, जो सायटिक नर्व के रास्ते का अनुसरण करता है। मुख्य लक्षण शामिल हैं: दाहिनी टांग में तेज, चुभने वाला दर्द, खासकर बैठने या आगे झुकने पर। दाहिने पैर में कभी-कभी झुनझुनी और सुन्नता। वजन उठाने, मरोड़ने या लंबे समय तक बैठने से दर्द बढ़ जाता है। फर्श पर घुटनों को थोड़ा मोड़कर लेटने या निचले हिस्से के नीचे एक छोटा तौलिया रखने से अस्थायी राहत मिलती है। निचले हिस्से में अकड़न और गति की सीमित रेंज के एपिसोड। पुराने दर्द और असुविधा के कारण यौन क्रिया में कमी। मरीज ने हाल ही में किसी चोट या प्रणालीगत लक्षण जैसे बुखार या वजन घटने से इनकार किया है। --- एमआरआई निष्कर्ष (लम्बर स्पाइन) इमेजिंग की तारीख: 22-अप्रैल-2025 (नवीनतम लम्बर एमआरआई उपलब्ध) निष्कर्ष: 1. लम्बर स्पोंडिलोसिस: लम्बर स्पाइन में हल्के अपक्षयी परिवर्तन देखे गए। 2. डिस्क डेसिकेशन: L4-L5 और L5-S1 पर, डिस्क हाइड्रेशन की कमी का संकेत। 3. डिस्क उभार: L4-L5 पर हल्का से मध्यम उभार। 4. L5-S1 डिस्क: दाहिनी ओर हल्का से मध्यम डिस्क उभार, जिससे दाहिनी L5-S1 नर्व रूट पर दबाव पड़ता है। 5. स्पाइनल कैनाल: L5-S1 पर हल्का केंद्रीय कैनाल स्टेनोसिस। 6. संरेखण: लम्बर लॉर्डोसिस का हल्का सीधा होना। 7. अन्य अवलोकन: फ्रैक्चर, मास या तीव्र डिस्क हर्नियेशन का कोई सबूत नहीं। प्रभाव: L4-L5 और L5-S1 पर डिस्क उभार के साथ लम्बर स्पोंडिलोसिस। दाहिनी L5-S1 नर्व रूट पर दबाव, जो दाहिनी टांग में रेडिकुलर दर्द से मेल खाता है। हल्का लम्बर लॉर्डोसिस का सीधा होना और हल्का कैनाल स्टेनोसिस। --- क्लिनिकल संबंध एमआरआई निष्कर्ष मरीज के निचले हिस्से के दर्द के लक्षणों के साथ मेल खाते हैं, जो संभवतः L5-S1 पर नर्व रूट के दबाव के कारण होते हैं। वर्तमान में, फिजिकल थेरेपी, नर्व पेन मेडिकेशन और पोस्चर में बदलाव सहित रूढ़िवादी प्रबंधन की सिफारिश की जाती है। वर्तमान दवाएं: टिज़ानिडाइन प्रेगाबालिन 75 मिग्रा (पहले बंद कर दिया गया) लाकोसामाइड (हाल ही में शुरू किया गया) ओमेप्राज़ोल कोबालामिन (विटामिन B12) पिरॉक्सिकैम बेटासाइक्लोडेक्सट्रिन अतिरिक्त नोट्स: मरीज ने बताया कि लाकोसामाइड के साथ लक्षणों का बेहतर नियंत्रण होता है, प्रेगाबालिन की तुलना में। लेटते समय निचले हिस्से के नीचे एक छोटा तौलिया रखने से अस्थायी राहत मिलती है। दर्द और नर्व के कारण मरीज की यौन गतिविधि करने की क्षमता सीमित है।
How would you describe the intensity of your pain?:
- ModerateHave you noticed any specific activities that trigger or worsen your pain?:
- Bending forwardHow often do you experience tingling or numbness in your foot?:
- Rarelyइस स्थिति के लिए डॉक्टर द्वारा सुझाए गए उपचार
डॉक्टरों की प्रतिक्रियाएं
Hello It was really nice of you to share your medication details along with the symptoms. I can totally empathize with you. Chronic back pain with nerve involvement naturally is very painful and takes away the comfort of the day-to-day life and also the personal life to some extent. I am going to help you in a very safe, integrative Ayurvedic way considering your existing medicines.
YOUR CONCERN Your symptoms depict Medium chronic pain The pain intensifies when you bend forward Occasional numbness and tingling Sexual activity limited due to pain & nerve discomfort Temporary relief with a small towel under the lower back
Your relief from the use of a towel confirms that you are supporting your lumbar lordosis, which is typical in Vata disorders of the spine.
👉Your Current Medicines –
You are taking: 1.Tizanidine – muscle relaxant 2. Lacosamide – nerve stabilizer (you feel better on this ✅) 3.Omeprazole – stomach protector 4.Vitamin B12 – nerve nourishment 5. Piroxicam Betacyclodextrin – pain killer ❌ Pregabalin – stopped (since Lacosamide works better)
➡️ The first piece of good news is that these are the right medicines for controlling nerve pain and spasm.
However, long-term use of painkillers and muscle relaxants can weaken the digestive system and, according to Vata, make it worse, so Ayurvedic support is very necessary at this time.
✅ Ayurvedic Treatment Plan
PANCHAKARMA (Purification - only under the supervision) In case pain becomes chronic or increases: Matra Basti (oil enema) with: Bala Taila This nourishes the nerves and lumbar spine directly.
INTERNAL MEDICATION
You are allowed to take the following along with your present medicines (it would be better if there is a gap of 1–2 hours between them):
1.Yograj Guggulu - 1 tablet twice daily after food (Reduces nerve compression & stiffness)
2. Dashmoolarishta – 20 ml with equal water at night (Best anti-Vata spine tonic)
3. Maharasnadi Kashayam – 15 ml twice daily with an equal amount of water before food (Perfectly suited for nerve and joint inflammation)
4. Ashwagandha Churna - ½ tsp at night with warm milk (Nerve, muscle strength & stamina improvement)
5. Balarishta – 15 ml at night (Improves pelvic, lower back & sexual strength)
✅ External Ayurvedic Therapy (Very Important)
Daily massage of: - Lower back - Hip region - Back of thighs with: Mahanarayan Taila
– 15 mins daily – Follow with a warm water bath – This brings about the following improvements: Better blood circulation Nerve lubrication Reduction of the stiff feeling Gradual sexual function improvement
✅ DIET PLAN As you are taking pain medicices
✅ Eat:
Warm, soft foods Rice gruel, khichdi Ghee – 1 tsp daily Milk at night Soaked almonds (5)
❌ Avoid
Dry food (biscuits, bakery) Cold drinks Too much tea/coffee Late-night dinner
✅LIESTYLE ADVICE While sleeping, use a small towel under your lower back (continue ✅)
❌ Avoid: Suddenly bending forward Sitting on the floor Using a squatting toilet
✔️ Do: Walking at a gentle pace Simple spine stretching (only within a pain-free range)
✔️ Do not lift heavy things
✅ Sexual Activity Issue – Important Reassurance
Your limitation is the result of: Compressed nerves Pelvic Vata aggravation Muscle spasm & fear of pain
✅ This is REVERSIBLE with nerve nourishment + oil therapy + Ashwagandha + Balarishta.
✅ Investigations Suggested (If Not Done)
MRI Lumbar Spine (if pain persists > 3 months) Vitamin D3 ESR / CRP Blood sugar levels
- Lacosamide is the one you are responding better to, and this confirms a nerve origin which Ayurveda treats root-level. - With oil therapy + internal Vata medicines + diet correction, you may: Reduce your reliance on painkillers Improve your movement Restore your confidence in daily life Naturally improve the quality of your sex life
Warm Regards Dr Snehal Vidhate
Medicines 1 Maha Rasnadi Kashayam: 15ml mixed with 45ml warm water, twice daily before food. 2 Trayodashang Guggulu: 2 tablets twice daily with warm water. 3 Ksheerabala 101 (Softgel Capsules): 2 capsules daily (1 morning, 1 night) with warm milk. 4 Ashwagandha Churna: 1 teaspoon mixed with 5 Kapikacchu Churna (1/2 teaspoon) in warm milk at bedtime.
External Therapy Local Abhyanga: Apply warm Mahanarayan Thailam gently on the lower back and down the right leg. Leave for 30 minutes before warm water bath. Kati Pichu: Soak a cotton pad in warm Murivenna Oil or Mahanarayan Oil and place it on the lower back (L4-S1 area) for 20 minutes daily while lying down.
Dietary Advice Vata Pacifying Diet: Eat warm, cooked, and slightly oily foods (using Ghee). Exclusions: Strictly avoid chickpeas (chana), kidney beans (rajma), potatoes, cauliflower, and cold drinks. Hydration: Drink only warm water to prevent constipation.
Lifestyle Advice Posture: Avoid forward bending completely. Ensure knees are not higher than hips when sitting. Lumbar Support: Continue using the small towel roll under the lower back. Activity: Restrict sexual activity until acute pain subsides.
Regards Dr Gursimran Jeet Singh MD Panchakarma
Maharasnadi guggulu 1 BD Ashwagandha capsule 1 BD Dashamoola aristha 4 tsp BD MAHAMASHA taila - for massage
No worries Let him start on Dashamoola kwath -1 teaspoon in 400 ML water boil until it remains hundred ML filter and drink twice daily on empty stomach Trayodashanga guggulu 1-0-1 Peedantaka vati 1-0-1 Maharasnadi kashayam 15-0-15 ml with water Ashwagandha churna half teaspoon with warm milk at night Mahanarayana taila gentle massage to be done Avoid lifting heavyweight Bending forward Take rest, if still pain persist. It’s better to offer for Panchakarma procedure.
Don’t worry take brihath vata chintamani ras 1tab bd, rasandi Guggulu 1tab bd,maha yoga Raja Guggulu with Gold 1tab, mahanarayana tail external application enough, swadista virechana churnam 1tsp with lukewarm water enough
Take ashtisrukhala ghee 5 ml morning at empty stomach Take lubartone 2 tds Take pulcurd 2 bd Take mahayograj gugulu 2 bd
Start with Brihat vat chintamani ras 1-0-1 after food with water Trayodashang guggul 1-0-1 after food with water Ekangvir ras 1-0-1 after food with water Apply ashwagandha oil+ Nirgundi oil on affected painful areas twice daily Wear lumbo sacral waist belt during the day Avoid moving in vehicles on rough roads surface. Once pain reduces start with yogasana or exercises specific under expert guidance. Follow up after 1 month.
The chronic lower back pain and right leg radiation you’re experiencing seems to be largely due to nerve root compression at L5-S1, linked with the disc bulge revealed in your MRI. The symptoms you describe, such as sharp shooting pain, occasional tingling, and the temporary relief from placing a towel under your back, align with the typical signs of sciatic nerve irritation.
From an Ayurvedic standpoint, the imbalances may be related to aggravated Vata dosha, which governs movement and nerve impulses. The goal here would be to pacify Vata through lifestyle adjustments, diet, and specific therapies.
Diet and Lifestyle Changes:
1. Support your digestion by favoring warm, nourishing foods that can quiet Vata. Use spices like ginger, cumin, and turmeric in cooking, which assist in reducing inflammation.
2. Ensure regularity with meals and consider including dairy like warm milk with a pinch of nutmeg or turmeric at bedtime, as these can be soothing and help improve sleep quality which is often disturbed by pain.
3. Sedentary positions can exacerbate your condition. Practice subtle spine movements and gentle stretches (like cat-cow) one to two times daily to maintain flexibility without straining. Capsaicin-based creams may also be applied locally for some relief.
Ayurvedic Therapies:
1. Abhyanga (warm oil massage) using oils like Mahanarayana or Dhanwantharam taila can aid in relieving stiffness and Vata accumulation. Massage should be gentle and, if possible, carried out by a trained therapist initially.
2. Bastis (medicated enemas) are recommended for Vata imbalances in the lower body. These should be administered under professional guidance for effectiveness.
3. Consider oral Ayurvedic formulations like Trayodashang Guggul or Yograj Guggul, which help normalizing Vata and support nerve health, always consulted with a practitioner to assure safe integration with current medications.
Remember, while these suggestions may alleviate symptoms, continuing consultation with your healthcare provider is crucial for multifaceted management of your symptoms to prevent further complications.
Some regime you should follow
✔️Do’s:✔️ Eat freshly cooked food. Chew an inch of fresh ginger half an before meal. Eat only fruit vegetables. Limit dairy products (stop if possible)
🧘♀️Yoga🧘♀️ Virabhadrasana Trikonasana Vrukshasan Prasavkonasan Bhujangasan Balasan Shavana
🧘♀️Pranayam🧘♀️ Anulom Vilom Bhastrika Kapalbhati
❌Dont’s:❌ Sitting directly under a fan or right in front of the A.C Oily, spicy, processed food. Packed food products. Sour and fermented items. Bakery items. Fried food products. Potatoes.
💊Medication💊
Tab. Ampachak Vati. 2 tabs twice a day before food. Tab. Sinhanad Guggul 2 tabs twice a day before food. Cap. Palsinuron 2 caps twice a day before food. Syp. Dashmoolarishta 3 tsp twice a day before food with warm water.
Tab. Shankhavati 2 tabs twice a day after food. Suck and eat like hajmola
Sunthi Siddh Castor Oil. 3 tsp at bed time with a cup of hot water.
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