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IVDP (Inter Vertebral Disc Prolapse- Low Back and Neck)

Dr.C Manoj Kumar,Chief Physician, Nagarjuna Ayurvedic Centre Kalady, Kerala

05-05-2005

IVDP is commonly known as slip disc. This is a condition wherein, due to injury, the disc or the cushioning structure between the vertebrae bulges out or the material inside the disc protrudes. Depending upon the severity and the way in which the material is expelled, it is classified in to disc bulge, protrusion, extrusion and sequestration. Basically the bulged disc or the disc material occupy the space through which the nerves pass, leading to mild to severe compression on the nerve. Based on the intensity of compression, it will lead to severe pain, pain radiating to the leg, numbness, burning sensation, tingling sensation, weakness of the legs and loss of bladder control and in some cases loss of bowel control. High impact on a healthy disc or a moderate to high impact on an already degenerated disc is the reason for its bulge. It can be due to lifting heavy weight, wrong movements, long duration sitting,long drive and rarely due to sneezing in a wrong postures.

Ayurveda consider this as a Vata type of disease, Grudhrasi. Here vata is aggravated at the lower back due to wrong diet, excessive movements and high impact on low back, continuous stress and strain, intolerable level of regular exercise etc. Vata is responsible for all movement and its predominant properties are dry, rough and light. So it creates dryness and roughness in and around the affected area leading to degenerative changes of the disc which is generally a highly hydrated, soft and flexible structure. As the dehydration progresses, the collagen fibres in the disc walls,due to continuous hard impacts on the low back,start breaking one after the other. When certain number of fibres are broken, that part of the disc will not be able to hold the disc material inside, due to the exerted pressure. So it starts bulging out. These symptoms when neglected or not taken care at this stage, leads to breakage of the wall and the inner material, which resembles chewing gum flows out and occupies the space through which the nerves pass. This applies pressure on the nerves leading to a condition known as GRUDHRASI ( Sciatica / Radiculopathy).

Ayurvedic management in such conditions are done with both internal medications and external therapies. No manipulations are done. As the condition is due to Vata aggravation, basic line of management is to pacify Vata by performing Panchakarma therapies. . The line of treatment is to first handle the inflammation, then help repair the wear and tear, and lastly reinforcement of the core muscles and ligaments supporting the vertebral column. This whole plan of treatment, when executed, will help in the management of the existing complaints and also prevent further deterioration of the condition. Proper rest is advised after the phase of reinforcement. This helps the structures to go through a resetting process and become firm enough to support the discs. Thisin turn will reduce the pressure exerted on the disc and give the patient considerable relief from the presenting complaints.

Ayurveda offers very effective prognosis up to the stage of extrusion, helping the patient avoid surgical intervention. In most of the cases, acute pain is from one level while other levels are vulnerable and could lead to acute pain at a later stage. So treatment for the management of the symptoms caused by a particular level will also benefit the other levels and reduce their vulnerability. Those who develop IVDP in the low back also have a risk of developing the same at the neck level. So when the patient undergoes our therapies, they also get the benefit of repair and reinforcement of the cervical spine.

Nagarjuna has successfully treated 100s of cases of such cases, including those advised for immediate surgery. We have developed a speciality protocol and our R&D have come up with speciality medicines for the treatment of such conditions. Integrative approach of taking expert opinion from orthopaedic surgeons, taking the advantage of MRI for precise diagnosis and treatments, physiotherapy are some of the steps practised for best results.

Disc prolapse can also happen at the neck level. The basic line of management is also the same. But based on area and severity, internal and external medicines, applications and therapies might differ. Nasal administration of medicated oil is an important procedure practised specifically in the management of cervical disc prolapse along with other therapies explained above.

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