Evaluation of Add on Efficacy of Agni Karma with Siravyadha in Pain Management of Gridhrasi W.S.R to Sciatica-A Randomized Comparative Clinical Study

Background: 3.8% in the working population and 7.9% of the total population suffers from Sciatica. The Modern conservative treatments give short-term pain reduction with mild to serious side effects. Anushalya karma (Para surgical procedures) are been practiced as Atyayikachikitsa (Emergency care) for the pain management. Gridhrasi (Sciatica) was described in Ayurveda as Rujapradhana (Pain predominant) under Vataja Nanatmaja vyadhis (Diseases caused by Vatadosha). Objectives: To evaluate adding on efficacy of Agnikarma (Cauterization therapy) with Siravyadha (Blood letting therapy) and Siravyadha (Alone) in pain management of Gridhrasi with special reference to sciatica. Materials and Methods: 40 subjects diagnosed with sciatica after fulfilling the inclusion criteria were enrolled in the study. The procedures were performed for once after obtaining informed consent according to the randomized groups i.e. Control group (Siravyadha) and Interventional group (Siravyadha followed by Agnikarma). The pain assessment parameters i.e. VAS (Visual Analogue Scale)/Wong-baker face rating scale, VDS (Verbal Descriptive Scale), FLACC (Face Leg Activity Cry Consolability) scale, SLR (Straight Leg Raising) test along with classical lakshanas of Gridhrasi i.e., Stamba (Stiffness), Ruja (Pain), Toda (Pricking pain), Spandana (Pulsating sensation), Sakti utkshepanani grahanthi (Difficulty to lift the limbs with pain) and Sandhi Spurana (Pulsation in joints) were assessed from baseline and at different time points. Results: The add on therapy i.e. Agnikarma with Siravyadha have showed significant results (within and in between group) in parameters like pain (with p value <0.01.) and other classical symptoms like Stamba, Ruja, Toda, Spandana, Sakti utkshepanani grahanthi and Sandhi Spurana with p value <0.01, when compared with Siravyadha alone from baseline and at various time points. Conclusion: Agnikarma followed with Siravyadha is found more effective than the Siravyadha alone in the management of Gridhrasi.