ABSTRACT

It is very rightly said, if you seek health, look first to the spine. Hence, describing the importance of the spine for the health of the body very well. Spine is considered to be the central support structure of the body. It is a bony structure that protects the spinal cord and helps to bend, sit or twist. There are various conditions related to the abnormality in the spine and spinal cord known to deplete the quality of life of the victim. One such problematic condition is the Cauda Equina Syndrome. This condition will be described in detail along with its causes, symptoms, management, and ayurvedic perspective, etc. in the following article.

INTRODUCTION

Cauda equina is a latin word translated as the horse tail. The Cauda Equina is the end part of the spinal cord where there is a collection of nerves. Due to resemblance of this part with the tail of the horse, it is referred to as cauda equina. The cauda equina syndrome is marked as a condition in which there is abnormality or dysfunction of multiple nerve roots such as the lumbar and sacral, etc. of the cauda equina. It is an emergency condition that requires regent medical attention. Unavailability of appropriate medical help can worsen the situation and have adverse results such as paralysis, impaired bladder and bowel movements, and various other neurological conditions, etc. The causes of cauda equina are described as follows.

CAUSES OF CAUDA EQUINA SYNDROME

There could be a variety of causes underlying the condition of cauda equina syndrome which will differ from patient to patient. The most common cause being the presence of a herniated disc of large size in the lumbar region. Various other possible causes of cauda equina syndrome include congenital deformities (birth defect), lumbar spine stenosis, lesions or tumors in the spine, etc. There can be iatrogenic causes also such as spinal anesthesia or as a postoperative complication of lumbar spine surgery. These causes along with numerous other causes can result in various presentations of the cauda equina syndrome which will be described as follows.

SYMPTOMS OF CAUDA EQUINA SYNDROME

The cauda equina syndrome is characterized by a wide range of features which depends on the extent of compression of the nerve roots. The patient may experience few or all of the following features such as -

• Disturbed urine urge - The patient does not feel the urge to pass urine or the normal sensation to urinate even when his/ her bladder is filled with urine.
• Reduced or no voluntary control over urine and bowel movement - The patient may experience incontinence of urine due to the overful bladder and the anal sphincter dysfunction will lead to fecal incontinence.
• The patient may experience pain and weakness in various parts of the body. Pain may be observed most commonly in the back or legs.
• The weakness may be felt either in one or both the lower extremities.
• There could be various difficulties or sensory disturbances related to anus, buttock region or the genital region. The patient may also face sexual dysfunction.

If there is presence of these features in anyone, he/she must be provided with urgent medical attention and detailed evaluation should be performed to identify or diagnose the condition.

DIAGNOSIS & TREATMENT

Diagnosing the cauda equina syndrome will require the detailed medical history of the patient. There can be different types of diagnostic tests that will be helpful in diagnosing the cauda equina syndrome such as MRI (magnetic resonance imaging), CT (Computed tomography) scan and myelogram, etc. After the diagnosis, immediate medical management must be provided. The line of treatment according to the modern system of medicine will indicate surgery as the main aim will be to remove the compression from the nerve roots. Urgent medical attention is required to deal with the scenario appropriately, in lack of the management, consequences may be very severe such as permanent paralysis and incontinence. Let’s discuss the ayurvedic perspective of the cauda equina syndrome.

AYURVEDIC ASPECT

The cauda equina syndrome presents similarities with various conditions described in ayurveda such as gridhrasi, khanja and pangu. It should not be designated with one name but can be associated with dushti of the vata dosha. There are five types of vata dosha mentioned in the ayurvedic texts namely, prana vayu, udana vayu, samana vayu, vyana vayu and apana vayu. In the condition of cauda equina syndrome, there is vitiation or dushti of the vata vaha srotas and considering the clinical manifestations, the affected regions are the adho nabhgata region and the vyana vayu and apana vayu are more prominently vitiated. The treatment methodology will target the equilibrium of the vata dosha levels to restore the health of the body. This can be achieved by using various ayurvedic formulations such as vrihat vat chintamani ras, ashwagandharishta, dashmularishta, etc. These ayurvedic formulations beneficial for the patients of cauda equina syndrome will be described as follows.

HERBAL REMEDIES FOR CAUDA EQUINA SYNDROME BY PLANET AYURVEDA

Planet Ayurveda is providing various preparations of natural herbs such as agnitundi vati, boswellia curcumin, dashmularishta, ashwagandharishta, etc. which are prepared using authentic ways and provide great results in improving the condition of cauda equina syndrome.The ayurvedic products beneficial for improving the condition of cauda equina syndrome is described as follows.

PRODUCTS LIST

1. Vrihat Vatchintamani Ras
2. Trayodashang Guggul
3. Ashwagandharisht
4. Boswellia-Curcumin
5. Maha Vatvidhwansan Ras
6. Dashmularisht
7. Agnitundi Vati

Herbal Remedies for Cauda Equina Syndrome

PRODUCT DESCRIPTION

1. Vrihat Vatchintamani Ras

Vrihat Vatchintamani Ras is a classical ayurvedic formulation which is very effective in managing the imbalanced levels of the vata dosha. It contains various beneficial ayurvedic components such as Swarna bhasma (Ash of gold), Rajata Bhasma (Ash of silver), Abhrak Bhasma ( calcined mica ash), Pravala Bhasma (Coral calyx), etc. Hence, it is useful in managing various vata disorders such as paralysis, hemiplegia, cauda equina syndrome, etc.

Dosage - 1 tablet two times a day, to be chewed, after meals.

2. Trayodashang Guggul

This wonderful ayurvedic formulation contains a combination of beneficial ayurvedic herbs such as ashwagandha (Withania somnifera), Guggul (Commiphora mukul), giloy (Tinospora cordifolia), etc. It helps to support a healthy musculoskeletal system and is a very effective vata pacifier. Hence trayodashang guggul helps to manage the various painful sensations and thus improves the condition of cauda equina syndrome.

Dosage - 2 tablets two times a day, after meals.

3. Ashwagandharisht

Ashwagandharisht contains various beneficial ayurvedic herbs such as manjistha (Rubia cordifolia), ashwagandha (Withania somnifera), arjun (Terminalia arjuna), haldi (Curcuma longa), etc. This combination of herbs is an excellent pacifier of the aggravated vata dosha. Ashwagandharisht helps to pacify vata and improves the strength of the nerves and brain. It helps to manage the condition of cauda equina syndrome along with managing the pain sensations.

Dosage - 2 teaspoons two times a day, with equal amount of water, after meals.

4. Boswellia-Curcumin

Boswellia-Curcumin are capsules prepared by Planet Ayurveda. It contains natural extracts of very beneficial ayurvedic herbs namely Boswellia serrata (shallaki) and Curcuma longa (haridra). This combination very effectively manages the pain and also hence improves the condition of cauda equina syndrome.

Dosage - 1 capsule two times a day, after meals.

5. Maha Vatvidhwansan Ras

Mahavat vidhwansan ras is a classical ayurvedic formulation which contains naga bhasma (Lead calyx), vanga bhasma (tin calyx), loha bhasma (ash of iron), pippali (Piper longum), etc. This combination of ayurvedic components help to pacify the vata effectively and hence useful in managing various vataj disorders. It also provides strength to the body along with managing the neurological condition.

Dosage - 1 tablet two times a day, to be chewed, after meals.

6. Dashmularisht

Dashmularisht contains very effective vata pacifying agents such as bilva (Aegle marmelos), patla (Stereospermum suaveolens), gambhari (Gmelina arborea), etc. These herbs will help to pacify the vitiated vata dosha from the body and thus, improves the neurological health of the body. Dashmularisht is also very beneficial in providing strength to the nerves and hence managing the difficulties faced by the patient such as reduced control over bladder and bowel. It also helps to manage various pain sensations in the body, thus improving the condition of cauda equina syndrome.

Dosage - 2 teaspoons two times a day, with equal amount of water, after meals.

7. Agnitundi Vati

Agnitundi vati is a combination of beneficial ayurvedic components such as pippali (Piper longum), triphala, chitrak (Plumbago zeylanica), etc. It acts as a very beneficial vata anulomana kara and hence improves the condition of cauda equina syndrome. It possesses various other health benefits also such as improves digestion, helps in balancing the vitiated dosha, etc.

Dosage - Agnitundi vati can be given 1 tablet two times a day, after meals.

CONCLUSION

After analyzing the above provided information regarding the cauda equina syndrome, it can be concluded that although it is not a fatal condition but if not managed timely and properly, may hinder the quality of life adversely, up to a great extent. The main aim of treatment of the cauda equina syndrome will be to pacify the vitiated vata dosha. This will be achieved with the use of ayurvedic formulation along with strictly following a healthy diet and lifestyle. So, ayurveda can effectively manage the cases of cauda equina syndrome and improve the health status of the patient.