Treatment of Katigraha (Back Pain) with Upanaha Sweda – A Randomized Comparative Clinical Trial

Katigraha (back pain) is a condition caused by Vata Dosha or Sama Vata Dosha (Vata in combination with toxins from disturbed digestion) and manifests as pain and stiffness in the lower back. This study investigates the efficacy of Upanaha Sweda (Ayurvedic heat pack) on Katigraha considering Samaja and Niramaja stages.

Method

The study included 36 patients who were divided into two groups:

Avasthanusara group (stage wise treatment):

In patients with Samaja Katigraha (Vata with Ama): Panchakoladi Upanaha (consisting of Piper retrofractum, Plumbago zeylanica, Piper longum, Zingiber officinale, Hordeum vulgare and Vitex negundo) was applied until the Ama symptoms disappeared. Godhumadi Upanaha (with Triticum sativum, Sesamum indicum, Ricinus communis) was then administered for 7 days.

In patients with Niramaja Katigraha (Vata without Ama): Godhumadi Upanaha was directly applied for 7 days.

Anavasthanusara group (non-stage related treatment):

Only Godhumadi Upanaha was applied for 7 days irrespective of stage.

The evaluation was done using:

Visual Analog Scale (VAS)

Oswestry Disability Index (ODI)

Assessment of stiffness in the back

Results

1st Avasthanusara group (stage-related treatment):

Pain reduction (VAS): improvement of 43.33% (p < 0.0001)

Reduction in stiffness: improvement of 36.07 % (p = 0.0002)

ODI: improvement of 37.25 % (p < 0.0001)

2. anavasthanusara group (non-stage related treatment):

Pain reduction (VAS): improvement of 27.2 % (p < 0.0001)

Reduction in stiffness: improvement of 15.73% (p = 0.0204)

ODI: improvement of 18.44 % (p < 0.0001)

Comparison of the groups:

Avasthanusara treatment showed significantly better results in pain reduction (p = 0.0107), stiffness (p = 0.0351) and ODI (p = 0.0002).

Stage-specific treatment with Panchakoladi Upanaha and Godhumadi Upanaha showed significantly better results in reduction of pain, stiffness and disability compared to non-stage-specific treatment. Treatment according to the Samaja and Niramaja stages proved to be more effective as it targets the specific properties of Vata and Ama.