Role of Agnikarma in the Management of Gridhrasi: A Review

In Ayurveda, Vata is considered responsible for almost all types of pain. Gridhrasi, described as a Vatavyadhi, presents with hallmark features of radicular pain originating from the lumbar–sacral region and radiating along the lower limb. The name “Gridhrasi” reflects the characteristic gait of the patient, who walks with difficulty due to severe pain, resembling the movement of a vulture (Gridhra).1 Based on these symptoms, Gridhrasi can be correlated with sciatica in modern medicine. Sciatica occurs due to irritation or compression of the spinal nerves and is characterized by pain along the distribution of the sciatic nerve. Globally, low back pain and radiating pain caused by lumbar disc prolapse are among the leading causes of morbidity. The lifetime incidence of low back pain is 50–70%, and sciatica affects more than 40% of the population at some point in life. These conditions significantly disrupt daily activities and overall quality of life. Conventional management primarily focuses on symptomatic relief through NSAIDs, muscle relaxants, and selected surgical procedures; however, these approaches may be limited by adverse effects, high cost, and variable long-term outcomes. Ayurveda offers multiple treatment modalities for Gridhrasi, including Bheshaja, Snehana, Swedana, Siravedha, Agnikarma, and Basti. Among these, Agnikarma—a para-surgical procedure utilizing controlled therapeutic heat application, has been documented to provide rapid and sustained analgesia through mechanisms such as enhanced local circulation, neuromodulation, and reduction of Vata aggravation. Agnikarma offers a safe, cost-effective, and clinically significant intervention for the management of Gridhrasi, with potential to complement or reduce dependence on conventional therapies.