Ayurveda approach in the management of Lumbar spinal stenosis and neurogenic claudication associated with foot drop (~Khanja): A case report

Lumbar Spinal Stenosis (LSS) is a degenerative condition leading to neural compression and neurogenic claudication. It can progress to foot drop, significantly impairing mobility and quality of life. This case report presents the Ayurveda management of a 43-year-old male diagnosed with LSS with neurogenic claudication and left-sided foot drop. Clinically, the condition was correlated with Khanja under Vatavyadhi (~disorders due to Vata dosha ), while the underlying pathogenesis was interpreted as Kaphavrita vata (~ Vata occluded by Kapha dosha ). The patient presented with chronic low back pain radiating to the left lower limb, numbness, gait disturbance, and inability to dorsiflex the left foot. Magnetic resonance imaging revealed L4-L5, L5-S1 disc bulges, anterolisthesis of L5 over S1, and foraminal compression. A 15-day inpatient Panchakarma (~five bio-cleansing procedures) protocol including Rukshana (~dryness inducing therapy), Koshtha shodhana (~cleansing of bowels), Snehana (~therapeutic oleation), Swedana (~therapeutic fomentation), and Yoga basti (~course of eight therapeutic enemas) along with internal Shamana (~pacification) and Rasayana (~rejuvenation) medications, focusing on pacification of Kaphavrita vata , promoting Vatanulomana (~proper functioning of Vayu ), Srotoshodhana (~cleansing of body channels), and Brimhana (~nourishment), was provided. After 60 days of follow-up period, there was complete functional recovery without surgical intervention, with significant reduction of Visual Analog Scale score from 8 to 0, Oswestry Disability Index improving from 78% (crippled) to 2% (minimal disability), and muscle power of left ankle dorsiflexion improving from grade 3/5 to 5/5. Moreover, the gait and balance were normalized, with sustained results on follow-up. This case highlights the novel potential of a structured Panchakarma protocol to achieve complete neurological and functional recovery, thereby offering a cost-effective and nonsurgical therapeutic alternative owing to the lower direct medical costs, avoidance of expensive surgical infrastructure, implants, and prolonged hospitalization, while still achieving significant functional improvement in the patient.