Gridhrasi (Sciatica): An Ayurvedic Perspective on Classical Understanding and Therapeutic Approaches – A Review

Gridhrasi is a Vata-dominant Nanatmaja Vyadhi described extensively in Ayurvedic classics, characterized by radiating pain starting from the Sphik, Kati, Uru, Janu, Jangha and extending up to the Pada. Clinically, Gridhrasi closely resembles Sciatica described in modern medicine. The disease significantly affects mobility and quality of life, making its effective management a major clinical concern. This review aims to critically analyze the concept of Gridhrasi with reference to Brihat Trayi and Laghu Trayi, highlighting its Nidana, Samprapti, Lakshana, Bheda, and Chikitsa, and to compile various therapeutic modalities described in classical Ayurvedic texts. Classical references from Brihat Trayi and Laghu Trayi and also some minor Samhitas to be systematically reviewed. According to Ayurvedic literature, Gridhrasi is primarily caused by Vata Dosha, either alone or in association with Kapha Dosha, leading to obstruction and vitiation in the Snayu, Kandara, and Asthi. The clinical features include Ruk, Toda, Stambha, Spandana, and Sakthikshepa Nigraha. Management principles emphasize Nidana Parivarjana, Shodhana and Shamana Chikitsa. Various therapeutic interventions such as Snehana, Swedana, Basti (Niruha and Anuvasana), Agnikarma, Siravedha, and internal medications including Kashaya, Churan, Ghrita, and Taila are described across classical texts. This review consolidates classical Ayurvedic knowledge on Gridhrasi and highlights the holistic and multi-modal approach of Ayurveda in its management. The study underscores the need for further clinical research to validate classical therapeutic strategies and establish standardized treatment protocols for Gridhrasi.