MANYASTAMBHA (CERVICAL SPONDYLOSIS-LIKE CONDITION)

CASE STUDY: MANYASTAMBHA (CERVICAL SPONDYLOSIS-LIKE CONDITION)

NIDANA (ETIOLOGICAL FACTORS)

• Ati vata pravritti (excessive exposure to vata)
• Sheeta jala snana
• Vegadharana (suppressing natural urges)
• Bhojanottara nidra (sleep immediately after meals)
• Ati vyayama, jhatapata karma
• Vata prakopaka nidana in excess
  

(Ref: Madhava Nidana 21/1-2; Ashtanga Hridaya Nidana Sthana 15/1)

POORVARUPA (PRODROMAL SYMPTOMS)

• Greeva pradesha ruk (pain in neck)
• Amsa bhara (heaviness in shoulders)
• Shiro gaurava (heaviness in head)
• Angamarda (body ache)
  

(Ref: Ashtanga Hridaya Nidana Sthana 15/2)

LAKSHANA (SYMPTOMS)

• Greeva pradesha stabdhata (stiffness of neck)
• Shoola or ruk in neck region
• Restricted neck movements
• Pain radiating to upper limbs in chronic cases
• Tingling or numbness (if nerve compression involved)
  (Ref: Madhava Nidana 21/3; Ashtanga Hridaya Nidana Sthana 15/3)

SYSTEMIC EXAMINATION TESTS (MODERN CLINICAL ASPECT)

1. Neck and Spine Examination:
• Limited range of motion
• Pain on neck extension or lateral rotation
• Tenderness over cervical spine
2. Neurological Examination:
• Motor/sensory deficits in upper limbs
• Reflexes: Biceps, triceps, brachioradialis may be affected

Expected Findings:

• Cervical muscle tightness
• Reduced neck mobility
• Possible signs of cervical radiculopathy

LABORATORY INVESTIGATIONS (MODERN ASPECT)

1. X-ray Cervical Spine:
• Loss of cervical lordosis
• Osteophyte formation
• Disc space narrowing
2. MRI Cervical Spine (if nerve involvement suspected):
• Disc prolapse, nerve root compression
3. CBC, ESR (if inflammatory conditions suspected):
• Usually normal unless co-existing pathology

Expected Results:

• Degenerative changes in cervical vertebrae
• Neural compression if advanced
• Rule out cervical disc herniation

DIFFERENTIAL DIAGNOSIS (MODERN CLINICAL ASPECT)

• Cervical disc herniation
• Cervical myelopathy
• Fibromyalgia
• Brachial neuralgia
• Ankylosing spondylitis

SAMPRAPTI (PATHOGENESIS)

• Due to nidana sevana, vata dosha gets aggravated
• Vata accumulates in greeva marma sthana
• Causes rookshata, shunyata, stabdhata in snayu, asthi, sandhi
• Leads to shoola, stabdhata, and reduced movement
  

(Ref: Madhava Nidana 21/3; Ashtanga Hridaya Nidana Sthana 15/3)

UPASAYA AND ANUPASAYA (PALLIATIVE & AGGRAVATING FACTORS)

Upasaya:

• Ushna abhyanga (oil massage with warm oil)
• Swedana (sudation)
• Vatahara ahara like grita, ksheera
• Basti karma

Anupasaya:

• Exposure to cold wind
• Sheeta snana
• Stress, jerky neck movements
• Ruksha, laghu, sheeta ahara
  

(Ref: Ashtanga Hridaya Chikitsa Sthana 21; Madhava Nidana 21)

SAMANYA CHIKITSA (GENERAL LINE OF TREATMENT)

• Snehana with mahanarayana taila, sahacharadi taila
• Swedana – Nadi sweda, Patrapinda sweda
• Mridu virechana
• Vatahara diet and regimen
  

(Ref: Ashtanga Hridaya Chikitsa Sthana 21)

VISHESHA CHIKITSA (SPECIFIC TREATMENT)

1. Abhyanga and Swedana:
• Mahanarayana taila abhyanga
• Patrapinda sweda or valuka sweda
2. Basti Chikitsa (in chronic cases):
• Ksheera basti or matra basti with dhanwantaram taila
• Erandamooladi niruha basti
3. Oral Medications:
• Rasna saptaka kvatha
• Dashamoolarishta
• Yogaraja guggulu
• Trayodashanga guggulu
4. Nasya Therapy:
• Anu taila or shadbindu taila nasya for shiro-greeva shamana
5. Lifestyle Advice:
• Avoid exposure to cold and jerky movements
• Neck exercises under supervision
• Maintain warm environment and vata-balancing diet

(Ref: Ashtanga Hridaya Chikitsa Sthana 21; Sahasrayoga Guggulu Prakarana; Madhava Nidana 21)