The presentation of cervical spondylosis in the Ayurvedic perspective may be in the form of either Manyasthamba or Visvachi with clinical presentations projecting nirama condition.

The general line of treatment should be focused on Vatakapha hara chikitsa, Sula hara chikitsa, Asthikshayajanya chikitsa and Naadi balya chikitsa. Based on the line of treatment the panchakarma treatment planned in the first stage is snehana and swedana with Snigdha pathra panda sweda which is vata kapha hara and sula hara. In the second stage for the asthikshayajanya chikitsa, brahmana nasya and guduchyadi ksheera basthi are administered. Finally if neurological manifestations are persisting then as Naadi balya chikitsa matra basthi is administered along with shashtika shali panda sweda.

• Snehana
• Swedana
• Nasyam
• Basthi

SNEHANA

Bahya snehana is generally done in the form of Abhyanga with out giving much pressure to the neck structures. The tailas which can be applied are Mahanarayana taila. Parinithakera ksheeradi, Kottamchukkadi taila (if sopha is present), Dhanwantharam tailam. Balaashawagandhadi, Mahamasha tailam.

SWEDANA

Pathra potali sweda is the preferred sweda as it is a type of snigdha sankara sweda. When done in the nirama condition, it reduces the symptoms rapidly. It is generally vata kaphahara in nature.

Snigdha pathra pinda sweda

Materials required

1. Leaves
   • Arka pathra-Calotrpis gigantean
   • Chinchapathra Tamarindus indicus
   • Eranda pathra- Ricinus communis
   • Sigru pathra-Moringa oleifera
   • Nirgundi pathra-Vitex negundo
   • Vatagna pathra-Justicia gendarussa
   • Dathura pathra-Datura alba
2. Grated coconut – 100 gm
3. Sliced lemon-2
4. Saindhava Lavana 10gms
5. Oil
   • For Frying leaf – 100 ml Nimba Taila
   • For heating potali – 250 ml oil
6.  Cotton cloth (45 x 45 cms), 4 pieces.

Preparation of pottali

Fresh leaves of above drugs are copped in to small pieces. First fry arka pathra followed by other leaves, grated coconut, saindhava lavana, sliced lemon in oil till coconut scrapings attain a brown tinge. It should be divided into four equal pats and pottalis are made out of it.

Pre operative procedure

The patient is made to sit comfortably with legs extended over the droni facing east. Abhyanga should be performed with suitable oil all over the body for about 10 minute. Thalam with suitable oil has to be done.

Procedure

The oil is heated in an iron pan up to 45 degree centigrade and the potali is dipped in to the oil and rotated 3-4 times. The potali is removed and the excess oil sticking to the sides are wiped out and hot potali is applied to the neck and the hands.

Duration – 45 minutes to 1 hr.

Post operative procedure

Oil in the body should be wiped off and the body should be covered with blanket for 10-15 mts. Patient should be asked to take hot water bath and advised to apply Rasnadi choornam on the vertex.

Precaution

1.  Care should be taken to prevent charring while frying leaves and while reheating.
2. Temperature of the potali should be checked by placing on the dorsum of the hands every time as there is chance for4 burns.

NB: By the snehana and swedana the muscle spasm will be reduced and so the pain and straightening of the spine due to spasm will be relieved. The heat during the swedana leads to vasodilation and there by increase the blood supply which reduces the inflammation and removes the metabolic wastes accumulated during the inflammatory process.