Efficacy of Gulpha Marma Therapy and Agnikarma in Managing Sciatica (Gridhrasi) Pain: A Pilot Study
Keywords:
Gridhrasi, Sciatica, Marma Chikitsa, Agnikarma, Pain ManagementAbstract
Background: Low back pain (LBP) represents a leading global health challenge, afflicting 80–90% of individuals at least once in their lifetime, with approximately 5% progressing to true sciatica due to lumbar nerve root irritation. Sciatica manifests as radiating pain from the lumbosacral region to the lower limb, predominantly affecting adults aged 30–50 years and often linked to intervertebral disc herniation or degenerative spondylosis. In Ayurveda, this condition aligns with Gridhrasi, a Vata-dominant Nanatmaja Vyadhi characterized by Ruka (pain), Toda (pricking sensation), Stambha (stiffness), and restricted leg movement.
Aim: This randomized controlled pilot study evaluated the comparative efficacy of two classical Ayurvedic therapies, Marma Chikitsa and Agnikarma in managing Gridhrasi related pain.
Materials and Methods: Thirty patients meeting inclusion criteria were randomly assigned to two parallel groups (n=15 each). Group A received daily Marma Chikitsa at Gulpha Marma for 21 days, while Group B underwent Agnikarma at Antara-Kandara-Gulpha Madhya weekly over the same period. Primary outcome was pain intensity, measured via Visual Analogue Scale (VAS) on days 1, 7, 14, and 21.
Results: Intragroup analysis revealed significant VAS reductions: Group A from 2.4 to 0.467 (z = 3.624, P < 0.01); Group B from 2.2 to 1.0 (z = 3.286, P = 0.001). Intergroup comparisons via Mann-Whitney U-test showed no significant differences at baseline (P = 0.461) or endpoint (p = 0.089). Marma Chikitsa likely modulates pain via neuromodulatory effects like gate control theory, whereas Agnikarma induces analgesia through counterirritant thermal effects on aggravated Vata.
Discussion and Conclusion: Both interventions yielded clinically meaningful pain relief, supporting their role in Gridhrasi management and justifying larger randomized trials.
References
1. World Health Organization. Low back pain - fact sheet. Available from: https://www.who.int/news-room/fact-sheets/detail/low-back- pain [Last accessed on 2025 Dec 25].
2. Shnayderman I, Katzman WB. Physical therapy and low back pain: Pilot clinical trial comparing yoga and physical therapy outcomes. J Bodyw Mov Ther. 2011;15(2):125-8.
3. Mayo Clinic. Sciatica- symptoms and causes. Available from: https:// www.mayoclinic.org/diseases/conditions/sciatica/symptoms/causes/ syc/20377435 [Last accessed on 2025 Dec 25].
4. Stat Pearls Publishing. Sciatica. National center for biotechnology information (NCBI); 2024. Available from: https://www.ncbi.nlm. nih.gov/books/nbk507908 [Last accessed on 2025 Dec 25].
5. Shastri K. Charaka samhita, Uttarardha chikitsasthana 28/56. Varanasi: Chaukhambha Bharti Academy; 2009. p. 787.
6. Sharma PV. Sushruta samhita, Nidanasthana. Ch. 1. Ver. 74., Varanasi: Chaukhambha Visvabharati; 2005. p. 15.
7. Shastri AD. Sushruta samhita, sharirsthan. Part. 1. Ch. 6. Shl. 16., Varanasi: Chaukhamba Sanskrit Samsthan; 2024. p. 69.
8. Shastri AD. Sushruta samhita, sharirsthan. Vol. 1. Ch. 6. Shl. 37., Varanasi: Chaukhambha Sanskrit Sansthan; 2024. p. 77.
9. Ambika K, Shastri D. Edited with ayurveda-tattva-sandipika, sushrut samhita. Part. 1; India: Rare Book Society of India; 2012.
10. Shastri AD. Sushruta samhita, sutrasthana. 12th ed. Part. I. Ch. 12. Sloka. 3., Varanasi: Chaukhamba Surbharti Prakashana; 2001. p. 38.
11. Dafny N. Neuroscience online: An electronic textbook for neuroscience. Pain modulation and mechanisms. Ch. 8. University of Texas Medical School at Houston. Available from: https://www.uth. tmc.edu/nba/neuroscience/toc.htm [Last accessed on 2025 Dec 25].
12. Tripathy R, Raj S, Rajeshwari PN, Athulya, Senan LC. A review on the action of Agnikarma. Int J Curr Res. 2016;8(6):32319-22.
