Significant resolution of migrated lumbar disc extrusion with Ayurveda management

Lumbar disc extrusion is a type of severe disc herniation that is mainly a cause of Low Back Pain (LBP) and radiculopathy with or without neurological deficits. A 36-year-old male patient presented with severe LBP radiating to the right lower limb associated with numbness and tingling sensation along with numbness in the right leg. The patient arrived at the outpatient department in wheelchair due to his inability to sit, stand, or walk without assistance, owing to the severity of the pain. The patient’s Oswestry Disability Index (ODI) score was 90%, and even Schober’s test indicated a severe reduction in lumbar flexion capacity. Magnetic Resonance Imaging (MRI) showed diffuse central and bilateral paracentral posterior disc bulge with postero-central disc extrusion and superior migration of extruded disc (extruded disc measures 10 mm × 8 mm) at L5-S1 disc level with significant neurological compression. The spinal canal diameter at this level was 4 mm. The patient was treated with Panchakarma viz. Basti (~medicated enema), Kati basti (~fomentation of lumbosacral region with medicated oil) , and Ayurveda oral medications on successive follow-ups. After four months of treatment, the patient showed remission in LBP, radiculopathy, hypoesthesia, paraesthesia, and disability. All other abnormal neurological findings were also responded significantly. The ODI score reduced to 9%, Schober’s test became negative, and a significant reduction in clinical symptoms was observed. The MRI was repeated post treatment, which showed significant changes in the extruded disc component with minimal superior migration of the extruded disc (extruded disc measures 4 mm × 2 mm) with mild compression over the left traversing S1 nerve root. The diameter of the spinal canal increased from 4 mm to 8 mm at the site of herniation. This case demonstrates that even severe lumbar disc herniations can be effectively managed with Ayurveda and Panchakarma treatment, resulting in significant clinical and radiological improvements.