An Ayurvedic Approach in the Management of Tubercolous Sacroiliitis – A Case Report

Sacroiliitis is an inflammation of the sacroiliac (SI) joints, often causing axial lower back pain that can radiate down the legs. Tuberculous Sacroiliitis is a rare form of osteoarticular tuberculosis affecting the SI joint, presenting with prolonged, inflammatory pain in the lower back, hips, or buttocks. Diagnosing and treating SI joint pain is challenging due to its complex anatomy and weight-bearing function. This case report details the Ayurvedic management of a 15-year-old female with tuberculous sacroiliitis, presenting with severe low back pain radiating to her left leg, stiffness, and immobility. In Ayurveda, her condition was identified as Gambhir Vatarakta, an advanced inflammatory joint disorder. Treatment involved Panchakarma therapies: Jalaukavacharan (leech therapy), Valuka Pottali Sweda (sand bolus fomentation), Patra Pinda Sweda (medicinal leaf fomentation), Ruksh Nadi Sweda (dry vapor fomentation), and Yoga Basti (medicated enemas). These were complemented by Shaman Chikitsa (palliative treatments). Patient progress was tracked using clinical assessments like the Visual Analog Scale (VAS), Straight Leg Raise (SLR) Test, Flexion, Abduction, and External Rotation (FABER) Test, Gaenslen’s, and pelvic compression tests, alongside radiological and pathological evaluations. This integrated Ayurvedic approach led to significant pain relief, improved mobility, and reduced stiffness, with no adverse effects. The case highlights Ayurveda's potential in managing tubercular sacroiliitis and other inflammatory joint conditions.