Etiopathological Study of Gridhrasi vis-à-vis Sciatica and Its Interpretation of Doṣha Predominance Through MRI-Based Structural Imaging
Keywords:
Gridhrasi, sciatica, intervertebral disc prolapse, MRI, Vataja, Vatakaphaja, doṣha predominance, radiological phenotyping.Abstract
Background: Gridhrasi, described in Ayurveda as a Vata Nanatmaja Vyadhi, presents clinically with radiating pain along the lower limb and is conceptually comparable to sciatica. It is traditionally classified into Vataja and Vatakaphaja subtypes based on doṣha predominance. In contemporary medicine, sciatica is primarily attributed to intervertebral disc degeneration, herniation, and nerve root compression; however, objective radiological validation of Ayurvedic subtypes remains limited.
Objective: To identify and compare magnetic resonance imaging (MRI) patterns in Vataja and Vatakaphaja Gridhrasi and to establish a diagnostic correlation between Ayurvedic subtyping and radiological disc pathology.
Methods: A cross-sectional clinical–radiological study was conducted on 60 patients presenting with Gridhrasi at a tertiary care Ayurvedic medical college hospital. Patients were classified into Vataja (n = 36) and Vatakaphaja (n = 24) subtypes using standardized Ayurvedic diagnostic criteria. Lumbosacral spine MRI (1.5 T) was evaluated for disc degeneration (Pfirrmann grading), disc desiccation, disc height loss, herniation morphology and direction, canal and foraminal stenosis, listhesis, and nerve root compression. Statistical analysis included the Chi-square test, odds ratio and p-values.
Results: Vataja Gridhrasi demonstrated significantly higher frequencies of disc desiccation, disc height reduction, and Pfirrmann grade II–IV degeneration (p < 0.05), reflecting a degeneration–instability pattern. In contrast, Vatakaphaja Gridhrasi showed broader disc bulges, a higher prevalence of central herniations, canal stenosis, and foraminal compromise, indicating a compressive mass-effect pattern. The differences in MRI findings between the two subtypes were statistically significant.
Conclusion: Distinct MRI phenotypes correspond to classical Ayurvedic differentiation of Vataja and Vatakaphaja Gridhrasi. Integration of radiological assessment with Ayurvedic clinical evaluation enhances diagnostic precision and supports an evidence-informed, individualized approach to disease characterization, consistent with the principle that diagnosis should precede treatment.
DOI: 10.8612/40.4.2025.5
