45 year old male patient came with history of Stiffness, Spasm, Numbness and Tingling sensation in all extremities since 3 months, First ignored then consulted top neurologist.... Please find the modern diagnosis and management in attached pictures Patient have Kaphaja-Pittaja Prakriti Kostha Madhyama Agni Samanya Occupation Software Developer Nindra Alpa Married (Not having any sexual disabilities) Ahar Satvika Weight 85kg BP 130/90mmhg BMI within limit Family History of DM & HTN but he is having normal BSL and BP After taking this management he is not satisfied, so came to me for Ayurvedic Management.... I ask him to visit tomorrow, as I need time to study this case.... Please help me, how should I approach in this case? Should I take help of Physiotherapist? As patient can't take Panchakarma Chikitsa (I was think to give Snehana Swedana and Vaman Virechan, as its a case of Vata Pitta Dushti) He can't stay here for long.... Please help me in managing this case... If know some classical references for such case, please mention it, or have any research or clinical paper/experience then please let me know......

(Edited)

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Sir As Per The History You Told He Is Software Developer Means He Has To Sit In One Position For More Time May Be Faulty Posture Of Sitting Causes The Scaliatic Nerve Compression With Degenerative Scoliosis So Advised Him To Do MRI LS Spine To Ruled Out The Any Spinal Or Vertebral Defformity Till We Can Suggest Sarvaanga Snehana With Ksheera Bala Tailam Or Mahavishagarbha Tailam Followed By Naadi Swedanam Or Shashtika Shaali Pinda Swedanam Internally Tab.Palsineuron Rasnasaptak Kwatha Trayodashaang Guggulu Mouktika Kaamdudha Rasa Avipattikar Churna Can Be Given A Physiotherapy Advice For Posture Correction With Modulative Therapy With IFT TENS SWD INTERMITTENT TRACTION

Thanks sir.... I am also planning to advice for Tens along with Ayurved
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Dr. Hemant Adhikari Sir, In this case , 2 findings are important with related to the symptoms Stiffness,spasam , numbness and tingling sensation in all extremities. 1. Hypothyroidism 2. Sacro - Iliac Radiculopathy Duration -3months Occupation - Software Engineer ( Mostly sitting type of job ) Again, the patient is not available near you Sir for a lengthy period. In this case, my advise is to advise him revisit again having sufficient amount of time and advise him for MRI - of whole spine and rule out again Ankylosing spondylosis. In these case , usually Proper Panchakarma will give good results ( not excellent as generally patient relaxes upto 60 to 70 percents ). Sir, what's about his bowel habits ? Rule out it. After through investigations, reach out any final diagnosis....Most probably these cases comes under Avarana janya Vata Vyadhi. So, please don't be hurry Sir....Advise him to come with proper time.

Thanks for your valuable opinion.....
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Here nerve conduction study is suggestive of rediculopathy, the spasm, stiffness, tingling sensation of lower limb suggestive of kaphavrut vaata, so tikshna sthanika abhyanga with chincha taila or kottamchukkadi taila can be advised if stambha is more then ruksha sweda can be advised to do at home Adari Sahacharadi kashaya 3 tsf tid Cap nuro xt Lashuna ksheerapaka 20 ml after may can be advised...

Thank you doctor
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Well seems to be a case of cervical muscle spasm, ?anxiety disorder(Neurologist have prescribed benzodiazepines), Subclinical hypothyroidism. I my practice I consider Hypothyroidism with Mandagni, Cervical as Kandra Shotha, anxiety with unmada sir. One thing I preferrably want to advise him daily exercise, Sahcharadi tail abhyang, and management of other with ayurveda aushadhs.

Thanks sir....
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Agree with @Dr. Ashish Deshpande sir Physiotherapy - SWD - TENS on nerve route - Lumbar traction. - Spine manipulation. - Lumbar Back support. - Back strengthening exercise . - McKenzie exercise. - Avoid forward bending ,weight lifting ,high heel footwear . - Avoid long sitting. - Ergonomics advice.

Thanx Sir
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Hello sir, In case paper that you mention these patient is having thyroid On the bases of these And nidiparikshan If We can do a treatment of shoth (which is always ther in thyroid patient) Then patient may get relive in symptoms and also in thyroid report of TSH then if you do पंचकर्म than it will giv u better result

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Dear Dr. Hemant Adhikari Advice for your patient Tab. Aam vatari Ras 1 tds or Tab. aam pachan vat 2 BD along with Tab. Rasraj Ras with gold 1 tds. Ardrak swaras with honey 1/2 an hour before meal. Maha Vishgarbha tailam for abhyang Arkpatra swedana its possible to da at home. Advice pathyapalana.

He has hypothyroidism. Pt says stiffness and spasms, but what clinically u find that? Is pt anxious or not? Is he suffering from any lumber and cervical problem. Joint movement.. Proper history and examination is must.

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Sir, I think do panch karma shodhan first N Brihat vatchintamani ras 1 bd ,Makardhwaj spl.1 bd n Tsh - kanchnar guggul 2 bd Kaishor guggl 1 bd Suyshekhar 1bd Medohar guggal 1 bd with warm water bd.

Make clear examination once again,,. Rx. Dhanvantara taila extl followed swedana,,. Ksheera bala cap bid, zeotone plus cap bid,,. Balarista bid,.

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