The prevalence of cervical spondylosis is increasing day by day because of sedentary work, keeping neck stiff, degeneration due to aging, injuries to the cervical spine, weight bearing, various professions involving more neck movements and excess usage of artificial food which contain chemicals that are harmful to the body.
Interpretation of changes in signs and symptoms
The exact mechanism of action of Nasya in reducing the signs and symptoms is obscure. Still a humble attempt to analyse the possible modes of action is made. Considering pain relief, patients in the study group had considerable relief of pain compared to that of control group. Analysis of the values on pain scale before and after Nasya proved specific efficacy of Nasya in reducing pain. Brimhana Nasya is Vatahara so as to reduce pain. On the other hand, Nasya gives stimulation to the brain through the olfactory pathway thus inducing the production of Neuro peptides which act as pain relievers. The Paka of the Taila used for Nasya is Mridu, which retains the water-soluble principles along with lipid soluble particles at an optimum level. Moreover Avartana increases the concentration of fat soluble phytoconstituents. The peripheral processes of the olfactory cells respond to volatile, water soluble and lipid soluble odorless chemical substances. The drug used for Nasya is of Mridu Paka which maintains the water solubility for diffusing through the olfactory epithelium and lipid solubility for interacting with the lipids of the membranes of olfactory receptors. All these factors contribute well for the specific ability of Sneha Nasya in stimulating the brain through olfactory pathway. In fact, structures of the Limbic system including Thalamus, Hypothalamus, Hippocampus, Amygdala and parts of the Basal ganglia are concentration areas for neuropeptides called nodal points. Nasya can stimulate areas like Amygdala in Limbic system, thus activating neuropeptide pathway.
In case of neck stiffness, Nasya relieved it considerably. The cause for neck stiffness is dehydration of intervertebral discs. Nasya with a nourishing drug can induce some nourishment to tissues by impregnating Kapha Bhavas and may reduce degeneration.
Most of the drugs in Dhanvantaram Tailam have Vatahara property and it contains groups of drugs like Dashamoola which have specific effect in Shopha and Shoola. This may be the reason for reduction in tenderness.
In cervical spondylosis, degenerative changes and osteophytosis occur which compress the nerve roots. This leads to radiculopathy and resultant radiation of pain. It is difficult to reverse these structural changes. So, complete relief cannot be expected in radiation of pain. Still, better results were obtained by Nasya. The exact mechanism is obscure but it is assumed that Nasya improves circulation and prevents degeneration up to some extent.
Brimhana Nasya alleviates vitiated Vata which is responsible for stiffness and movement restriction. This may be the reason for improvement of range of movements.
As far as vertigo is concerned, there was a mean decrease of 0.6, which was statistically insignificant but patients got satisfactory relief. In Ayurvedic terms Brimhana effect of the Nasya done may be responsible for reducing vertigo. Brimhana is Vata-Pitta Shamaka. Vitiation of Vata-Pitta with Rajas cause Bhrama. The nourishing and strengthening effect of Nasya is evident from the improvement of hand grip strength.
When the Snigdha Bhavas exhaust from the body as a part of natural wear and tear, the most vulnerable regions start showing symptoms, the cervical spine is one such.
Based on the theory of Svaabhavoparama, there is an inherent tendency for natural self cure. The body heals by itself and a natural cure is endowed after every injury and insult. The role of medicine is only to assist the nature.
Here the major processes in pathology are disc dehydration and bone degeneration – vividly showing a reduction in Kapha Bhavas and increase of Vata. At the level of Mahabhootas the Prithvi and Jala
Mahaabhootas exhaust gradually with a subsequent increase of Vayu and Aakaasha Bhootas. Hence body needs to acquire more Snigdha Bhavas to resist the process of degeneration.
Here the facts to be considered are
- Nostrils are the easiest routes to approach diseases above the clavicle.[10]
- Drugs with a certain quality increases similar principle in the body (Samanya theory).[11]
- The duty of medicine is to help the natural healing process.[12]
By giving Brimhana Nasya with Avartita Taila which has increased amount of fat-soluble principles, we are giving a stimulus to the body with those Gunas which are necessary to induce natural Kapha Bhaavas.
The mode of action of
Nasya is explained in Ayurveda as follows. The instilled medicine moves up the channels to the
Shringaataka, spreads all over the head, channels of eyes, ears, and throat there by removing
Doshas. Thus cures the diseases affecting the
Urdhva Jatru.[
13]
The position specifically advised for performing
Nasya is such that the head is kept a little down and the feet a little high from the plane.[
14] This can increase the pressure of CSF due to gravitational back flow from the pressure of CSF due to gravitational back flow from the spinal cord. When the CSF pressure rises and equals the arterial pressure, it compresses the whole brain as well as arteries in the brain and cuts off the blood supply to the brain. This initiates a CNS ischemic response that causes the arterial pressure to rise as a part of natural homeostatic mechanism. When the arterial pressure rises to a level higher than the CSF pressure, blood flows once again into the vessels of the brain to relieve ischemia. This mechanism is known as cushing reaction[
15] and potentially deserves mention in this context. Probably it plays a crucial role in spread of active principles of the medicine used for Nasya through circulatory channels at the earliest.
