Ayurvedic medicine, treatment and remedies for Neuropathic (Nerve) Pain

As per Ayurveda, vata dosha controls the nervous system and its functions. Thus, vitiation of vata is one of the primary causes of nervous system disorders. As neuropathic pain is a condition of the central and peripheral nervous systems, it is also caused due to vata diseases such as:

• Diabetic neuropathy: It is a common complication experienced by individuals with diabetes. These individuals experience burning sensation, pain, tingling sensation and numbness, especially in their hands and feet. Pain and tingling sensations indicate the involvement of vata dosha, whereas burning sensation suggests the involvement of pitta dosha. Diabetic neuropathy also leads to a diminished perception of sensations like cold, heat and vibration.
• Gridhrasi (sciatica): It is a neuropathic pain originating from the sciatic nerve. Sciatica pain may range from mild to severe and it travels along the sciatic nerve from buttock to thighs and downward. Sometimes this neuropathic pain extends till the foot. As per Ayurveda, sciatica can cause pricking pain, stiffness, tingling sensations in one or both limbs and it mainly affects calf muscles, knee joint, lower back and upper back. Sciatica can be caused due to vitiation of vata alone or kapha and vata together. Vitiation of kapha along with vata leads to additional symptoms like drowsiness, heaviness and loss of taste.
• Visarpa (shingles): It is a spreading skin disease that occurs due to viral infection and leads to varying symptoms. It can be caused by any of the seven dhatus and three doshas and. Depending on the dhatu and dosha affected, the symptoms will vary. The most commonly observed symptoms of visarpa are numbness, fever, stiffness, pricking pain, muscle cramps and loss of appetite. Visarpa causes post-herpetic neuralgia, leading to neuropathic pain.
• Ananta vata (trigeminal neuralgia): This condition affects the trigeminal nerve. Trigeminal nerve supplies the skin of the face and anterior half of the head. Trigeminal neuralgia involves either vata alone or vata as a predominant dosha along with kapha. Vitiation of vata in this condition causes intense pain in the neck, twitching in cheeks, lockjaw and also affects eyes. Acharya Sushruta mentioned it as a disease caused by vitiation of all three doshas.

• Nidana parivarjana
  • Nidana parivarjana involves avoiding the causes of a condition.
  • As aggravation of vata is the primary cause of neuropathic pain, avoiding foods that increase vata plays a vital role in the treatment of neuropathic pain.
  • Nidana parivarjana has two potential benefits – inhibiting the progression of the condition and prevention of relapse.
• Snehana
  • Snehana therapy involves lubricating the body internally and externally to mobilise and eliminate the accumulated wastes and pacify aggravated vata.
  • Snehana is indicated in the treatment of vata diseases such as sciatica and osteoarthritis and can thus alleviate neuropathic pain caused by these conditions.
• Swedana
  • Swedana involves the use of various tools such as metallic objects, cloth, warm hands, etc. to induce sweating.
  • It helps pacify and eliminate the excess doshas from the body.
  • Swedana also liquefies and mobilises toxins to the digestive tract from where they can be quickly eliminated using various panchakarma (five therapies) methods like virechana and basti.
  • It improves blood circulation and is one of the best therapies for all vata-related disorders.
  • As neuropathic pain is primarily associated with vata dosha, swedana can be a useful procedure in the treatment of this type of pain.
• Virechana
  • Virechana involves the administration of herbs for inducing purgation and eliminating the aggravated doshas and ama from the body.
  • It is primarily indicated for the elimination of aggravated pitta dosha, which is responsible for skin disorders. Thus, it can be effectively used in the management of visarpa and its associated symptoms such as neuropathic pain.
  • Virechana also helps in the management of neuropathic pain associated with sciatica and trigeminal neuralgia.
• Basti
  • It is one of the panchakarma procedures, which involves the administration of herbal enemas in the form of decoctions, oils or paste.
  • Basti clears the bowel and eliminates ama and vitiated doshas from the body.
  • Erandamooladi basti is useful in relieving stiffness and heaviness in the body due to its deepana (appetising) and lekhana (scraping) nature, which pacifies the aggravated kapha.
  • It also pacifies aggravated vata and has anti-inflammatory, antioxidant, pain-relieving and bone-regenerative properties.
• Nasya
  • Nasya involves the instillation of herbs in the form of a decoction or oil in the nasal cavity.
  • As the nose is the gateway to the head, it helps in cleansing morbid doshas from the head.
  • This procedure opens the channels of head and eliminates ama from the head, nose, eyes, mouth, ears and paranasal sinuses. It produces lightness in the body and head.
  • Herbs that are commonly used for nasya are vidanga (false black pepper), brihati (bari katheri), apamarga (Chaff-flower) and shigru (drumstick).
  • Nasya is used to treat conditions such as sinusitis, cold and allergic rhinitis.
  • It helps in treating problems associated with ears and eyes like loss of hearing and tinnitus, itching and watering of the eyes, conjunctivitis and glaucoma.
  • Badam rogan taila is commonly used in the management of trigeminal neuralgia.
• Kati basti
  • In this procedure, a frame made of flour is placed on the back and warm oil is poured in it. It is then allowed to stay in contact with your skin for a certain period of time. The oil is replaced continuously to ensure that a specific temperature is maintained.
  • This procedure oleates the skin and induces sweating, thereby eliminating ama and aggravated doshas. This relieves heaviness, stiffness and pain.
  •  It is useful in the management of sciatica and other conditions with similar symptoms.
• Raktamokshana
  • Raktamokshana involves the application of metallic instruments, cow’s horn, leeches or bitter gourd to remove the impure blood out of the body.
  • Removal of impure blood flushes the toxins out of the body is conducive to improved health and symptomatic relief. It also helps in eliminating aggravated doshas like vata and pitta.
  • This procedure can be useful in the treatment of neuropathic pain due to sciatica. As visarpa is caused due to vitiation of rakta, it can also be effective in the management of visarpa.

Ayurvedic Herbs for Neuropathic (Nerve) Pain

• Bhumiamalaki
  • Bhumiamalaki acts on the digestive, urinary, and reproductive systems and has bitter, astringent (constricts body tissues), and stomachic (promotes digestion) properties.
  • This herb is known to pacify the aggravated vata dosha and treat numerous vata-related diseases.
  • Bhumiamalaki is also used in pacifying pitta and kapha doshas, thus relieving pain and burning sensations caused due to the aggravation of these two doshas. It improves the perceptions of cold, heat and vibration that are diminished in diabetic neuropathy. Therefore, it is an effective therapy in the treatment of neuropathic pain due to diabetes.
  • It is also one of the main herbs useful in the treatment of liver diseases.
  • Additionally, Bhumiamalaki can be used in the management of diabetes, oedema, jaundice, colitis, gonorrhoea and dysentery.
  • External applications of this herb help treat inflammation, sores, swellings, itching and other skin diseases.
  • It can be used in the form of an infusion, juice, powder, poultice or pill.
• Haridra
  • Haridra acts on the circulatory, digestive, respiratory and urinary systems and has antioxidant and anti-inflammatory properties.
  • It helps in the formation and purification of blood and is used for relieving neuropathic pain.
  • It can be used in the form of infusion, decoction, milk decoction, powder and external paste.
• Bala
  • Bala acts on circulatory, nervous, reproductive, respiratory, and urinary systems and has nervine, pain-relieving, rejuvenating, stimulant, and diuretic properties.
  • It is one of the main herbs that are used for strengthening.
  • Bala heals tissues and treats chronic inflammation. It can be used in the management of various vata disorders and treating numbness, nerve pain and muscle cramps.
  • It is also effective in treating sciatica, diabetic neuropathy and arthritis, some of the common causes of neuropathic pain.
  • It can be used in the form of a decoction, powder or medicated oil.

Ayurvedic medicines for neuropathic (Nerve) pain

• Vasantkusumakar
  • Some of the ingredients of this medicine are bhasmas (calcined preparations) of suvarna (gold), raupya (silver), vanga (tin), naga (lead), and abhraka (mica), which are infused with the properties of herbs like vasa (Malabar nut), chandana (sandalwood), and haridra.
  • It is used in the treatment of diabetes, tuberculosis and urinary disorders.
  • Vasantkusumakar strengthens the nervous system and is helpful in the management of nerve pain caused due to vata imbalance.
  • This formulation reduces burning sensation and weakness, which make it an effective therapy for nerve pain.
• Shirashuladivajra rasa
  • It is a rasayana (rejuvenating) medicine prepared from shuddha parad (purified mercury), gandhak (brimstone), shuddha guggulu (purified Indian-bdellium tree), lauha (iron) bhasma, tamra (copper) bhasma, triphala (a combination of amalaki [Indian gooseberry], vibhitaki [belleric myrobalan], and haritaki [chebulic myrobalan]), gokshura (small caltrops) and dashamoola (10 roots).
  • Guggulu, one of the ingredients in this formulation, has strong vata-pacifying properties and is useful in the management of all types of pain including neuropathic pain, especially that caused by trigeminal neuralgia.
• Mahavatavidhvansan rasa
  • It is one of the best medicines that pacifies aggravated vata and is useful in treating disorders and painful conditions of the nervous systems.
  • Mahavatavidhvansan rasa acts on the channels of vata and vata-dominant locations. It brings vata into balance, thereby reducing the symptoms caused by aggravated vata.

As treatments vary according to numerous factors and an individual’s prakriti (constitution), consult a qualified Ayurvedic doctor for the appropriate medications and treatments for your specific complaints.

Do’s

• Use comfortable, soft and spongy mattresses and opt for comfortable chairs with soft cushions.
• Include foods like methi, asafoetida, brinjal, drumsticks, tamarind, coconut water, lemon, garlic, mango, grapes, yoosha (water boiled with different types of pulses), meat juice, milk, rice, wheat, black gram, ghee (clarified butter), saindhava (salted butter) and pomegranates in your regular meals.
• Maintain the right body posture while exercising and sitting.
• Practice yoga and take hot water bath regularly.

Don’ts

• Do not suppress natural urges such as hunger, thirst, and evacuating the bladder or bowel.
• Do not consume foods that aggravate vata, e.g., biscuits, stale food, cold food, pulses, wafers, cold drinks and peas.
• Do not expose yourself to cold weather.
• Avoid excessive physical activities.
• Avoid negative emotions like grief and anger.

A clinical study involving 30 participants with symptoms of diabetic neuropathy indicated the effectiveness of holistic Ayurvedic therapies in the management of neuropathic pain. These participants were treated using bhumiamalaki churna and a decoction of atibala root. The duration of treatment was 30 days, and it was found that these Ayurvedic remedies could effectively treat the symptoms of diabetic neuropathy including pain.

Another clinical study including 30 participants with sciatica compared the effectiveness of three Ayurvedic remedies. The participants were divided into three groups. One group was treated with a herbal preparation called Parijata patra ghana, the second group was treated with kati basti using dashamoola taila, and the third group was treated using both the therapies. All the groups showed symptomatic improvement, but the third group reported significant relief as compared to the other two groups, indicating the efficacy of combined therapy.

Although natural therapies are safe and effective, side effects and contraindications may occur depending on the clinical condition of the individual. The following contraindications and risks of the above-described therapies should be considered before treatment

• Virechana is not advisable in individuals with anorectal injury, diarrhoea, bleeding from the lower parts of the body, prolapse of the rectum and after basti.
• Basti should be avoided in individuals with intestinal obstruction, anal inflammation and anaemia.
• Raktamokshana is not recommended for individuals with bleeding disorders, anaemia and piles.
• Haridra should not be used in acute jaundice and hepatitis.
• Bala is contraindicated in individuals with chest congestion.

Neuropathic pain, caused by the damage and dysfunction of the nerves, is a common condition affecting a wide range of population all over the world. Although conventional medicines provide immediate relief from pain, more often than not it is temporary and associated with minor side effects. Ayurvedic procedures, herbs and medicines are safe and effective in the management of nerve pain, when taken appropriately. These remedies not only treat the underlying condition but also prevent the relapse of nerve pain.