Application of Gunja (Abrus precatorius Linn.) Beeja lepa: An Ayurvedic protocol for the treatment of Gridhrasi (sciatica)

The most common musculoskeletal disorder affecting the movement of legs is low back pain. Among the affected patients, 40% have ridiculer pain, and these cases can be classi ied under the umbrella of the sciatic syndrome. Low back pain is extraordinarily common, frequently resulting from degenerative arthritis of the lumbosacral spine. The annual prevalence of disc-related sciatica in the general population is estimated at 2.2%. Sciatica is characterised by constant aching pain which felt in the lumbar region may radiate to the buttock, thigh, calf and foot. Acharaya Charaka explained Gridhrasi in eighty types of nanatmaja Vata vikara. The present study is aimed at evaluating the effect of Gunja (Abrus precatorius Linn.) Beeja lepa in the management of Gridhrasi (Sciatica) and thereby assessing the changes in quality life. The present study is designed as a Non-randomized controlled clinical study, in which a minimum of 30 patients will be enrolled. Gunja beej lepa will be administered external application two times in a day with lukewarm water. Assessment will be recorded on the 3, 5, 7, 14 and 28 day. Changes will be observed in subjective parameters such as Ruk (pain) Toda (pin pricking sensation) Stambha (Stiffness), Spandana (Fasciculation) and objective parameters such as measuring the changes in the angle of elevation of the leg by SLR Test, Sciatica Bothersomeness Index and Sciatica Frequency Index before and after the treatment. Suitable conclusion will be drawn post completion of the trial.

The most common musculoskeletal disorder affecting the movement of legs is low back pain. Among the affected patients, 40% have ridiculer pain, and these cases can be classi ied under the umbrella of the sciatic syndrome. Low back pain is extraordinarily common, frequently resulting from degenerative arthritis of the lumbosacral spine. The annual prevalence of disc-related sciatica in the general population is estimated at 2.2%. Sciatica is characterised by constant aching pain which felt in the lumbar region may radiate to the buttock, thigh, calf and foot. Acharaya Charaka explained Gridhrasi in eighty types of nanatmaja Vata vikara. The present study is aimed at evaluating the effect of Gunja (Abrus precatorius Linn.) Beeja lepa in the management of Gridhrasi (Sciatica) and thereby assessing the changes in quality life. The present study is designed as a Non-randomized controlled clinical study, in which a minimum of 30 patients will be enrolled. Gunja beej lepa will be administered external application two times in a day with lukewarm water. Assessment will be recorded on the 3 rd , 5 th , 7 th , 14 th and 28 th day. Changes will be observed in subjective parameters such as Ruk (pain) Toda (pin pricking sensation) Stambha (Stiffness), Spandana (Fasciculation) and objective parameters such as measuring the changes in the angle of elevation of the leg by SLR Test, Sciatica Bothersomeness Index and Sciatica Frequency Index before and after the treatment. Suitable conclusion will be drawn post completion of the trial.

INTRODUCTION
The twenty-irst century is the era of lifestyle disorders. The most common musculoskeletal disorder affecting the movement of legs is low back pain.
Among the affected patients, 40% have ridiculer pain, and these cases can be classi ied under the umbrella of the sciatic syndrome. Low back pain is extraordinarily common, frequently results from degenerative arthritis of lumbosacral spine or disk and commonly follows a dermatomal distribution with the involvement of nerve root between L4 and S3 (Longo et al., 2011).
Sciatica is characterised by constant aching pain which felt in the lumbar region may(1)dilate to the buttock, thigh, calf and foot (Walker et al., 2014). Sciatic pain radiates alongside the course of the sciatic nerve (Stafford et al., 2007).
It is common between 30-40 yrs of age and affects both the sexes (male and female) equally. About 50% of working adults experience a back injury each year. The annual incidence of disc-related sciatica in the general population is estimated at 2.2% (Lohith and Girish, 2013).
In lammation of joints and muscles, irritation of the sciatic nerve are the causative factors for the development of sciatica. Gunja (Abrus precatorius) is one of the poisonous plants which have proven anti-in lammatory activity (Sudaroli and Chatterjee, 2007). In Rasatarangini paste of Gunja seeds is advised in sciatica (Wadnerwar et al., 2020).

Study type
Non-Randomized, single-arm interventional study.

Study design
Diagnosed Patients will be selected from OPD & IPD of Panchkarma department MGACH and RC Wardha. The detailed study design is shown in Figure 1 and Table 2.

Schedule of enrollment, interventions
Diagnosed patients of Gridhrasi (Sciatica) will be enrolled in the present study after ful illing the inclusion criteria.

Interventions
Local application of Gunja Beeja lepa will be done for twice a day over sciatic notch for seven days.
Sample size-30. Data collection methods-Non-Randomized. Time duration until the follow-up -The follow-up period will be 28 days. During treatment -3 rd , 5 th , & 7 th day. After treatment -14 th & 28 th day.

Inclusion Criterion
1. Patients diagnosed as the case of Gridhrasi (Sciatica) with the presenting symptoms of either sex.
2. Patients in the age group 30 to 50 years of age.

Exclusion Criterion
1. Patients with Sensitivity test positive.
2. Monoplegia, paraplegia, hip joint arthritis, TB of the spine, severe accidental cases and other surgical emergencies.

Criteria for discontinuing or modifying allocated interventions
If any undesired incidence occurs then the patient will be withdrawn from the study and free of cost treatment will be provided to the patient till the disease subsides.

Secondary Outcomes
To observe the changes in the angle of elevation of the leg by SLR Test and changes in the Sciatica Bothersomeness Index and Sciatica Frequency Index before and after the treatment.

Statistical analysis
Wilcoxon signed-rank and paired t-test will be done to analyse the data. Follow up will be on 3 rd , 5 th , 7 th , 14 th.

Recruitment and Implementation
The patients will be enrolled and allocated by Principal invigilator.

Data management
The data entry coding will be done by PI.

PI will do the data entry coding dissemination
Permission for research has been taken from

Informed consent or assent
All the research related documents and consent form will be given to the patients. The con identiality of patients will be maintained during the study.

Dissemination policy
In future data will be disseminated for clinical work and publication.

Informed consent materials
Consent form and other related documentation will be given to participants and authorised informants with all the information.

DISCUSSION
The main causative factor for the pathogenesis of sciatica is in lammation which leads to the presentation of pain and other symptoms. In Ayurveda, Gunja Beeja lepa is used for the management of kandu, kustha, darunaka, many skin diseases and various arthritic conditions like aamvata. Gunja seeds are tikta (Bitter) and kashaya (Astringent) rasa and katu (Pungent) vipaka due to which Gunja lepa may act as a potent Vata kaphahara, Shothahara, Vedna shamak.

CONCLUSION
Gunja (Abrus precatorius) is a plant which has proven anti-in lammatory activity. This study will demonstrate treatment modalities of Ayurved, wherein the ef icacy of gunja Beeja lepa will be studied in the management of Gridhrasi (sciatica).