CLINICAL OUTCOMES OF MULTIPLE PUTAKA (REPEATED ADMINISTRATION) MĀDHUTAILIKA VASTI IN ĀTURA-HASTA PRAMĀṆA (PATIENT-SPECIFIC HAND MEASUREMENT) IN KAT’EEGRAHA (LOW BACK PAIN)

Abstract

Introduction: Kat’eegraha, described as a manifestation of Pakvāśayagata Vāta under Vātavyādhi, represents a common and functionally disabling condition comparable to low back pain. Vasti Karma is considered the principal therapeutic modality for Vāta disorders owing to its systemic and regulatory actions. Mādhutailika Vasti, a type of Yāpana Vasti (sustaining or rejuvenative enema), is traditionally administered in Āturahastapramāṇa (in­dividualised patient-specific dose). Classical references also advocate multiple Putaka ad­ministrations until the attainment of Samyak NiruhaLakṣaṇa (proper signs of therapeutic purification) to ensure optimal therapeutic outcomes; however, this practice is less com­monly implemented in contemporary settings. The present study aimed to evaluate the safety and clinical effectiveness of multiple Putaka administrations of Mādhutailika Vasti in re­ducing the signs and symptoms of Kat’eegraha and in attaining Samyak Niruha Lakṣaṇa.

Materials and Methods: This study presents a subgroup analysis of 16 participants aged 20–60 years who were diagnosed with Kat’eegraha and required multiple putaka admin­istrations during the Yoga vasti period. Ethical approval was obtained from the Institutional Ethics Committee (IRB No: IRB/CL/20/23; dated 10-10-2023). Eligible patients received Yoga Vasti on alternate days for 8 days as per institutional protocol. Pain intensity, tender­ness, and functional disability were assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at baseline (Day 0) and on Day 9 (the day following com­pletion of therapy) and the Event evaluation scale were assessed after each putaka in each Niruha. Data were analyzed using SPSS 2016.Results: Significant improvement was observed in all primary outcomes (n = 16), with pain intensity, tenderness, and ODI scores showing highly significant reductions (p < 0.001). Five of seven Samyak NiruhaLakṣaṇa parameters also improved significantly (p < 0.05) across successive Niruha stages following multiple Putaka administration of Mādhutailika Vasti. Discussion: The clinical improvement may be attributed to the Vātānulomana (normaliza­tion of Apāna Vāta) and Vāta–Kapha hara (pacification of Vāta and Kapha) actions of Mādhutailika Vasti, with progressive attainment of Samyak NiruhaLakṣaṇa, indicating a cu­mulative therapeutic effect in Kat’eegraha.Conclusion: Multiple Putaka administration of Mādhutailika Vasti in Ātura-hasta Pramāṇa significantly reduced pain and disability in Kat’eegraha and promoted attainment of Samyak Niruha Lakṣaṇa. No adverse events were observed during the intervention period, indicating that the procedure is safe and clinically beneficial in low back pain.