Aetiopathological Perspectives On Gridhrasi W.S.R. To Sciatica And The Therapeutic Potential Of Vitex Negundo: A Comprehensive Review

Abstract

Background: Gridhrasi, described in Ayurveda as a Nanatmaja Vata Vyadhi, presents with radiating pain, stiffness, and functional limitation of the lower limb, closely resembling the modern clinical entity of sciatica. Its pathogenesis is rooted in Vata aggravation, often associated with Kapha vitiation, leading to Srotorodha (channel obstruction) and nerve compression. In modern pathology, sciatica commonly results from intervertebral disc herniation, degenerative changes, or spinal canal stenosis, causing irritation of the lumbosacral nerve roots. Vitex negundo (Nirgundi), widely referenced in classical Ayurvedic literature, exhibits Vata–Kapha Shamana, Shothahara, and Vedanasthapana properties, aligning with the therapeutic needs in Gridhrasi. Aim To explore the aetiopathology of Gridhrasi with special reference to sciatica and to assess the therapeutic potential of Vitex negundo in its management. Objectives To review Gridhrasi from Ayurvedic and modern perspectives. To analyze the aetiopathogenesis (Samprapti) of Gridhrasi and its correlation with sciatica. To compile classical and modern literature on Vitex negundo. To evaluate pharmacological evidence supporting Vitex negundo in neuro-musculoskeletal disorders. Materials and Methods: An extensive review of classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya was conducted for descriptions of Gridhrasi and Nirgundi. Modern literature was reviewed from indexed medical journals, pharmacognosy sources, and phytopharmacological studies. Data were synthesized to compare pathophysiological mechanisms and therapeutic approaches, with special emphasis on phytoconstituents, pharmacological actions, and experimental evidence supporting Vitex negundo in neuro-musculoskeletal conditions. Results: Ayurvedic literature attributes Gridhrasi to aggravated Vata, sometimes in association with Kapha, producing Ruk, Toda, Stambha, and Spandana. Modern correlates show compression-induced inflammation and neuropathic pain mechanisms. Vitex negundo contains flavonoids, iridoid glycosides, and essential oils that demonstrate anti-inflammatory, analgesic, muscle relaxant, and neuroprotective effects in preclinical and clinical studies. Topical and internal formulations of Nirgundi have shown symptom relief in pain, stiffness, and mobility restriction, with minimal adverse effects. Conclusion: The aetiopathogenesis of Gridhrasi shares significant conceptual parallels with sciatica, enabling integrative understanding and treatment strategies. Vitex negundo, supported by both Ayurvedic indications and modern pharmacology, holds promise as a safe, multi-targeted therapeutic in the management of Gridhrasi. Further high-quality clinical trials are warranted to establish standardized dosage forms and protocols.