Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

‘Manyastambha’ is a situation defined in Ayurveda within the context of Vata Vyadhi – particular problems brought on by aggravated vata.

Which means of Manyastambha

The phrase Manyastambha is made up of two phrases. They’re –

–         Manya = again facet of the neck
–         Stambha = stiffness, catch

Placing each the phrases collectively, Manyastambha means ‘stiffness of the again of the neck area’.

Definition of Manya

Manya has been outlined as ‘greeva paschad bhaga’ which implies ‘posterior a part of the neck – again of the neck’. Stambha means stiffness, catch or a situation whereby there may be lack of actions.

Manyastambha is a vata dysfunction and is brought on when the aggravated vata afflicts the mamsa – muscle groups, snayu – ligaments and nerves and delicate tissues in the back of the neck.

Understanding the phrase Stambha

Stambha / stabdhata means stiffness. However it may be understood in line with scenario and context. In circumstances like Manyastambha, stambha not solely means stiffness but in addition the opposite circumstances brought on by and related to stambha. They embody loss or limitation of actions, mal-presentation and positioning of chin and head.

Stambha could also be brought on both by vata or kapha. We’ll additional perceive the involvement of kapha within the causation of stambha or manyastambha within the dialogue of pathogenesis of the illness.

So, stambha or stiffness is brought on by –

–         Vata – when manyastambha is brought on by solely vata, as in manyastambha being one of many eighty vata nanatmaja roga
–         Kapha – as per the pathogenesis of manyastambha defined by Grasp Sushruta whereby kapha obstructs or envelopes vata, thus hampering the vata, inflicting a kaphavrita vata like situation which additional results in stiffness and limitation of actions on the neck
–         Vata drying up the kapha behind the neck and inflicting stiffness

Sorts of Manyastambha

The kinds of Manyastambha haven’t been laid out in Ayurveda texts. However we are able to infer the kinds primarily based on the reason and references we discover in regards to the illness within the treatises.

1.    Vata Pradhana Manyastambha – On this situation, manyastambha is brought on by aggravation of ‘solely vata’ within the area of manya. This matches with manyastambha talked about as one among the many eighty kinds of ‘vata nanatmaja rogas’.
2.    Kapha Pradhana or Kaphavrita Vata Janya Manyastambha – This situation has been defined by Grasp Sushruta. On this situation, aggravated kapha blocks vata within the area of the manya and causes a regional ‘kaphavrita vata like situation’ in manya.

1. Manyastambha – a Vata Nanatmaja Vyadhi

Manyastambha is counted as one among the many eighty kinds of vata nanatmaja vikaras i.e. particular vata problems whereby no different dosha is concerned within the pathogenesis. This additionally explains the position of vata within the causation of this dysfunction.

On this situation, aggravated vata will get lodged within the area of manya and causes stiffness, tough actions, ache and different associated signs. The causative elements of this situation are additionally the ‘vata aggravating’ ones. The interventions too might be focused in direction of balancing vata.

2. Manyastambha – a Kaphavrita Vata situation

This can be a variant of Manyastambha whereby aggravated kapha can be concerned together with vata within the pathogenesis of the illness. Right here the aggravated kapha blocks and envelopes vata. That is referred to as as kaphavruta vata. This mechanism can occur wherever within the physique however when it occurs within the manya area, it is going to trigger manyastambha. Avarana is a vata dysfunction itself. However right here the actions and features of vata are hampered by kapha. The stiffness on this situation is brought on by kapha. Restriction of actions and ache are brought on by vata which has been blocked and attempting to battle again to flee from the captivity.

Causes of Manyastambha

Under talked about are the necessary causes of Manyastambha –

1. Normal Causative elements –

Any vata rising, aggravating or triggering causative elements, together with meals and way of life actions could cause or set off manyastambha, when aggravated vata finds place and get lodged within the nape of the neck – manya. These causes might be thought of as basic causative elements of manyastambha.

Manyastambha brought on by the below-mentioned particular causes could additional be triggered or worsened by these basic causative elements.

Conserving it brief, generalized causative elements for vata aggravation are these which predominantly trigger ‘vata nanatmaja sort of manyastambha’ however could in later a part of time get related to kapha in these having kapha aggravation and may result in avarana sort of manyastambha, however not as a rule.

2. Particular Causative elements –

–         Divaswapna – extreme sleeping throughout day time
–         Asama sthana – sleeping on an uneven floor, in odd and untoward positions. It additionally contains uneven work locations whereby one must work by compromising the place of the neck.
–         Urdhwa nirikshanah – wanting upwards / with upward gaze in extra

All these etiological elements contain irregular positions of the neck, which on longer run could cause stiffness, ache and decreased actions on the neck – manyastambha.

These etiological elements clearly worsen each kapha and vata. Whereas diwaswapna aggravates kapha in extra, the opposite two elements are chargeable for aggravation of vata.

So, these set of causative elements give rise to the kind of manyastambha brought on resulting from kaphavrita vata.

Whereas there isn’t a description of ‘manyastambha’ defined within the context of vata nanatmaja rogas and the causative elements talked about above have been talked about within the context of manyastambha involving kapha together with vata (kaphavrita vata) by Grasp Sushruta, these elements shall be thought of as ‘particular causative elements for manyastambha’ whereas generalized causative elements as talked about above are those which can trigger the nanatmaja vata vyadhi – manyastambha.

Pathogenesis of Manyastambha

1. Vata Nanatmaja Sort of Manyastambha

Attributable to extreme consumption of or publicity to vata aggravating etiological elements, the vata would abnormally enhance within the physique. When this vata will get localized within the manya area, it is going to trigger stiffness, restriction of actions of the neck and ache. Vata causes this by drying of kapha, and tissues within the manya together with sira, snayu, mamsa and kandara.

Extreme consumption of vata aggravating etiological elements

Aggravation of vata

Vata will get lodged within the manya – again of the neck

Vata dries up kapha, sira, snayu, mamsa and kandara within the area of manya

Stiffness, ache and restriction of actions of neck

Vata Nanatmaja Manyastambha

2. Kaphavruta Vata Sort of Manyastambha

Attributable to extreme consumption of / publicity to the above stated etiological elements, vata and kapha would endure imbalance. Primarily kapha would get severely aggravated. This kapha would trigger avarana of vata i.e. the aggravated kapha envelopes vata and blocks (interferes) with its regular functioning. This will also be thought of as a state of ‘kaphavruta vata’ occurring within the area of the neck.

Extreme consumption of / publicity to the etiological elements resulting in extreme aggravation of kapha and partial imbalance of vata

The doshas transfer in direction of manya – again of the neck / nape of the neck and get lodged therein

Kapha envelops and blocks the vata

The traditional functioning of vata is disturbed

There happens ache and lack of actions and tilting of neck because of the affliction of nerves, muscle groups, tendons and delicate tissues within the nape of the neck

This situation is known as as manyastambha / Kaphavrta Vata Janya Manyastambha

Although manyastambha is a vata dysfunction, this situation is brought on by the blockage of features of vata by the aggravated kapha. When blocked and surrounded by kapha, vata tries laborious to flee from the zone of restriction and categorical itself. This wrestle would trigger the signs.

Since kapha is predominant within the combo inflicting this illness there may be elevated stiffness within the nape of the neck i.e. stambha. Stambha is a attribute function and symptom of aggravated kapha. Ache and different signs are brought on by the enveloped vata. Restriction of actions, if any, is brought on by the mechanism of blockage of vata by kapha.

Remedy Rules of Manyastambha

Vata Pradhana (Nanatmaja) Manyastambha – This situation ought to be handled on the traces of Vata Vyadhi Chikitsa – all measures and medicines prescribed for remedy of Vata predominant problems.

The principle interventions embody –

Exterior interventions –

–         Abhyanga – Ksheerabala Taila, Prasarinyadi Taila, Mahanarayana Taila, Mahamasha Taila, Balashwagandha Taila – can be utilized for soothing therapeutic massage
–         Griva Vasti – oil pooling on the again of the neck
–         Pinda Sweda – Patrapinda Sweda and Shashtika Shali Pinda Sweda are extremely helpful
–         Lepa / Upanaha – Vata assuaging herbs could also be used for anointment or poultice

Inside interventions –

–         Nasya – errhines with Ksheerabala Taila, Mahamasha Taila
–         Vasti – medicated enemas – in persistent / cussed / persistent circumstances – Ksheerabala Taila, Prasarinyadi Taila, Guggulutiktaka Ghrta – are helpful for enemas.

Kapha Pradhana (Kaphavrita Vata) Manyastambha – This situation ought to be handled on the traces of ‘Avarana Chikitsa’. Avarana is a pathological occasion whereby pitta, kapha, any tissue or excreta or meals would envelope and impede vata. Herein the traditional actions and features of vata might be hampered. One subtype of vata could also be enveloped and blocked by one other subtype of vata additionally. That which envelops and causes obstruction of vata is known as avaraka, vata is known as avruta and the whole occasion is known as avarana. Avruta is fixed – it’s at all times vata or a subtype of vata.

In kaphavruta vata happening within the area of manya resulting in Manyastambha, kapha is avaraka and vata is avruta. As a rule of treating avarana, first the avruta ought to be handled and the vata ought to be freed.

So, the preliminary interventions on this situation might be to do away with kapha and the obstruction to vata that it has brought on. Later when vata will get freed, it’s nonetheless aggressive and confused and erratic because it was attempting an escape route on a regular basis. This vata ought to now be calmed and be delivered to a state of steadiness.

The interventions and remedy ideas for this situation contains –

Exterior interventions –

–         Abhyanga – with kapha assuaging oils like Kottamchukkadi Taila or any oil which is ready with kapha assuaging herbs
–         Swedana – examine ought to at all times be completed after abhyanga / snehana. Right here, ruksha sweda – dry sudation / fomentation is desired. Choorna Pinda Sweda is preferable on this situation. Kottamchukkadi Churna or Rasnadi Churna could also be used for this goal.
–         Lepa / Upanaha – Kapha assuaging herbs could also be used for anointment or poultice

Inside interventions

–         Mrudu Vamana – gentle emesis ought to be administered to expel morbid kapha if its aggravation is extreme

–         Nasya – Anu Taila shall be used for errhine

Vata administration

As soon as the kapha avarana has been eliminated, the vata might be uncovered. This vata ought to now be managed on the traces of ‘vata vyadhi chikitsa’ as per the ideas of remedy talked about above.

Useful formulations in Manyastambha

–         Maharasnadi Kashayam
–         Prasarinyadi Kashayam
–         Rasonadi Kashayam
–         Varanadi Kashayam
–         Mahayogaraja Guggul
–         Rasnadi Guggulu
–         Balarishta
–         Ashwagandharishta
–         Guggulutiktakam Ghrta