Critical Study of the Disease Sciatica in Ayurveda with Special Reference to Kukundara and Nitamba Marmaghata (Nervine Trauma)

Background: Sciatica, clinically characterised by radiating pain along the distribution of the sciatic nerve from the lumbar spine to the lower extremity, is one of the most prevalent musculoskeletal complaints encountered in clinical practice worldwide. In Ayurveda, this condition is described under the nomenclature Gridhrasi, a distinct vatavyadhi (disease of neurological origin), enumerated in the classical texts of Charaka Samhita and Sushruta Samhita with detailed aetiological, pathophysiological, diagnostic, and therapeutic frameworks. Objectives: This literature review aims to critically examine the Ayurvedic conceptualisation of Gridhrasi with special reference to Kukundara Marmaghata (spinal trauma at the iliac crest level) and Nitamba Marmaghata (nerve trauma at the gluteal region), and to establish their biomedical correlates with contemporary understanding of lumbar radiculopathy and sciatic neuropathy. Methods: A systematic narrative review of primary classical Ayurvedic texts — Charaka Samhita (Chikitsa Sthana 28), Sushruta Samhita (Nidana Sthana 1, Shareera Sthana 6), and Ashtanga Sangraha (Nidana Sthana 15) — alongside peer-reviewed biomedical literature published between 2015 and 2025 was conducted. Databases including PubMed, Scopus, AYUSH Research Portal, and Google Scholar were searched using MeSH terms and Ayurvedic nomenclature. Results and Discussion: The Ayurvedic concept of Marmaghata to Kukundara and Nitamba precisely maps onto compression injuries of lumbar nerve roots (L4–S1) and sciatic nerve trauma, respectively. The Samprapti (pathogenesis) of Gridhrasi — involving Vata aggravation, Sira-Kandara involvement, and progressive motor-sensory dysfunction — demonstrates substantial concordance with the neuroinflammatory and compressive mechanisms of modern lumbar radiculopathy. The ancient Straight Leg Raise equivalent described in Ashtanga Sangraha (A.S.N. 15/54) further affirms this correlation. Conclusion: Integrating Ayurvedic Marma-based diagnostic frameworks with contemporary neuroimaging and electrodiagnostic standards offers a promising interdisciplinary model for the holistic management of sciatica. Further prospective clinical trials evaluating classical Ayurvedic interventions against established biomedical benchmarks are warranted.