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Suggest Treatment For Sacral Perineural Cyst, Pain In Joints And Muscles
Question: Hi Doctor,
I'm 29 yrs old male. For the past 5 months I've been going through knee pain. The pain has spread to my thighs(severe), to lower part till ankle (mild) and fingers(mild) and mild pain on my hips area(from last one month). Initially, the treatment was being done for a possible partial ligament tear on my knees (by an orthopaedic), later for GOUT (by another orthopaedic), then one month of ayurvedic treatment for both gout and ligament tear. Then I visited another orthopaedic without any relief for previous treatments. Several tests were done ranging from xray (lumbar spine), blood tests, MRI (lumbar spine), some neurology test to check the pressure on my nerves on leg. All the results were negative except for MRI which states a well defined perineural cyst within the thecal sac at the level of S1-2 intervertebral level directly indenting on the descending intrathecal nerve roots. My doctor is of the conclusion that it is this cyst that is causing a pressure on my nerve causing a pain on my right leg and hip area. The current treatment is consumption of a tablet (gebapentin 100 mg) twice a day for one month, physiotherapy and one or two painkiller as required. If no improvement is seen surgery may be required.
Please advise if any treatment is there in ayurveda for above condition. If yes, please suggest them and advise a good ayurvedic hospital in XXXXXXX
I'm 29 yrs old male. For the past 5 months I've been going through knee pain. The pain has spread to my thighs(severe), to lower part till ankle (mild) and fingers(mild) and mild pain on my hips area(from last one month). Initially, the treatment was being done for a possible partial ligament tear on my knees (by an orthopaedic), later for GOUT (by another orthopaedic), then one month of ayurvedic treatment for both gout and ligament tear. Then I visited another orthopaedic without any relief for previous treatments. Several tests were done ranging from xray (lumbar spine), blood tests, MRI (lumbar spine), some neurology test to check the pressure on my nerves on leg. All the results were negative except for MRI which states a well defined perineural cyst within the thecal sac at the level of S1-2 intervertebral level directly indenting on the descending intrathecal nerve roots. My doctor is of the conclusion that it is this cyst that is causing a pressure on my nerve causing a pain on my right leg and hip area. The current treatment is consumption of a tablet (gebapentin 100 mg) twice a day for one month, physiotherapy and one or two painkiller as required. If no improvement is seen surgery may be required.
Please advise if any treatment is there in ayurveda for above condition. If yes, please suggest them and advise a good ayurvedic hospital in XXXXXXX
Brief Answer:
Sacral Perineural Cyst
Detailed Answer:
Dear
Thanks for contacting Ayurveda with your health concern and since you are already under guidance and treatment of a qualified doctor, remain under his guidance and regular supervision, and following is/are my guidelines for you:
1. Since cyst at sacral area are uncommon but major cause of paresthesia-pain, and going by your age (29 years), one has to exclude any familial tendency of the same.
PS. do let me know whether there is any family history or it id developmental in origin and any past history of trauma or meningitis
2. Any problem with bladder,bowel dysfunction?
3. What classification has the attending doctor made of the diagnosis, whether it is Type I- II or III.
4. Going by your age it will be wise to undergo surgery since there is drastic reduction in symptoms once the surgery is performed.
Do revert back with your clarifications, since pressure is the CAUSE, thus decompression will be the mainstay of treatment. Ayurveda management can be started/incorporated once the surgical correction/resurrection is done.
Dr. Munish Sood
Consultant & Physician
Naimittika
Sacral Perineural Cyst
Detailed Answer:
Dear
Thanks for contacting Ayurveda with your health concern and since you are already under guidance and treatment of a qualified doctor, remain under his guidance and regular supervision, and following is/are my guidelines for you:
1. Since cyst at sacral area are uncommon but major cause of paresthesia-pain, and going by your age (29 years), one has to exclude any familial tendency of the same.
PS. do let me know whether there is any family history or it id developmental in origin and any past history of trauma or meningitis
2. Any problem with bladder,bowel dysfunction?
3. What classification has the attending doctor made of the diagnosis, whether it is Type I- II or III.
4. Going by your age it will be wise to undergo surgery since there is drastic reduction in symptoms once the surgery is performed.
Do revert back with your clarifications, since pressure is the CAUSE, thus decompression will be the mainstay of treatment. Ayurveda management can be started/incorporated once the surgical correction/resurrection is done.
Dr. Munish Sood
Consultant & Physician
Naimittika
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thanks Doctor,
Answers to your questions:
1. PS. do let me know whether there is any family history or it id developmental in origin and any past history of trauma or meningitis
ans - There is no known family history of Sacral Perineural Cyst.
I don't know if it is developmental in origin.
Past history of trauma - I had met with an accident 2-3 yrs back where I had injured my knee. No medication was done except for 1 week rest and recovered. No doctor was consulted at that stage.
No history of meningitis.
note: My mother passed away in 2011 due to brain tumor (type 4). I'm not sure if this info will be of any use in this case.
2. Any problem with bladder,bowel dysfunction? - no
3. What classification has the attending doctor made of the diagnosis, whether it is Type I- II or III. - Dr has not communicated any such details yet.
4. Going by your age it will be wise to undergo surgery since there is drastic reduction in symptoms once the surgery is performed. - Is there no treatment in ayurveda to cure the cyst. Is performing surgery the only option.
Regards,
Answers to your questions:
1. PS. do let me know whether there is any family history or it id developmental in origin and any past history of trauma or meningitis
ans - There is no known family history of Sacral Perineural Cyst.
I don't know if it is developmental in origin.
Past history of trauma - I had met with an accident 2-3 yrs back where I had injured my knee. No medication was done except for 1 week rest and recovered. No doctor was consulted at that stage.
No history of meningitis.
note: My mother passed away in 2011 due to brain tumor (type 4). I'm not sure if this info will be of any use in this case.
2. Any problem with bladder,bowel dysfunction? - no
3. What classification has the attending doctor made of the diagnosis, whether it is Type I- II or III. - Dr has not communicated any such details yet.
4. Going by your age it will be wise to undergo surgery since there is drastic reduction in symptoms once the surgery is performed. - Is there no treatment in ayurveda to cure the cyst. Is performing surgery the only option.
Regards,
Brief Answer:
symptomwise approach
Detailed Answer:
Dear
Thanks for reverting back and possible with recommended step wise management in brief is as follows:
i. Some author believe that these cysts are only benign outpouching from sacral area which needs no treatment
PS. Since you are experiencing symptoms and MRI & Doctor Opine that it could be the cause of your pathology thus have a second opinion [ Orthopedic/ Neurologist ]
ii. You may start with non surgical approach like:
. lumbar CSF drainage
. CT scan guided cyst aspiration
PS. both will not prevent recurrence ( if chances are there)
iii. Although there are Neurosurgical techniques also: (laminectomy,nerve root excision) BUT best results are achieved with surgery.
iv. Take magnesium balanced diet
. Rehabilitation with Yoga ( Pelvic Floor Physical Therapist)
. Search for 'seat solution': wedge shaped cushion.
v. In Ayurveda although we treat cases on cyst on the basis of "granthi" but there also provision of shalya chikitsa (surgery) is clearly explained.
PS. If interested you may start with:
. Shodhan (elimination)
. XXXXXXX (pacification)
. Rasayan (Rejuvenation) which will include mainly: sweda (sudation), nasya (errhine), and Vasti (medicated enema) therapy.
Dr. Munish
Naimittika
symptomwise approach
Detailed Answer:
Dear
Thanks for reverting back and possible with recommended step wise management in brief is as follows:
i. Some author believe that these cysts are only benign outpouching from sacral area which needs no treatment
PS. Since you are experiencing symptoms and MRI & Doctor Opine that it could be the cause of your pathology thus have a second opinion [ Orthopedic/ Neurologist ]
ii. You may start with non surgical approach like:
. lumbar CSF drainage
. CT scan guided cyst aspiration
PS. both will not prevent recurrence ( if chances are there)
iii. Although there are Neurosurgical techniques also: (laminectomy,nerve root excision) BUT best results are achieved with surgery.
iv. Take magnesium balanced diet
. Rehabilitation with Yoga ( Pelvic Floor Physical Therapist)
. Search for 'seat solution': wedge shaped cushion.
v. In Ayurveda although we treat cases on cyst on the basis of "granthi" but there also provision of shalya chikitsa (surgery) is clearly explained.
PS. If interested you may start with:
. Shodhan (elimination)
. XXXXXXX (pacification)
. Rasayan (Rejuvenation) which will include mainly: sweda (sudation), nasya (errhine), and Vasti (medicated enema) therapy.
Dr. Munish
Naimittika
Note: Deal with your health issues naturally by getting closer to Ayurveda. click here to learn more.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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