Background: Sciatica is a type of musculoskeletal pain experienced in the leg along the distribution of the sciatic nerve. It is occasionally accompanied by lower backache. According to the Unani system of medicine, Irq al-Nasa (Sciatica) is a form of Wajaul Mafasil (Arthritis), characterised by hip pain that travels from the back of the thigh to the ankle joint. Conventional treatments for Sciatica typically involve medication, surgery, or occasionally both. The use of corticosteroids and painkillers is associated with a higher risk of adverse events, and their effectiveness is also questionable. This warrants the need for an effective, complementary treatment option for Sciatica.
Aim: This case report aims to evaluate the efficacy of Fasd (Venesection) in managing Irq al-Nasa.
Case description: The patient was a 63-year-old non-hypertensive, non-diabetic, euthyroid male, complaining of persistent left-sided pain in the upper thigh, lower buttock region, with pain radiating to the left leg, calf, and toes, along with numbness and tingling sensations. Sciatica was diagnosed based on three objective criteria: Visual Analogue Scale (VAS) pain score, Oswestry Disability Index (ODI), and Straight Leg Raising Test (SLRT), as well as from magnetic resonance imaging (MRI) of the lumbo-sacral spine.
Intervention: Fasd (Venesection) was performed on the left saphenous minor vein of the patient once a week for two weeks. The patients were assessed using VAS, ODI, and SLRT.
Outcome: Before the intervention, the VAS score was 8, the ODI was 42%, and the SLR was 30%. Following the first Fasd procedure, the VAS score decreased to 4, the ODI reduced to 22%, and the SLR improved to 60%. After the second procedure, the VAS score reached 0, the ODI further dropped to 8%, and the SLR increased to 90%.
Conclusion: This case report provides preliminary evidence supporting the use of Fasd in treating Sciatica.
Keywords: Fasd, Venesection, Sciatica, Irq al-Nasa, pain management, case report.
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