J.T. Electricwala, Associate Orthopaedic Surgeon,
K.H. Sancheti, Medical Director,

and

J.H. Ralwani, Head, Academic Division,
Sancheri Institute of Orthopaedics & Rehabilitation, Pune - 5.

Key words: Low backache, lumbar spondylosis, anti-inflammatory drugs, Rumalaya.

Low back pain is the most common problem that confronts an orthopaedic surgeon today. The complaint attributed to degenerative or mechanical causes is more amenable to therapy be it medical surgical or physical. Lumbar spondylosis and associate conditions manifest themselves in the later age groups of life and most often run an insidious course. Treatment in these cases is long drawn. The above factors put constraints on the choice of drugs. The physician has to weigh judiciously between the efficacy, tolerance, side-effects, duration and cost of therapy against factors such as alleviation of pain and maintenance or improvement in the activity status of the patient. Analgesics and anti-inflammatory agents with proven therapeutic value but devoid of adverse reactions need to be administered over prolonged periods in chronic and progressive ailments. The present study was undertaken to recognise the role of an indigenous drug, Rumalaya, in patients of lumbar spondylosis with chronic pain and disability.

Forty-five patients of lumbar spondylosis attending the orthopaedic clinic at the Sancheti Institute were selected for the present study. Detailed history elicitation and clinical assessment was made and documented. AP and lateral view of the spine was taken in all. Myelography was performed in selected case. Patients were categorised into various grades depending on the degree of pain, disability and level of activity performance.

Definites regimes were chalked out for each patient depending on the severity of the clinical gradings. All patients were put on Rumalaya two tablets three times a day for 3 weeks and one tablet four times a day for 2 weeks. The maintenance dose was 1 tablet three times a day for periods ranging from 2 months to 6 months. Intensity of pain and muscle spasm initially indicated the need for short courses of allopathic anti-inflammatory agents, muscle relaxants and steriods in some patients ^1,2,3.

Patients were regularly followed up. During each visit emphasis was laid on assessment of the activity grading and relief of pain. Appropriate adjustments in the dosage of tab. Rumalaya were made and information on manifestation of tolerance problems and side effects was sought by directing leading questions. Final assessment was made after 12 weeks in patients.

Evaluation of the results was essentially based upon the Grade of the activity status achieved by the patient at the time of last evaluation. Significant shift in grade, i.e., Grade 4 to Grade 2 to Grade 0 were categrorised as Good and Excellent categories. Patients with partial relief from disabling symptoms or insignificant shift in grade, i.e., Grade 3 to 2 were classified as Fair gradings. Patients who failed to benefit at all were classified in the Poor category.

Seventeen patients had developed secondary changes such as spinal canal stenosis, lumbar disc prolapse and spondylolisthesis for which various surgical procedure were carried out. In such cases, Rumalaya was administered for 24 weeks.

There were 18 males and 27 females. Their ages ranged from 40-80 years. There was a preponderance of females belonging to the 6th and 7th decade (Table 1).