Are Greevastambha and Manyastambha one and the same?

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

There are two conditions explained in Ayurveda namely Greevastambha and Manyastambha which are pathological manifestations which occur in the neck region and present with neck stiffness, difficulty in making neck movements and pain amongst the chief complaints. But there is confusion as to whether both of these conditions are the same or represent two different conditions. Many people believe that they are synonyms of each other and are not different conditions.

This article is to clarify this doubt.

Greevastambha vs Manyastambha: Same or different conditions?

Definitely both Greevastambha and Manyastambha are different. The reasons are as below mentioned.

Name of the disease

Both these conditions have different names – Greevastambha and Manyastambha. They have been mentioned as different entities and have not been mentioned as synonyms of each other.

Separate mention amongst Vata Nanatmaja Vyadhis

Both are Vata Nanatmaja Vyadhis i.e. specific disorders caused by aggravation of ‘only vata’ without the involvement of any other dosha i.e., pitta or kapha. Both these conditions are separately mentioned amongst Vata Nanatmaja Vyadhis, one after the other.

By Definition of Manyastambha

Manya has been defined as ‘manya greeva paschad bhaga’ which means ‘posterior part of the neck – back of the neck’. Here it is interesting to note that both terms ‘greeva’ and ‘manya’ have been mentioned in the word derivation / definition of the word ‘manya’ in the context of explanation of manyastambha – Madhukosha Commentary on 51^ST verse of Chapter 22 of Madhava Nidana Vatavyadhi Nidanam chapter. This clearly indicates that both are two different entities.

Place / site of occurrence

By definition of Manya in the context of Manyastambha, as explained above, it can be inferred that –

–         Greeva is a term which includes the ‘entire neck region’
–         Manya is a part of the neck, – ‘the posterior part of the neck’

From perspective of ‘Kapha associated variant’

As explained above, both conditions i.e. Greevastambha and Manyastambha are mentioned as separate disease entities amongst the list of eighty vata nanatmaja vyadhis. Both are predominantly caused by vata aggravation.

But the explanation of pathogenesis of ‘Manyastambha’ by Master Sushruta indicates a ‘kapha component’ being involved.

The explanation goes like this – ‘Both vata and kapha, mainly kapha among the two, will undergo aggravation due to excessive consumption of or exposure to the etiological factors which bring about their imbalance. This kapha would envelope vata and block it and interferes with normal functioning and movements of vata. This condition is called as kaphavruta vata. These events lead to manifestation of stiffness and other symptoms in the backside of the neck. This condition is called as Manyastambha’.

So, Manyastambha occurs in two forms –

1.    Due to aggravation of vata affecting the manya region
2.    Due to vata being obstructed by kapha in the manya region

These variants, especially the kaphavruta vata condition, are not seen in Greevastambha.

So, Greevastambha is purely a vata condition while Manyastambha can be a vata predominant or vata-kapha predominant condition.

Treatment Perspective

It is important to know the difference between these two conditions to implement proper treatment for either condition.

The line of treatment for both these conditions are almost same with the exception of the stiffness of the neck (back of the neck) caused by kaphavruta vata condition. Otherwise, greevastambha and manyastambha caused by only vata should be treated on the lines of ‘vata vyadhi’ treatment principles.

To sum up

Greevastambha and Manyastambha are caused predominantly by aggravated vata and both are vata nanatmaja diseases. Manyastambha is also caused by the kaphavrita vata condition, while we do not get any reference of Greevastambha having this manifestation. Greevastambha is stiffness and other symptoms occurring in the entire neck while Manyastambha presents with stiffness and other symptoms occurring only in the back of the neck.

Therefore, Greevastambha and Manyastambha are different disease conditions.

Related Reading –

Greevastambha
Manyastambha

Modern Correlation

Greevastambha is popularly correlated with ‘Cervical Spondylosis’.

Manyastambha is popularly correlated with ‘Torticollis’.