AYURVEDIC MANAGEMENT OF PILONIDAL SINUS (SHALYAJA NADI VRANA): A REVIEW STUDY

Pilonidal sinus disease is a chronic acquired disorder of the sacrococcygeal region that causes considerable morbidity and increases healthcare expenditure. Numerous surgical and conservative treatment methods have been proposed, yet no single modality has achieved universal acceptance. The condition commonly develops in the natal cleft due to the accumulation of loose hair within hair follicles, leading to chronic sinus formation with occasional acute flare-ups. Patients usually present with classical signs of inflammation such as pain, swelling, redness, increased local temperature, and purulent or serous discharge from the sinus tract. Risk factors including prolonged sitting, obesity, a deep natal cleft, repeated local irritation by hair, and positive family history contribute to the development of the disease. In Ayurvedic literature, pilonidal sinus can be correlated with Nadi Vrana. Acharya Sushruta has described eight varieties of Nadi Vrana, among which pilonidal sinus may be classified under Shalyaja Nadi Vrana.