Introduction

"In Ayurveda, Vata Dosha governs Gati (movements) in our body and Vyana Vayu playing a crucial role in joint mobility. When Vata Dosha is aggravated due to Atichesta, Ativyayam etc. and get Sthansmshraya in Snayu of Kurpara Sandhi by Vata Vardhak Ahar and Vihar its leads to Shula (pain), Stambha (stiffness), difficulty in gripping by wrist and the other side Samprapti also here that Sandhi is the Sthana for Kapha and here Vyana Vayu get obstructed by the Kapha can disrupt smooth functioning of Kurpara Sandhi (elbow joint) and Hasta Pradesha (forearm) leading to pain and impaired movement. Thus, it is also regarded as a significant contributing factor for the manifestation of S. Vata.

स्नायुप्राप्तः स्तम्भकम्पौ शूलमाक्षेपणं तथा || (सु.नि.२७)

गुरूणि सर्वगात्राणि स्तम्भनं चास्थिपर्वणाम् |

लिङ्गं कफावृते व्याने चेष्टास्तम्भस्तथैव च ||(सु.नि.३९)

This condition can be co related with Tennis elbow, also known as lateral epicondylitis, is caused by inflammation of the tendons attaching the extensor muscles of the forearm to the lateral epicondyle, leading to pain and discomfort on the outer elbow. But the causes are not well understood. The forearm muscle and tendons become damaged from overuse, repeating the same motion again and again, which leads to pain & tenderness outside of the elbow and restricted movement of forearm which require treatment for long time. Tennis elbow affects about 1-3% of the general population, with higher incidence rates seen in younger adults and those between 30-60 years old. Notably, women aged 42-46 have a significantly higher incidence, reaching up to 10%. Tennis elbow, once thought to primarily affect athletes like tennis players, is now recognized to impact a broader range of individuals, particularly those with occupations involving repetitive arm movements. This includes people like painters, plumbers, carpenters, drivers, cooks, and butchers who often experience strain on their elbow tendons due to the nature of their work. The dominant arm is more prone to developing tennis elbow due to increased usage and repetitive strain, making it significantly more often affected than the non-dominant arm. This condition can be diagnosed using specific tests, including Cozen's Test, Maudsley's Test, Mill's Test, and the Lateral Epicondylitis Test,

ΒΡ: 130/90mm of hg
RR: 21/min.
Kshudha: Prakrut
Nidra: Samyak
Mala: Samyak
Mutra: Samyak
Muscle power: Not affected significantly - grade V.
Dosha: Vatapradhana Kapha
Dushya: Rasa, Mamsa, Snayu
Srotas: Rasa, Rakta, Mamsa, Meda , Asthi
Srotodusti: Sanga
Sthana: Kurpara Sandhi

Clinical examination

Pain score: 08 before treatment

Table 1:

Following a thorough assessment and examination, the patient was prescribed a Agnikarma with Oral medication of tab Ashwagandha and Yogaraj Guggulu and advice to avoid lifting heavy weight during procedure plan involving Agnikarma and oral medication.

Intervention

Table 2:

With a short course of treatment, the patient experienced significant relief from 1^st sitting in pain and a noticeable increase in gripping strength in the affected hand, all without any adverse effects.

Procedure

After taking written informed consent, Agnikarma was done.

In Post procedure - Agnikarma, fresh Aloe vera pulp was applied to prevent burning, followed by topical application of coconut oil with Haridra powder starting the next day, twice daily to prevent scarring. The patient was advising to not to expose the Agnikarma site to water for 24 hours. Post-Conductive Agnikarma using Suvarna Shalaka yielded favourable outcomes, with minimal scarring observed in most cases. This technique proved advantageous over direct Agnikarma, with four weekly sessions administered to this patient for complete relief in pain and stiffness.

Result

Pain score: 02 after treatment

Table 3:

Discussion

According to Ayurveda, this condition likely arises from an imbalance of Vata, accompanied by Kapha specifically in that case Vyan Vayu was obstructed by Kapha. The Vata and Kapha Dosha having key role in causing inflammation and pain with stiffness and heaviness and here its hampers the activity of Kurpar Sandhi and Sandhi is Sthan of Shleshak kapha. Agnikarma treatment was used to pacify the imbalanced Vata and Kapha, leveraging its Ushna (hot), Tikshna (sharp), and Asukari (quick-acting) properties to alleviate inflammation and pain.

1. Ushna (Heat): Agni karma's heat helps liquefy and break down Kapha's heavy, oily nature, making it easier to eliminate and reducing Vata,s Sheeta and Ruksha

2. Tikshna (Sharpness): The sharp quality of Agnikarma penetrates deep into tissues, helping to clear blockages and restore balance and relieving Shula (pain) and stiffness.