AN OPEN LABELLED RANDOMIZED CONTROLLED CLINICAL STUDY TO EVALUATE THE EFFECT OF VIDDHA AGNIKARMA IN THE MANAGEMENT OF SNAYUGATHA VATA VIS-À-VIS TENNIS ELBOW

Introduction:

•Acharya Sushrutha   has   explained the importance of Agnikarma in cases of highly painful conditions precipitated by Vata affecting  Sira, Snayu, Sandhi and Asthi . Pain in the lateral aspect of the elbow is commonly known as Tennis elbow or Lateral epicondylitis. It is estimated to affect 1–3% of the adult population each year and is more common in the dominant arm. Although it can occur as an acute injury (trauma to the lateral elbow), it’s also seen in labourers who utilise heavy tools or engage in repetitive gripping or lifting task, who carryout repetitive, one sided movements in their jobs like electricians, carpenters, needle work, knitting, gardening.

• Tennis elbow is difficult to cure with conventional medicines  and  we can consider  the role of Agnikarma in reducing the pain of tennis elbow. On the basis of signs and symptoms, tennis elbow can be correlated with Snayugata Vata described in Ayurveda Samhitha.

•Snayugata Vata is developed when the vata dosha aggravates due to atichesta, ativyayam, etc and gets localized in snayu of kurpara sandhi

• The vayu responsible for this function is, vyanavayu.  Ultimately unable to carry out the function of kurpara sandhi (elbow joint) and hasta pradesha (forearm) smoothly. The features such as pain, stiffness and restricted movements develop  in this region  These symptoms may also develop due to kaphavritta vyana vayu. Hence, it is also considered an important causative factor for manifestation of Snayugatha Vata. The disease which are situated over Twak, Mamsa, Snayu, Asthi are treated with Agnikarma using different Dahanopakaranas. Acharya Chakradattahas added Suchi also one among the Dahanopakaranas. Bindu  Roopi  Agnikarma with Panchaloha Shalaka is being extensively done and it has proved its efficacy.

•   But as it involves burning of the skin & superficial tissues there may be discomfort to the   patient and also skin scarring. The uniformity of heat is not maintained throughout the procedure. Viddha Agnikarma is selected because it goes deep into the fascia and spreads the heat uniformly and cosmetically good as there will be no scarring of tissues. A Pilot study was done using  acupuncture needles and diathermic cautery which showed encouraging results and may overcome the lacunas of conventional method of Agnikarma. Hence here an attempt is made to develop and evaluate the efficacy of modified method of Agnikarma.

Aims and objectives:

•To evaluate the efficacy of Suchividdha Agnikarma in the management of Snayugatha Vata Vis-À-Vis Tennis Elbow

•To compare the efficacies of Suchividdha Agnikarma and Panchaloha Shalaka in the management of Snayugatha Vata Vis-À-Vis Tennis Elbow.

Materials and methods:

SOURCE OF DATA:

•Literary source: Classical Ayurvedic literature, contemporary texts, journals and websites related to the disease, drugs and procedure will be reviewed and documented for the present study

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•Drug source:  Accupuncture needles used for the study trials will be purchased from the Pharmacy of JSS Ayurveda Medical College hospital, Mysuru.

Panchaloha Shalaka will be procured from the department of PG studies in Shalyatantra, JSS Ayurveda medical college and hospital, Mysuru, Karnatka.

 

•Sample source: 40 patients diagnosed with Tennis elbow fulfilling the inclusion criteria will be selected from OPD and camp conducted at JSS Ayurveda Hospital, Mysuru.

 

METHOD OF COLLECTION OF DATA

Study design: An open-labelled controlled randomized clinical trial.

40 subjects diagnosed with after proper examinations and investigations, fulfilling the inclusion

criteria will be selected & categorized into 2 groups of 20 each for the study.

Group A: 20 subjects, Suchividdha Agnikarma will be  done.

Group B:  20 subjects, Agnikarma with Panchaloha Shalaka will be done.