A randomized comparative clinical trial to evaluate combined efficacy of viddha karma plus agnikarma with only viddha karma in avbahuka.

In textual refrences of Ayurveda, Avabahuka is described as vata vadhi in which vata dosha is localized in the shoulder region, when Vata gets vitiated, it dries up the ligaments of the shoulders and constricts the Siras present there and causes Avabahuka.

In modern, Frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint. Frozen shoulder is also called adhesive capsulitis as the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue called adhesions develop. This typically occurs in cycle of 3 stages as painful phase, stiff phass and thawing phase which can be correlated to avabahuka in ayurveda.

In Ayurveda literature, Acharya Sushruta has given the description of Viddha karma and Agnikarma as a parasurgical procedures are unique therapeutic procedures because of its primitive, preventive and prophylactic properties.

•Viddha Karma - viddha karma is a miniature of bloodletting procedure. A very small puncture or piercing certain points that helps in reducing pain. It acts as pain reliever by releasing Endorphin that helps to reduce pain in body.

• Viddha karma plus Agnikarma- With Viddha karma Agnikarma can be done in circular manner, or Appling dot at most tender point or parallel linings at the tender point.

So viddha karma and agnikarma to the maximum tenderness points of shoulder may release the Vataavrodha and ultimately pain will be decreased. When pain is relieved, the patient will definitely try to make the active movements of his arm.