A comparative clinical trial on agnikarma, autologous whole blood injection and local infiltration of steroid in tennis elbow

Tennis elbow also known as lateral epicondylitis of the humerus, is a common ailment that causes pain and tendernesson pressure over a very localized spot on the lateral side of the elbow joint, immediately below the epicondyle.It causes restricted movements of the forearm due to strain of the common extensor tendon from the lateral epicondyle of the Humerus**.**Every year, 1-3% of adults mainly those aged from 35 to 55 years, with an equal gender distribution, are thought to develop tennis elbow, which is more likely in the dominant arm.It is typically regarded as an overuse injury involving repeated wrist extension against resistance, although it can occur from a series of minor pronation and supination strains.As the term Tennis Elbow suggests, up to 50% all tennis players experience this symptom due to various reasons. It is also seen in labourers who use heavy tools or are engaged in repetitive gripping or lifting tasks.The tennis Elbow is also known by other names like Tendonosis, Lateral Epicondylitis and Angiofibroblastic Hyperplasia. An area of degenerative alteration or non-specific inflammation at the site of origin of extensor tendons appears to be the underlying pathophysiology of Tennis Elbow. When the forearm is semi-pronated, the muscles are tensed, if rapid activity was performed, a sudden flexion of the wrist pulls the forearm’s extensor muscle at its epicondylar attachments, which results in damage and cause Lateral epicondylitis.Amongst the extensor tendons taking origin in the region of the lateral epicondyle, the extensor carpi radialis brevis has often been implicated as the key structure in Tennis Elbow. Its unusual anatomy exposes it to shearing forces in almost all movements of the arm.

In Ayurveda literature, the diseases of ligaments and tendons were mentioned in SnayugataVikara.  Snayugatavata means vitiated Vata Dosha causes various diseases taking Snayu as Adhisthana. Acharya Sushruta has explained various modalities to manage Snayu, Sandhi Vikara and it includes Snehana, Upanaha, Agnikarma and Bandhana.

Current epidemiological status and morbidity associated with tennis elbow necessitates its safe, effective and economic management.There is a need to explore the most effective management modality among the various interventions used to manage it in Ayurveda and contemporary system of medicine