Open-label clinical study to compare the effect of Agnikarma, as a stand-alone treatment, versus, in association with Snayugatavata treatment protocol, in tennis elbow

AbstractBackground:Tennis elbow, the painful condition of extensor tendons of the humerus caused by repetitive stress, has no reliable treatment apart from symptomatic support. Ayurvedic practitioners widely use Agnikarma (therapeutic/thermal cauterization) and Snayugatavata Chikitsa (tendinitis treatment protocol) as treatment modalities for it. Agnikarma or Daha is indicated in extremely painful conditions of tendons. Snayugatavata Chikitsa includes Snehana (oleation), Upanaha (medicated bandage), and Daha (thermal cauterization).Aim:To evaluate the efficacy of “Agnikarma” alone and along with Sneha and Upanaha as a part of Snayugatavata Chikitsa’ in tennis elbow treatment and to compare their relative effectiveness.Materials and methods:The study was an open-label, double-armed, prospectively designed, comparative clinical study with 60 patients with tennis elbow randomly allocated into two groups. Group I received Snayugatavata treatment protocol for 8 days, where Kottamchukkadi oleation and medicated bandage were administered for 7 consecutive days and a single sitting of Agnikarma was done on the 8th day. Group II received Agnikarma with Panchadhatu Shalaka (a five-metal alloyed thermal cautery instrument) alone in two sittings on the 1st and 8th days. Assessment was carried out on the 8th, 15th, 30th, and 90th days for five parameters, namely pain, tenderness, inability to do specific tasks, Cozen’s test, and Mill’s maneuver.Results:Both groups showed significant results in all five assessed parameters with P < 0.0001. On comparative analysis between the groups, Agnikarma alone was proved more effective than Snayugatavata Chikitsa with P < 0.0001 for all the parameters for 3 months.Conclusion:Agnikarma, as a stand-alone treatment, can be chosen to offer a simple, cost-effective, safe, and short-term treatment to cure the tennis elbow.