Abstract

AGNIKARMA IN MUSCULOSKELETAL PAIN FROM CLASSICAL RATIONALE TO CLINICAL EVIDENCE

*Dr. Sneha Ramchandra Dombale, Dr. Anupama Arjun Bhosale

Abstract

Background: Agnikarma is an Ayurvedic thermal cautery procedure discussed in relation to painful disorders. Interest in its use for musculoskeletal pain requires critical examination of traditional reasoning, clinical outcomes, and procedural safety. Aim: To review the conceptual basis of Agnikarma and assess selected evidence relevant to knee osteoarthritis and tennis elbow. Methodology: A focused narrative review examined an accessible translation of the Sushruta Samhita, selected clinical publications, and professional guidance. No systematic search or meta-analysis was performed. Review findings: Classical descriptions emphasize selection of the patient, treatment site, instrument, and intended tissue effect. Small comparative studies report symptomatic improvement, but limited sample sizes, open-label designs, differing comparators, and restricted follow-up reduce certainty. Case reports provide clinical observations but cannot establish efficacy. Proposed analgesic mechanisms remain hypotheses rather than proven explanations. Conclusion: Agnikarma merits further investigation as a possible adjunct for selected musculoskeletal conditions. Current evidence does not establish structural repair, permanent cure, or superiority over comprehensive standard care. Diagnostic accuracy, informed consent, prevention of excessive tissue injury, and systematic adverse-event reporting are essential.

Keywords: Agnikarma; Thermal cautery; Musculoskeletal pain; Shalya Tantra; Knee osteoarthritis; Tennis elbow; Narrative review.