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| REVIEW OF ARTICLE |
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| Year : 2019 | Volume
: 7
| Issue : 1 | Page : 43-46 |
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Review on role of Agnikarma in pain of various musculoskeletal disorders
Natasha A Rathod, Vaishali V Kuchewar
Department of Kayachikitsa, Mahatma Gandhi Ayurved College and Research Centre, Salod, Wardha, Maharashtra, India
| Date of Web Publication | 27-Aug-2019 |
Correspondence Address:
Dr. Natasha A Rathod
Department of Kayachikitsa, Mahatma Gandhi Ayurved College and Research Centre, Salod, Wardha, Maharashtra.
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JISM.JISM_7_19
Pain is the cardinal feature of most of the musculoskeletal disorders. Pain is the factor for which patient generally approaches a doctor. Pain is defined as “an unpleasant sensory and emotional experience, which is generally associated with actual or potential tissue damage.” It can affect the quality of life; hence, its preventive measures are of prime importance in health care. In Ayurveda, the word “pain” can be correlated with Ruja, which is caused due to vitiation of Vata. Use of heat therapy for various ailments was found in Ancient Ayurveda treatises. There are different treatment modalities in Ayurveda, which are described by acharyas, Agnikarma (heat therapy) is one among them. Acharya Sushruta has mentioned use of Agnikarma in various disorders such as Granthi (tumor), Arsha (hemorrhoids), Bhagandar (fistula), Arbuda (tumor), Shlipad (filariasis), Antra Vrana (internal injury), and Nadi Vrana (sinuses) in detail. There are different materials that are used, such as Pippali (Piper longum), Aja Shakrut (goat excreta), Godanta (gypsum), Shara (arrow), Shalakha (metal rod), Kshaudra (honey), Guda (jaggery), and Sneha (oil/fat), for giving Agnikarma to various parts of the body such as skin, muscles, blood vessels, and ligaments. As Agnikarma is a parasurgical procedure, Acharya Charak has not described it in separate chapter but has described it as one of the treatment measures in different Vatavyadhis (neuromusculoskeletal disorders) such as Gridhrasi (sciatica). If the drugs such as nonsteroidal anti-inflammatory drugs, which are generally used for relieving pain factor in musculoskeletal disorders, are used for longer duration they can cause potential side effects on the body; hence, there is an emerging need to search for a safe option for the same. In this article, an attempt has been made to search the researches conducted on Agnikarma related to musculoskeletal disorders to establish its role in musculoskeletal pain. Keywords: Agnikarma, pain, parasurgical, Ruja
How to cite this article:
Rathod NA, Kuchewar VV. Review on role of Agnikarma in pain of various musculoskeletal disorders. J Indian Sys Medicine 2019;7:43-6 |
| Introduction | |  |
Pain is the cardinal feature of most of the musculoskeletal disorders. Pain is the factor for which patient generally approaches a doctor. Pain is defined as “an unpleasant sensory and emotional experience, which is generally associated with actual or potential tissue damage.”[1] It can affect the quality of life; hence, its preventive measure is of prime importance in health care. In Sushrut Samhita, the word pain is mentioned as Ruja.[2] There are different treatment modalities in Ayurveda, which are described by acharyas, Agnikarma is one among them. Acharya Sushruta has mentioned Agnikarma in various disorders such as Granthi, Arsha, Bhagandar, Arbuda, Shlipad, Antra Vrana, Nadi Vrana, and in the diseases of the joints.[2] As it is a parasurgical procedure, Acharya Charak has not described Agnikarma in separate chapter but has described it as one of the treatment measures in different Vatavyadhis such as Gridhrasi.[3]
Agnikarma is the application of heat directly or indirectly to the affected part by using different materials. According to Sushruta, if Agnikarma is used in such diseases, there will be less chances of their recurrence and it will be successful in curing the diseases, which are incurable by drugs and surgery.[2]
Need for study
If drugs such as nonsteroidal anti-inflammatory drugs are used for longer duration in chronic musculoskeletal disorders, they can cause potential side effects on the body; hence, there is an emerging need to search for an efficient, safe, and cost-effective option for the same.
Aim
The present review is aimed at analysing the role of Agnikarma in pain of various musculoskeletal disorders.
Objectives
- To review the research articles related to Agnikarma in musculoskeletal disorders.
- To analyze the collected data.
| Materials and Methods | | |
Data source: The related data were collected from various research articles from the years 2008–2018 and from the classical texts of Ayurveda.
| Observation and Result | | |
The observations and results are being mentioned in [Table 1].
| Discussion | | |
Of the total 16 studies, 9 were clinical trials and 7 were case studies. In these studies, different types of Shalakha such as Panchadhatu (rod made of five types of metal), Rajat (silver rod), and Tamra Shalakha (copper rod) were used. In Sushrut Samhita, various substances are described for Agnikarma such as Pippali, Aja Shakrut, Godanta, Shalakha, Jambavaustha (instrument having shape similar to black plum fruit), Madhu, Guda, and Sneha. Among them Pippali, Aja Shakrut, Godanta, and Shalakha are used for the diseases located in skin, Jambavaustha and Shalakha are used for the diseases located in muscles, Madhu, Guda, and Sneha are used for the diseases affecting blood vessels, ligaments, joints, and bones.
According to Ayurveda, any musculoskeletal pain, that is, Ruja is caused due to vitiation of Vata Dosha. In various conditions, such as chronic plantar fasciitis, sciatica, osteoarthritis, calcaneal spur, cervical spondylosis, and frozen shoulder, there is a predominant involvement of Vata and Kapha Dosha. In the procedure of Agnikarma, Agni is given at the site of pain, which acts by its Ushna (hot), Tikshna (penetrating), Sukshma (minute), Laghu (small), Vyavayi (quick acting), and Vikasi (quickly spreading) Guna. This Guna acts against Vata and Kapha Dosha, thereby relieving pain and inflammation at that site.[7]
According to Ayurveda, every Dhatu (tissue) has its own Dhatvaagni (digestive fire of tissues) for its Poshan (nourishment), if there is any Dhatvaagni Vishamata (deviation in digestive fire) it may lead to Vikar of that particular Dhatu. Mamsaasthigata Pida (musculoskeletal pain) might be due to Mamsa (muscle), Meda (fat), and Asthidhatu (bone) Agnimandya. In the process of Agnikarma, local heat therapy causes Dhamaniprasaran that increases the Raktapravahan of that Sthana, which is helpful in correcting Dhatvaagnimandya.
According to modern science, the heat therapy, which is given at the local or affected area increases the blood circulation with metabolism by causing vasodilation, increase in the elasticity of connective tissue, and exudation of fluid with increase in white blood cells and antibodies.[2] Local tissue metabolism rate is increased by warming, which helps in healing. As there is an increase in local metabolism, the waste products that are generated get excreted, which normalize the blood circulation, resulting in decreased intensity of pain.[11] Heat may stimulate lateral spinothalamic tract, which causes stimulation of descending pain inhibitory fibers, which again causes release of endogenous opioid peptide that binds with the opioid receptors to substantia gelatinosa Rolandi, leading to inhibition of release of P-substance with blockade of transmission of pain sensation.[20]
Limitation of the study: Present work includes data obtained from researches conducted in last 10 years i.e. 2008-2018 only.
| Conclusion | | |
From this review, it can be concluded that Agnikarma can be used in various musculoskeletal disorders such as cervical spondylosis, corn, tennis elbow, chronic plantar fasciitis, heel pain, sciatica, osteoarthritis of knee joint, calcaneal spur, frozen shoulder, and cervical spondylosis.
Future studies can be conducted on large number of patients of musculoskeletal pain to establish its efficacy and mechanism of action.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 2. | Sharma PV Sushruta Samhita. Sutrasthana. Vol. 1. Varanasi, India: Chaukhamba Orientalia; 2004. p. 126. |
| 3. | Harishchandra VKS Chikitsasthan 28/56. In: Charak Samhita, Part 2. Varanasi, India: Chaukhambha Orentalia; 2012. p. 720. |
| 4. | Meena MK, Kushwah HK A clinical evaluation of Agnikarma in Sandhigata Vata w.s.r to cervical spondylosis. J Ayurveda2008;4. |
| 5. | Borkar KM, Shekokar AV Role of Agnikarma therapy in management of Kadara: A case report. Int J Ayurveda Pharm Res 2013;1: 67-72. |
| 6. | Ravishankar AG Agnikarma with guda in tennis elbow. Int Ayurvedic Med J 2013;1:18-23. |
| 7. | Shekokar AV, Borkar KM Role of Agnikarma in the management of chronic plantar fasciitis. Int J Ayurvedic Med 2013;4: 421-5. |
| 8. | Dwivedi AP, Lakshmanan S A clinical study of efficacy of Agnikarma: An ancient treatment method in the management of heel pain. Ayurvedic J 2015;2:1-6. |
| 9. | Mhatre A, Padavi DM, Bhadlikar DS, Shukla M A comparative clinical study of Vajigandhadi Taila Basti and Agnikarma in the management of sciatica. Int J Adv Ayurveda, Yoga, Unani, Siddha Homeopathy 2015;4:219-34. |
| 10. | Lata A, Badwe Y, Vaidya U A comparative study of conductive and direct method of Agnikarma with Tamra Shalaka in Sandhigatvata with special reference to osteoarthritis of knee joint. Int J Ayurveda Pharm Res 2015;3:37-40. |
| 11. | Kumar JV, Bharat Kumar S, Hemantha Kumar P Efficacy of Agnikarma in the management of Gridhrasi w.s.r to sciatica. Int Ayurvedic Med J 2015;3:2295-300. |
| 12. | Jethava NG, Dudhamal TS, Kumar Gupta S Role of Agnikarma in Sandhigata Vata (osteoarthritis of knee joint). Int Q J Res Ayurveda 2015;36:23-8. |
| 13. | Gadhari AB, Raut SY, Lakhapati AM Role of Agnikarma in the management of calcaneal spur—A case study. Int J Ayu Pharm Chem 2015;4:153-8. |
| 14. | Charde VA Role of Agnikarma and Snehapana in management of pain in cervical spondylosis: A case study. Int J Ayurveda Pharm Res 2017;5:22-6. |
| 15. | Dhanokar CA, Kanani VP Management of frozen shoulder by Agnikarma (therapeutic cauterization) and Patrapinda Sweda (herbal hot fomentation): A case study. Am J Phytomed Clin Ther 2017;5:1-3. |
| 16. | Rao G, Vijay B, Ashok N, Chandrakanth H Agnikarma in the management of Avabahuka (frozen shoulder). Int J Curr Res 2017;9:48432-4. |
| 17. | Maan A, Umesh V, Amit P Pilot study on effect of Agnikarma by Gud in Avabahuka. Int Ayurvedic Med J 2017;5: 2296-9. |
| 18. | Misar S Agnikarma in management of Vatakantak (plantar fasciitis). J Indian Sys Med 2017;5:126-9. |
| 19. | Shukla MB, Amarprakash D Management of Manyagata Vata by Agnikarma (locally) adjuvant to Shaman Chikitsa (internally). Int J Res Ayurveda Med Sci 2018;1:59-64. |
| 20. | Nagnath Rahul S Critical appraisal of Agnikarma and its therapeutic aspects. Int Res J Pharm 2013;4:75-7. |
[Table 1]
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