Management of primary frozen shoulder (Avabahuka) through Agnikarma (peripheral nerve field stimulation) and adjuvant therapy: A case series

Abstract

Background: Frozen shoulder (FS) is a commonly experienced health problem in orthopedic practices. It may arise naturally without a noticeable influencing reason or be linked with a variety of secondary local as well as systemic disorders. FS can be diagnosed on the basis of the distinctive features of the painful shoulder and the restriction of internal rotation, but the underlying pathological courses remain unexplored. Pain relief is the main objective of most of the treatments for FS. However, the prolonged nature of this disease and its impact on the patient’s functionality, the objective should be refined to early pain relief and functional reinstatement. Materials and Methods: This case series comprised four cases of primary FS managed through four sittings of Agnikarma (peripheral nerve field stimulation) in 1 week interval by Panchadhatu shalaka (rode of five metals). Along with local management 40 ml Dashmooladi kwatha (decoction) orally empty stomach in the morning and 1 h before dinner in the evening for a duration of 4 weeks. Statistical Analysis: The observed results in the study were subjected to descriptive statistics to derive the conclusion. Results: Complete pain relief was noticed in all four cases, and the affected range of motion was achieved to normal except for internal rotation and Apley’s scratch test in all four cases after 1 month of treatment. Disabilities of the Arm, Shoulder and Hand score improved from 65 to 27, 41.5 to 28, 44 to 29, and 45 to 28, respectively. Agnikarma is a prevalent intervention in nonsurgical management to provide better pain relief in the late phase of stage I and stage II, III FS. Conclusion: These series signify that management of the FS (Avabahuka) with peripheral nerve field stimulation through Panchadhatu shalaka and Dashmooladi kwatha can reduce FS pain immediately and diminish the inefficiency of the shoulder from weeks to months.