Agnikarma With Guḍa in the Management of Trigger Finger: A Case Report

Trigger finger is a common musculoskeletal condition of the flexor tendon sheath at the A1 pulley, producing painful locking of the affected digit, most commonly the ring finger and thumb. Contemporary management of trigger finger includes splinting, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injection and surgical release of the A1 pulley, but these carry the risk of recurrence, side effects and cost burden. In Ayurveda, trigger finger can be correlated with Sn?yugata V?ta (V?ta [bioenergy] vitiated in the tendons and ligaments), a type of V?tavy?dhi (V?ta disorders), with treatment modalities including Snehana (oleation therapy), Dahana (thermal cauterization; Agnikarma) and Upan?ha (poultice therapy). Agnikarma, which may be of snigdha (unctuous) or r?k?a (dry) type, acts through its u??a (hot), t?k??a (penetrating), s?k?ma (minute) and ??uk?r? (fast-acting) properties and is considered the most effective procedure for rapid relief. A 51-year-old female, a known case of Type 2 Diabetes Mellitus, presented with a two-month history of painful locking of the left thumb. We treated her with Snigdha Agnikarma using Gu?a (jaggery), along with Punarnav?di Ka??yam (a polyherbal decoction) and Kaishora Guggulu (a classical guggulu-based tablet) as adjuvant internal medication for the first two weeks. The results were assessed before treatment, immediately after treatment, and on the 7th, 14th and 21st day. The assessment showed improvement in pain (Visual Analogue Scale [VAS] score from 4 to 0), tenderness (grade 2 to 0), and Quinnell grading for trigger finger (grade 2 to 0), which was sustained until day 21, without adverse effects.