Agnikarma in Chronic Tendinopathies (Tennis Elbow & Plantar Fasciitis): A Thermal-Imaging Based Assessment of Depth of Agni-Scar Tissue Response — An Ayurvedic Interventional Review

Background: Chronic tendinopathies such as Lateral Epicondylitis (Tennis Elbow) and Plantar Fasciitis remain painful, recurrent, and resistant to conservative management. Agnikarma is a para-surgical thermal cauterization modality described extensively in Ayurveda for Vata-Kapha dominant Snayu-Sandhi-Asthi disorders, provides deep-penetrating heat to relieve pain, reduce fibrosis thermal diffusion layer depth estimated 4–7 mm depending on Shalaka metal & dwell time.● Thermal imaging showed peak temperature 68–92°C at contact, with gradual fall-off over 6–12 minutes indicating Vata-Kapha-bhedana effect. ● Pain relief of 40–75% VAS improvement within 3–10 days reported across several trials.678 ● Plantar fascia & lateral epicondyle showed scar depth pattern dependent on pressure & copper/iron shalaka conduction. Conclusion: Agnikarma is a potent intervention for chronic degenerative tendinopathies where fibrosis, stiffness & micro-tears persist. Infra-red thermal imaging confirms controlled and predictable burn depth, supporting tissue remodelling physiology. Future randomized thermal-guided studies will strengthen evidence and standardize dosimetry parameters.