Management of Refractory Avabahuka (Frozen Shoulder) via Combined Para-Surgical Interventions (Agnikarma and Viddha Karma) With Supportive Ayurvedic Management: A Case Report

Avabahuka is a classic musculoskeletal disorder categorized under the umbrellas of Nanatmaja Vatavyadhi, structurally and symptomatically mimicking Adhesive Capsulitis (Frozen Shoulder) in modern orthopedics. It is clinically recognized by progressive stiffness, profound nighttime pain (Shoola), and restricted Range of Motion (Bahupraspandanahara). Standard systemic interventions often provide temporary relief, highlighting the need for efficient, minimally invasive protocols. This case report documents the clinical management of a 40-year-old male patient suffering from chronic Avabahuka for three years. The patient was treated with an integrated multimodal framework combining Viddha Karma (para-surgical piercing) for immediate neural modulation and pain management, Agnikarma (therapeutic cauterization) to address deep capsular pathology and tissue desiccation, and targeted oral supportive Ayurvedic medicines. Significant improvements in the Visual Analogue Scale (VAS) score for pain and a rapid restoration of glenohumeral kinetics (Abduction, Flexion, External/Internal Rotation) were achieved within 5 treatment sittings. This case highlights the rapid clinical efficacy, safety, and cost-effectiveness of combining Anushastra Karma with conservative oral treatment for long-standing refractory frozen shoulder.