A Single Case Study on Nyagrodhadi Lepa in the Management of Ankle Sprain (Gulpha Sandhija Agantuja Shotha)

Trauma or physical injury encompasses any bodily harm resulting from accidents, falls, sudden twisting movements, or other forms of physical exertion. Among the wide spectrum of injuries encountered in clinical practice, musculoskeletal injuries are the most prevalent, involving the muscles, ligaments, bones, cartilage, and associated supportive tissues. Ankle sprain is among the most frequently presenting musculoskeletal complaints. It affects not only sportspersons and dancers but also individuals engaged in ordinary daily activities involving improper foot placement or abrupt rotational movements. According to Ayurveda, the ankle joint (Gulpha Marma) is counted among the twenty Sandhi Marma (vital joint-related points) and the eight Rujakara Marma, which are highly susceptible regions that elicit severe pain when traumatised. Injuries to this region typically produce marked pain, swelling, and restricted joint mobility. In Ayurveda, such traumatic conditions are classified under Agantuja Vyadhi (exogenous disorders) and more specifically correlated with Agantuja Shotha (traumatic or externally induced swelling), as elaborated in Sushruta Samhita. The Shotha arising from trauma (Abhighata) involves vitiation of all three Doshas, primarily Vata and Pitta. Ayurvedic management advocates Alepa (topical medicated paste) as the foremost Upakrama for Shotha. In this case, a 22-year-old male patient presented with pain, swelling, and restricted movement in the left ankle following a sudden twisting injury. He was diagnosed with ankle sprain (Gulpha Sandhija Agantuja Shotha) and managed with Nyagrodhadi Lepa along with Bandhana (bandaging) for 15 days. The patient demonstrated significant clinical improvement, with notable reduction in pain, swelling, and restoration of ankle mobility by the end of treatment.