Efficacy of Viddha Karma in Brachial Neuralgia

Brachial neuralgia—used clinically for brachial neuritis, cervical radiculopathy–related arm pain, and brachial plexopathy—presents with severe neuropathic pain, paresthesia, and upper limb functional limitation. Ayurveda describes comparable symptom clusters under Viśvācī and related Vāta vyādhi entities. Viddha Karma, a para surgical needling (Vedhana/Suchivedhana) procedure from the Suśruta tradition that stimulates selected anatomical or Marma/Srotas loci to relieve āvaraṇa, normalize Vāta gati, and reduce śūla, has been modernized with fine sterile needles analogous to dry needling/acupuncture, with reports of rapid analgesia in pain syndromes. This paper consolidates theoretical basis, indications, contraindications, standardized technique, patient care pathway, and integrative (Ayurvedic + biomedical) mechanisms for applying Viddha Karma in brachial neuralgia, and proposes a prospective research plan: open label Phase I/II pilot and/or pragmatic randomized comparison with standard conservative care in adults with brachial neuralgia (including cervical radicular arm pain or idiopathic brachial neuritis) treated at predefined cervical–shoulder–upper limb points mapped to the classical Viśvācī mārga. Primary outcomes: NPRS, VAS, DN4, DASH; secondary: ROM, grip strength, PGIC, and safety over 6 week follow up. By reducing local doṣa saṅcaya / pressure, modulating segmental nociception, improving microcirculation, and activating descending endorphinergic /serotonergic inhibition, Viddha Karma may provide short term analgesia and functional gains, potentially augmented by Vāta hara internal therapy and rehabilitation; standardized protocols support reproducible evaluation.