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 & restore function.[1][2] Thermal imaging offers real-time visualization of tissue temperature and depth of therapeutic burn. Aim/Objectives 1. To analyse Ayurvedic theoretical basis of Agnikarma in Snayugata Vyadhi with emphasis on pathogenesis involving Vata-Kapha and Rakta-dushti. 2. To evaluate chronic tendinopathy response to Agnikarma using infra-red thermography (IRT). 3. To estimate burn-depth and thermal spread pattern of Agni-Scar using imaging-based study indicators. Materials & Methods: A narrative Ayurvedic & biomedical review was conducted reviewing Bruhatrayi, Nighantu Nidanika, Panchakarma treatise along with PubMed-indexed clinical research. Thermal imaging studies used FLIR-T640 IRT system, analysing pre-treatment baseline, immediate post-Agni thermal mapping & day-7 scar tissue healing. Parameters assessed include surface temperature rise, diffusion diameter, healing time, and pain-VAS response.[3][4][5] Key Findings ● Agnikarma triggers-controlled collagen remodelling within degenerative tendons; 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.[6][7][8] ● 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.