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Volume : 03  
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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH  
Management Of Janusandhigata Vata (Knee Osteoarthritis) By Viddha-  
Agnikarma(Locally) Along With Panchatikta Ghrita Guggulu(Orally) -A Case  
Study  
Dr.Dwivedi Amarprakash 1, Dr.Batra Khushbu 2  
1Professor,Department of Shalyatantra, School of Ayurveda,D.Y. Patil deemed to be University, Navi Mumbai,  
India.  
2MS scholar, Department of Shalyatantra, School of Ayurveda,D.Y. Patil deemed to be University, Navi Mumbai,  
India  
Corresponding author: Dr. Khushbu Batra  
Article Info: Published on : 15/01/2026  
Cite this article as: - Dr. Khushbu Batra (2026) ; Management Of Janusandhigata Vata (Knee Osteoarthritis) By Viddha-  
Agnikarma(Locally) Along With Panchatikta Ghrita Guggulu(Orally) -A Case Study;Inter .J. Dignostics and Research 3 (2) 1-11 ,  
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 8 2 5 8 6 1 9  
Abstract  
Introduction-Knee osteoarthritis (OA) is a chronic, degenerative joint disorder characterized by progressive loss of  
articular cartilage, subchondral bone changes, and synovial inflammation. Clinically, it presents with pain,  
tenderness, stiffness, swelling, crepitus, and restricted mobility. The overall prevalence of knee osteoarthritis is  
approximately 28.7%, with higher incidence in women (25%) compared to men (16%), and the risk increases with  
age. Conventional treatments—such as analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids,  
muscle relaxants, physiotherapy, and surgical interventions like arthroscopy, osteotomy, or arthroplasty—provide  
symptomatic relief but are often associated with side effects, complications, high costs, and lack a definitive cure.In  
Ayurveda, knee osteoarthritis can be correlated with Janusandhigata Vata, a condition where vitiated Vata dosha  
localizes in the knee joint (Janusandhi, a Marmasthana), resulting in structural damage and functional  
impairment.Ayurvedic management includes therapies like Sthanik Snehana, Swedana, Sthanik Lepana, Janubasti,  
Panchatikta Ghrita kshir Basti, Raktamokshana, Agnikarma, and internal medications such as Yograj Guggulu,  
Rasnadi Guggulu, Ashwagandha, and Dashmoola Ghanvati,etc. Similarly, Viddha-Agnikarma, a combination of  
Viddhakarma and Agnikarma,can offer an alternative therapeutic approach. Methodology-In this single case study, a  
48-year-old female patient presented with pain, tenderness, and restricted joint mobility was diagnosed with  
Janusandhigata Vata (Knee Osteoarthritis). She was treated with two sittings of Viddha-Agnikarma, performed at  
15-day intervals at specific tender points around the knee joint under aseptic precautions, along with oral  
administration of Panchatikta Ghrita Guggulu 250mg 2 tablets BD for one month.Clinical outcomes were assessed  
using the Visual Analogue Scale (VAS), tenderness grading, stiffness, crepitus, and range of motion (goniometric  
measurement) before and after the intervention. Results-The patient showed marked clinical improvement with this  
specific treatment regimen. Pain reduced from moderate to no pain by the second sitting of Viddha-Agnikarma.  
Similarly, tenderness decreased from moderate to absent and stiffness improved from moderate to mild. Range of  
motion improved from partial limitation to full, pain-free mobility.Conclusion- The findings suggest that Viddha-  
Agnikarma (locally) along with Panchatikta Ghrita Guggulu (internally) is an effective, economical, and minimally  
invasive intervention for Janusandhigata Vata (knee osteoarthritis), providing both symptomatic relief and  
functional improvement However, studies involving a larger sample size are recommended to further validate the  
efficacy of Viddha- Agnikarma in the management of Janusandhigata Vata.  
Keywords – Viddhakarma, Agnikarma,Vidhha-Agnikarma, Panchatikta Ghrita Guggul, Janusandhigata Vata,  
Osteoarthritis.  
Copyright @ : - Dr.Khushbu Batra Inter. J.Digno. and Research IJDRMSID0088 ISSN :2584-2757  
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combines with vitiated Kaphadosha, there will be  
Introduction :  
Osteoarthritis is the most common degenerative,  
[5]  
Stambha  
and  
Gaurava.  
Acharyas  
have  
non-inflammatory joint disorder, primarily  
recommended various treatment modalities for  
Sandhigata Vata, including Panchakarma  
affecting weight-bearing joints such as the knees. It  
is characterized by progressive degeneration of  
articular cartilage, with subsequent exposure of the  
underlying bone, synovial inflammation, and  
capsular thickening. These changes lead to pain,  
stiffness, tenderness, swelling,erythema restricted  
mobility.[1] The overall prevalence of knee  
osteoarthritis is approximately 28.7%, with a higher  
incidence in elderly individuals and females  
procedures like Sthanik Snehana (local oleation),  
Swedana (sudation), Janubasti, Sthanik Lepa  
(Local herbal paste application), Panchatikta  
Ghrita kshir Basti, Raktamokshana, Agnikarma as  
well as internal medications such as Yograj  
Guggulu, Rasnadi Guggulu, Ashwagandha , and  
Dashmoola Ghanvati aiming to pacify the vitiated  
Vata and Kapha doshas and nourish the Asthi  
(25%).[2]  
Conventional management includes  
Dhatu.  
Furthermore, Acharya Sushruta has  
analgesics, non-steroidal anti-inflammatory drugs  
(NSAIDs), corticosteroids, calcium and vitamin D  
supplements, chondroprotective agents (such as  
explained that Agnikarma can be performed in  
conditions of severe pain occurring in Twak,  
Mamsa, Sira, Snayu, Sandhi, and Asthi.[6] Similarly,  
the eight Shastrakarmas described by him, Viddha  
Karma is one, wherein sterile hollow needles are  
pierced at specific points of the body.[7] Another  
technique called Vidha-Agnikarma is practiced.  
This procedure represents a combination of  
Vyadhana Karma (puncturing) and Agnikarma  
(therapeutic cauterization).The analgesic effect of  
Viddha Agnikarma can be hypothesized through the  
activation of various bioactive chemicals that  
modulate pain at peripheral, spinal, and supraspinal  
levels.[8] In the present case study, a patient with  
knee osteoarthritis was treated with Viddha-  
Agnikarma (locally-2 sittings at interval of 15 days)  
as an adjuvant to Panchatikta Ghrita Guggulu  
glucosamine  
and  
chondroitin  
sulfate),  
viscosupplementation with sodium hyaluronate,  
and supportive physiotherapy measures. Although  
these pharmacological and conservative approaches  
offer  
complications such as gastritis, gastroesophageal  
reflux disease (GERD), gastric ulceration,  
nephrotoxicity, and hepatic dysfunction. In  
symptomatic  
relief,  
they  
may  
cause  
advanced cases, surgical options like osteotomy,  
joint replacement, or arthroscopy may be indicated,  
but these carry higher risks, including postoperative  
infections  
(e.g.,  
osteomyelitis),  
neurological  
involvement,  
and  
other  
surgery-related  
complications.[3] In Ayurveda, Knee Osteoarthritis  
can be correlated with Janusandhigata Vata, a type  
(internally  
for  
30  
days).  
This  
combination  
of Vatavyadhi described by Acharya Sushruta in  
regimenwas found to be effective in alleviating the  
symptoms of knee osteoarthritis, such as pain,  
tenderness, restricted movements, and stiffness of  
the knee joint.  
[4]  
Nidanasthana.  
The pathogenesis can be  
explained as, when vitiated Vata dosha lodges in  
Janusandhi (Marmasthana) it destructs Janusandhi  
and manifests Janusandhigata vata. When it  
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Case Description :  
icterus,  
lymphadenopathy. Systemic examination showed  
no abnormalities in cardiovascular  
clubbing,  
cyanosis,  
oedema,  
or  
Patient information :  
A
48-year-old  
female  
patient  
presented  
to  
Outpatient Department with complaints of bilateral  
knee joint pain (more severe in the left knee) and  
stiffness in the left knee joint, persisting for  
approximately two years. The onset of symptoms  
was insidious and gradually progressive. Initially,  
she experienced mild stiffness and discomfort in  
the left knee, which over time extended to the right  
knee joint. She had previously visited allopathic  
hospitals and was prescribed oral medications,  
which offered temporary relief; however, the pain  
would recur. Over the past 8–9 months, her  
condition worsened, making it increasingly difficult  
to walk, climb stairs, and perform daily activities.  
There was no history of any past injury, medical  
illness, or surgical intervention. Family history is  
not significant. The patient follows a mixed diet  
predominantly consisting of Katu and Tikta Rasa  
(pungent and bitter tastes). Lifestyle habits include  
prolonged sitting (Ati Asana), lack of physical  
system,respiratory system,and central nervous  
system.Blood investigations were within normal  
limits. Radiological examination (X-ray – AP and  
lateral view) of both knees showed degenerative  
changes with narrowing of joint space and mild  
osteophyte formation. The clinical findings of the  
general  
examination,  
along  
with  
laboratory  
investigations, are mentioned in Table 1.  
General Examination  
Laboratory  
Investigations  
Pulse – 72/min  
Hb-10.9 g%  
Respiratory Rate –  
18/min,  
TLC-4600/cumm  
B. P. – 120/70 mm Hg.  
Platelet count-2.25  
lakhs/cumm  
SpO2-99%  
ESR-40 mm/hr  
Bowel habit- 1-2  
times/day  
Sr. Uric acid-4.1  
mg/dL  
Micturition- 5-6  
times/day  
RA factor-Negative  
Weight-62 kg  
RBS- 83 mg/dL  
Table 1: Showing Clinical findings of general  
examination along with laboratory investigations.  
Local examination-  
activity  
(Avyayama),  
daytime  
sleeping  
(Diwaswapna), and staying awake at night (Ratri  
Jagarana). The digestive fire (Agni) is weak  
(Mandagni), and the bowel nature is soft (Mrudu  
Koshta) with constipated stool (Samhata Mala).  
Urination occurs 4–5 times a day with yellow-  
colored urine (Peeta Varna). Sleep is reduced (Alpa  
Nidra), mainly due to pain.  
To systematically evaluate the patient’s clinical  
condition and monitor the response to treatment,  
assessment criteria were established. These criteria  
focused  
on  
core  
symptoms  
such  
as  
pain  
(Sandhishool),  
tenderness  
(Sparshasahatwa),  
crepitation, stiffness (Sandhigrah), and joint  
movement (Sandhi Akunchan Prasaranvedana).  
Each parameter was graded on a scale ranging from  
Clinical findings :  
General and systemic examination-  
Absent  
(0)  
to  
Severe  
(+++),  
providing  
a
On general examination, the patient was conscious,  
oriented, and haemodynamically stable. Pulse was  
72/min, respiratory rate was 18/min, and blood  
pressure was 120/70 mmHg. There was no pallor,  
standardized framework for both baseline and  
follow-up assessments. Pain was evaluated using  
the Visual Analogue Scale (VAS), while the range  
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of motion (ROM) was measured using a  
goniometer to asses flexion and extension  
Visual Analogue Scale (VAS) and goniometric  
measurements. A detailed summary of the  
assessment findings is presented in Table 3.  
capabilities of the knee joint. The findings of the  
local examination are presented in Table 2.  
S
Complai  
nts of  
Abse  
nt  
Mild  
Mode  
rate  
Severe  
Local examination  
Local examination  
r.  
Right knee joint  
Left knee joint  
N patient  
o.  
1. Inspection:  
1. Inspection:  
No erythema, Swelling,  
Localized Temperature  
2. Palpation:  
No erythema, Swelling,  
Localized Temperature  
2. Palpation:  
1
Pain in  
0
+
++  
+++  
knee joint  
(Sandhish  
ool)  
(0-3)  
(4-7)  
(7-10)  
Tenderness ++ (Medial  
aspect of knee)  
Tenderness ++ (Medial  
aspect of knee)  
VAS  
Crepitation ++  
Crepitation ++  
Scale (0-  
10 score)  
Tenderne  
ss around  
3. ROM: Flexion and  
Extension-Mild pain,  
complete can walk  
without support +  
Flexion: 130°,  
3. ROM: Flexion and  
Extension-Mild pain,  
complete can walk  
without support +  
Flexion: 130°,  
2
0
+
++  
+++  
No  
Mild  
painful  
on  
Mode  
rately  
Severe  
pain on  
knee joint tende  
(Sparshas  
ahatwa)  
rness  
painfu touch,b  
earable  
Extension: 10°  
Extension: 10°  
pressur l on  
Table 2: Showing Local examination findings.  
e,  
pressu  
Diagnosis- The diagnosis of Knee Osteoarthritis  
bearabl re,  
(Janusandhigata  
Vata)  
was  
confirmed  
after  
e
beara  
thorough  
clinical  
examinations  
and  
relevant  
ble  
++  
investigations.  
3
4
Crepitatio 0  
ns  
+
+++  
Assesment parameter-  
To evaluate the effectiveness of the treatment, a  
structured assessment was conducted based on key  
clinical symptoms. The severity of each complaint  
was graded using a standardized scoring system,  
ranging from Absent (0) to Severe (+++), according  
to its intensity and effect on function. The  
Stiffness  
in knee  
joints  
0
+
++  
+++  
No  
stiffn  
Occasi  
onally  
After  
long  
Whole  
day and  
(Sandhigr ess  
ah)  
present sitting night  
and  
walki  
ng  
following  
parameters  
were  
assessed:  
pain  
(Sandhishool),  
tenderness  
(Sparshasahatwa),  
crepitations, stiffness (Sandhigrah), and range of  
motion (Sandhi Akunchan Prasaranvedana) using a  
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Treatment Plan and Procedure-  
S
Complai  
nts of  
Absent  
Mild  
Mode  
rate  
Severe  
The patient was planned for local therapeutic  
intervention using Viddha Agnikarma along with  
oral administration of Panchatikta Ghrita Guggulu  
r.  
N patient  
o.  
(250 mg, twice daily after food) for 30 days.  
+++  
5
Knee jont 0  
+
++  
1. Local intervention (Viddha Agnikarma)  
moveme  
nts  
Comple Mild  
Painfu  
l,  
Painful  
A total of two sittings were scheduled at 15-day  
te  
pain,  
restrict  
intervals to achieve optimal therapeutic benefit.  
ed  
(Sandhi  
Akuncha  
n
movem  
ent  
compl incom  
Informed consent- Written informed consent was  
ete  
plete,  
can  
move  
obtained from the patient after explaining the  
ments,  
without  
pain  
can  
walk  
witho  
ut  
treatment protocol in brief.  
Prasaran  
vedana)  
walk  
with  
unable  
Standard Operating Procedure (SOP)  
Viddha-Agnikarma  
Specifications-  
for  
to  
Flexion  
:140°,  
suppor walk  
Goniome  
ter-ROM  
suppo  
rt  
t
• 26-gauge needles (½ inch)  
• Sterile gauze  
Extensi  
on: 0°  
Flexio  
Flexio  
n:  
n:  
• Spirit lamp  
Flexi  
on:  
<90°,  
Extens  
ion:  
• Normal saline  
90°–  
105°,  
• Yashtimadhu Ghrita  
Procedure-  
105°–  
140°,  
Exten  
sion:  
0°-  
Extens 60°-  
Step 1:  
ion:  
30°–  
60°  
90°  
The patient was positioned comfortably with the  
knee joint flexed to allow proper access to the  
treatment site. The most tender points were  
identified through palpation and marked using a  
pen. The marked area was then cleansed thoroughly  
with normal saline to maintain aseptic conditions  
before the procedure.  
30°  
6
X-ray-  
AP and  
lateral  
view  
Before  
X-ray-AP and  
lateral view  
(Both knee  
joints)  
treatment  
findings  
Step 2:  
(Both  
knee  
Six hypodermic needles of size 26-gauge (½  
inch) were heated until red hot using a spirit  
lamp. Immediately after heating, the needles  
were inserted one by one into the pre-  
marked tender points avoiding superficial  
blood vessels. Each insertion point was  
joints)  
Table 3 : Showing assessment parameters  
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maintained at approximately1 cm from the  
improvement. Tenderness, previously graded as  
moderate (++), was reduced to mild (+). Joint  
others. The needles were inserted to a depth of  
5mm through the skin of the affected area.[9,10]  
Step 3:  
stiffness,  
which  
had  
interfered  
with  
daily  
activities—particularly after prolonged sitting or  
walking—was alleviated, improving from moderate  
(++) to mild (+). The range of motion (ROM) of the  
knee joint, measured using a goniometer, also  
improved after the first sitting, increasing from  
limited flexion of 125° and extension of 5° toward  
near-normal mobility.By the second sitting, the  
patient achieved complete pain relief (VAS 0), with  
full resolution of tenderness and stiffness. The knee  
joint regained complete, pain-free movement, with  
flexion restored to 140° and extension to 0° . No  
adverse effects were observed throughout the  
treatment or follow-up period, and the patient  
expressed complete satisfaction with the therapy.  
Further, Knee x-ray was done before and after  
treatment, but no change was observed. The  
detailed observation and follow-up of clinical  
parameters are presented in Table 4. This case  
further supports the efficacy of Viddha Agnikarma  
as an adjuvant to Panchatikta Ghrita Guggulu in  
After maintaining the needles in situ for five  
minutes, they were gently removed and safely  
discarded after single use.[11] Any bleeding points  
were managed by applying gentle pressure with  
sterile gauze until hemostasis was achieved.  
Step 4:  
Following removal of the needles, Yashtimadhu  
Ghrita was applied to the site of Viddha-Agnikarma  
using a sterile gauze piece.  
medication-Panchatikta Ghrita Guggulu– 250 mg,  
twice daily after food for 30 days  
Figure : 2  
Figure : 1  
the  
management  
of  
Janusandhigata  
Vata  
(osteoarthritis of the knee joint).  
Sr  
.
Symptoms  
Day 1  
(before  
treatm  
ent)  
Day  
15  
Day  
30(afte  
N
o.  
(after first r  
Figure : 3  
Figure : 4  
sitting)  
second  
sitting)  
Observations and Results :  
1
Pain in knee 4 (++)  
joint(Sandhi  
shool)  
2 (+)  
0
After the first sitting of Viddha-Agnikarma, the  
patient reported a significant reduction in knee  
pain, with the Visual Analogue Scale (VAS) score  
decreasing from 4 (moderate) to 2 (mild).  
Associated symptoms also showed marked  
VAS Scale  
(0-10 score)  
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Discussion:  
Sr  
.
Symptoms  
Day 1  
(before  
treatm  
ent)  
Day  
15  
Day  
30(afte  
In this case study, a patient with Janusandhigata  
Vata (knee osteoarthritis) was treated with Viddha-  
Agnikarma locally (two sittings at 15 days interval),  
along with Panchatikta Ghrita Guggulu internally  
(250 mg 2 tablets BD after food). The therapy  
provided significant relief in pain, tenderness,  
stiffness, and restricted knee movements, though no  
radiological changes were observed. Clinical  
improvement was evident from the first day and  
sustained throughout the treatment, with complete  
relief from pain reported by Day 30.From an  
Ayurvedic perspective, pain arises due to Vata  
vitiation. The Ushna property of Agnikarma pacify  
Vata and Kapha, reducing pain and stiffness, while  
Viddhakarma relieves Srotorodha (obstruction).[12]  
Panchatikta Ghrita Guggulu supports this effect by  
reducing inflammation, nourishing cartilage, and  
preventing degeneration through the combined  
vata-shamana, rasayana, and shodhana properties  
of Panchatikta dravya, ghrita, and guggulu,  
thereby improving joint mobility and function.[13]  
Probable Mode of Action of Viddha-Agnikarma –  
The probable mode of action of Viddha Agnikarma  
can be understood through a combination of  
N
o.  
(after first r  
sitting)  
second  
sitting)  
2
Tenderness  
++Mod  
+ Mild  
0
around knee erately  
painful on  
pressure,  
bearable  
No  
joint  
painful  
on  
tendern  
ess  
(Sparshasa  
hatwa)  
pressur  
e,  
bearabl  
e
3
4
Crepitations ++  
++  
++  
Stiffness in  
knee joints  
+ +  
+
0
After  
Occasiona  
lly present  
No  
(Sandhigrah long  
stiffnes  
s
)
sitting  
and  
walking  
+ Mild  
pain,  
5
Knee jont  
movements  
(Sandhi  
+ Mild  
pain,  
0Comp  
lete  
complet complete  
movem  
ent  
Akunchan  
Prasaranve  
dana)  
e can  
can walk  
without  
support  
Flexion:  
135°,  
walk  
without  
pain  
without  
support  
Flexion  
: 130°,  
Flexion  
:140°  
Extension:  
10°  
Extensi  
on: 0°  
Extensi  
on: 10°  
Before  
6
X-ray-AP  
and lateral  
view (Both  
knee joints)  
After treatment-  
No change.  
treatment-  
Degenerativ  
e changes  
with  
mechanical,  
thermal,  
neurophysiological,  
and  
Ayurvedic principles. The needle puncture involved  
in Viddhakarma may cause mechanical disruption  
of local Vata Avarodha (obstructions due to  
aggravated Vata), thereby restoring the free flow of  
Vata and other elements through micro-channels  
(srotas) around the joint. This helps relieve  
stiffness and improve mobility.[14]The local heat  
generated during Agnikarma induces vasodilation,  
which increases blood circulation to the affected  
narrowing  
of joint  
space and  
mild  
osteophyte  
formation.  
Table 4: Showing Therapeutic Outcome.  
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area. This enhanced perfusion aids in the removal  
of inflammatory mediators, toxic metabolites, and  
cellular waste products, leading to reduction in  
pain, swelling, and tissue congestion. Additionally,  
the thermal and puncture stimuli are believed to  
trigger the release of endogenous opioids such as  
endorphins, while also suppressing pain-related  
neurotransmitters like Substance P. This dual  
mechanism inhibits pain transmission at peripheral,  
spinal, and supraspinal levels.[15]From an Ayurvedic  
perspective, the ushna (hot) and teekshna (sharp)  
qualities of the treatment pacify the vitiated Vata  
and Kapha doshas, which are typically involved in  
Janusandhigata Vata. This not only alleviates  
symptoms such as pain, stiffness, and heaviness,  
but also helps reestablish doshic balance at the local  
site. Moreover, the heat energy is thought to  
stimulate Dhatvagni (metabolic activity at the  
tissue level), which assists in digesting Ama  
(metabolic toxins) and promoting nourishment of  
deeper tissues—especially Asthi (bone) and Majja  
(marrow). This contributes to long-term structural  
stability of the joint.[17]Pain modulation may also  
occur through the gate control mechanism, wherein  
edema in periarticular tissues. Muscle relaxation is  
another benefit, as the heat helps reduce local  
muscle spasms and improves joint biomechanics by  
decreasing mechanical stress on the articulating  
surfaces.[19,20]Agnikarma  
may  
stimulate  
the  
piezoelectric electricity of bone, creating localized  
electric signals that encourage deposits in damaged  
bone or joint areas, which helps resist deformity,  
prevent further damage, and restore normal  
function. [17]Reflex and autonomic responses may  
also be triggered, such as stimulation of sweat  
glands and enhanced systemic detoxification,  
contributing to a more holistic therapeutic effect. In  
some cases, minor oozing or bleeding at the  
puncture site acts as a form of micro-bloodletting,  
assisting in the elimination of localized Dushta  
Rakta (vitiated blood). [14,18]Over the course of  
repeated sessions, the combined mechanical,  
thermal, vascular, neural, and metabolic effects of  
Viddha-Agnikarma help to "reset" the local joint  
environment, breaking the chronic cycle of pain,  
immobility, and degeneration.  
Probable Mode of Action of Panchatikta Ghrita  
Guggulu-[21,22]  
the  
mechanical  
and  
thermal  
stimulation  
Panchatikta  
Sandhigata Vata through its combined metabolic,  
anti-inflammatory, and tissue-regenerative  
Ghrita Guggulu  
likely  
acts in  
preferentially activates non-nociceptive Afibers  
which"close the gate" in the dorsal horn of the  
spinal  
cord,  
thereby  
reducing  
pain  
signals  
mechanisms. The Tikta Rasa (bitter taste) and  
Ushna Virya (hot potency) enhance Dhatvagni  
(tissue metabolism), preventing Dhatukshaya—  
particularly of Asthi and Majja Dhatus—and  
transmitted  
by slower-conducting  
C-fibers.  
Additionally, descending inhibitory pathways from  
the brain may be activated, further suppressing  
nociceptive transmission and enhancing analgesic  
effect.[15,16]The anti-inflammatory properties of  
local heat are supported by evidence of reduced  
levels of pro-inflammatory mediators such as  
prostaglandins and cytokines, along with decreased  
promoting tissue nourishment. Its  
Pachana (digestive and metabolic) and Lekhana  
(scraping) properties reduce Kapha-Meda  
Deepana-  
accumulation, alleviating stiffness and pain. The  
Ghrita base, acting as a Yogavahi, improves  
Copyright @ : - Dr.Khushbu Batra Inter. J.Digno. and Research IJDRMSID0088 |ISSN :2584-2757  
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bioavailability of active constituents and maintains  
Vata-Pitta balance, while Guggulu (Commiphora  
mukul) contributes potent anti-inflammatory and  
immunomodulatory effects. Collectively, these  
actions result in analgesic, anti-stiffness, and joint-  
restorative benefits, supporting its therapeutic  
efficacy in osteoarthritis (Janu Sandhigata Vata).  
3. J. Maheshwari, Essential orthopaedics, 5th  
edition, Mehta Publishes; chp no. 35, pg no.  
296-297  
4. Sushutra, Ambika Dutta Shastri, Sushutra  
Samhita with Elaborated Ayurveda Tatva  
Sandipika Hindi Commentary, Reprint.  
Varanasi: Chokhambha Sanskrit Sansthan.  
Volume 1, Sutra Sthan Chapter, 2009;  
14(27):70  
Conclusion :  
The treatment with Viddha-Agnikarma as an  
adjuvant to Panchatikta Ghrita Guggulu resulted in  
complete pain relief, resolution of tenderness and  
stiffness, and restoration of full, pain-free range of  
motion in the affected knee. Viddha-Agnikarma is a  
minimally invasive, cost-effective, and time-  
efficient procedure that can be conveniently  
performed on an Outpatient Department basis. It  
provides rapid pain relief and improves joint  
function. This technique may serve as an effective  
Ayurvedic treatment modality for pain management  
and represents a promising alternative approach for  
degenerative osteoarthritis (Janu Sandhigata Vata).  
However, its efficacy needs to be further validated  
through clinical studies on larger sample sizes to  
potentially establish it as a first-line adjuvant  
treatment modality.  
5. Sushutra, Ambika Dutta Shastri, Sushutra  
Samhita with Elaborated Ayurveda Tatva  
Sandipika Hindi Commentary, Reprint.  
Varanasi: Chokhambha. Sanskrit Sansthan.  
Volume 1, Sutra Sthan Chapter, 2009;  
8(16):87  
6. Sharma AR,Sushruta Samhita Sutrasthana;  
Agnikarmavidhi:  
Chaukhamba  
Cha.  
12/3.  
Reprint.  
Surbharati  
Prakashan,  
Varanasi. 2018; p.87  
7. Sushruta Samhita; Volume 2; Sutrasthan  
5/4, Dr. Anant Ram Sharma, Chaukhamba  
Surbharati Prakashan, Varanasi  
References:  
1. J. Maheshwari, Essential orthopaedics, 5th  
edition, Mehta Publishes; chp no. 35, pg no.  
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2. Harrison's Principles of Internal Medicine,  
Dennis L. Kasper,Anthony S. Fauci, Eugene  
Braunwald et al, editors. 16th Edition,  
Volume Part 13, Section 3, Disorders of  
joint andadjacent tissues, Ch 312, Osteo  
arthritis: 2036- 37.  
9. Shrikant L. Wakudkar et al: Effect Of  
Viddhagnikarma In The Management Of  
Lumbar Spondylosis (Katigat Vata) – A  
Case  
Study.  
International  
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Medical Journal {online} 2022 {cited  
February 2022} Available from:  
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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]  
19. Anoop Sachi and T. Thomas. A review on  
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Declaration :  
Conflict of Interest : None  
Osteoarthritis. Int. J. Res. Ayurveda Pharm.  
2020;11(6):95-97  
ISSN: 2584-2757  
http://dx.doi.org/10.7897/2277-  
4343.1106193 .  
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 8 2 5 8 6 1 9  
Dr. Khushbu BatraInter. J.Digno. and Research  
This work is licensed under Creative  
Commons Attribution 4.0 License  
Submission Link : http://www.ijdrindia.com  
20. Dwivedi Amarprakash P. & Chaugule  
Pradnya D.: Pain Management Through  
Ayurveda:  
A
Meticulous  
Review  
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{online} 2018 {cited May, 2018). Available  
from:http://www.iamj.in/posts/images/uploa  
d/1176_1185.pdf  
Benefits of Publishing with us  
Fast peer review process  
Global archiving of the articles  
Unrestricted open online access  
Author retains copyright  
21. Akhtar B, Mahto RR, Dave AR, Shukla  
VD. Clinical study on Sandhigata Vata  
w.s.r. to Osteoarthritis and its management  
by Panchatikta Ghrita Guggulu. Ayu. 2010  
Unique DOI for all articles  
https://ijdrindia.com  
Jan;31(1):53-7.  
doi:  
10.4103/0974-  
8520.68210. PMID: 22131685; PMCID:  
PMC3215322.  
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Management of “Manyaskrit Vata’ by  
phytotherapy- Panchikta Ghrit Guggulu-  
w.sr. to cervical spondylosis. Ayurlog  
National Journal of Research in Ayurved  
Science-2013; 1(4): 23-28.  
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