Most shoulder pain is related to muscle or tendon strain. Chronic pain is often triggered by prior injuries, especially if original injury was severe or was not allowed to heal completely. Shoulder injury can cause weakness, tenderness and loss of full joint mobility. More common and less traumatic causes include lifting, reaching and pulling move- ments that strain the muscles and tendons or sprain ligaments surrounding the shoulder joint. Injury may or may not be realized during the activity. Various conditions like shoulder joint impingement, frozen shoulder, and rotator cuff tendinitis have resembling symptoms under the umbrella of disease Avabahuka described in Ayurveda. Leech application was carried out in first stage where there is reduced vascular supply. Here a case report of a female aged 31years old, who had an acute on chronic rotator cuff strain from strenuous activity underwent three sittings of Jaloukavacarana. Keywords: Rotator cuff tendon injury, Avabahuka, Jaloukavacarana.

Nowadays, the role of local anaesthesia in the surgical field is highly appraisable. Local anaesthetics are the drugs that produce a loss of sensation over the localised areas without producing a loss of consciousness. Humans have been using various methods to block pain for thousands of years. Controlling pain during the śhastrakarma in śalyatantra has been always challenging. There has been the introduction of various methods of local anaesthetics since the origin of medical science, topical anaesthetics being one of them. Studies have been conducted to discover novel anaesthetic agents by various scholars. Herbal extracts do not stand far in the pathway of this search. Owing to these discoveries, 30% ethanolic extract gel of Ākārakara (Spilanthes calva DC.) is selected here as a topical anaesthetic to evaluate the efficacy in facilitating the management of warts by a painful procedure agnikarma. Keywords: Dermal anaesthetic, Ākārakara, Spilanthol