Open Access Open Access  Restricted Access Subscription Access

Roghan Mālish ‘A Topical Formulation’ Attenuates Joint Pain, Down-Regulates C-Reactive Protein Level and Improves Quality of Life in Patients with Waja‘ al-Mafāṣil (NUMC: L-4) (Arthralgia) – A Pilot Clinical Study


Affiliations
1 Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
2 Ammu Jayanthi Viswanathan Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
 

Roghan Mālish is a cost effective topical application recommended for joint pain management. This prospective pilot study evaluated the safety, analgesic, and anti-inflammatory effect of Roghan Mālish in patients with arthralgia to validate the therapeutic claim and generate evidence for further studies. The study was conducted in patients with joint pain as chief complaint, with or without swelling and morning stiffness. The study was approved by Institutional ethic committee prior to initiation. Patients were advised to apply Roghan Mālish (2.5 mL/joint) followed by gentle massage in circular motion for 5 mins twice daily for 14 days. The efficacy was calculated from the reduction in Visual Analogue Scale (VAS), C-Reactive Protein (CRP) level and improvement in Quality of Life Scale (QOLS). Relevant pathological and biochemical indices and the observation of adverse events were used to evaluate the safety. A total number of 58 patients completed the trial with the mean age of 46.2 years and the majority (70.7%) being female. The overall therapeutic response was 93%. A significant (P<0.05) decrease in VAS score and CRP level, and significant improvement in QOLS was observed after treatment with Roghan Mālish. No significant difference in pathological and biochemical indices was observed before and after treatment. Roghan Mālish was well tolerated upon topical application with no any undesirable side effects. The study results indicate that the topical application of Roghan Mālish is safe and may be used successfully to treat arthralgia.

Keywords

Arthralgia, Joints Pain, Roghan Mālish, Sesame Oil, Turpentine Oil, Waja‘ al-Mafāṣil
Font Size

User

Notifications
JOURNAL COVERS
  

  • Neogi T. Joint pain epidemiology. FACT SHEET No. 11. International Association for the Study of Pain; 2016. Available from: https://www.apsoc.org.au/PDF/GYAP/2016_GYAP/Fact_Sheet_11_Joint_Pain_Epidemiology.pdf
  • Finney A, Dziedzic KS, Lewis M, Healey E. Multisite peripheral joint pain: A cross-sectional study of prevalence and impact on general health, quality of life, pain intensity and consultation behaviour. BMC Musculoskeletal Disorders. 2017; 18:535. https://doi.org/10.1186/s12891-017-1896-3
  • Thiem U, Lamsfuß R, Günther S, Schumacher J, Bäker C, Endres HG, et al. Prevalence of self-reported pain, joint complaints and knee or hip complaints in adults aged ≥ 40 years: A cross-sectional survey in Herne, Germany. PLoS One. 2013; 8(4). https://doi.org/10.1371/journal.pone.0060753
  • Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian J Orthop. 2016; 50(5):518-22. https://doi.org/10.4103/0019-5413.189608
  • Kaushik D, Kumar A, Kaushik P, Rana AC. Analgesic and anti-inflammatory activity of Pinus roxburghii Sarg. Adv Pharmacol Sci. 2012. https://doi.org/10.1155/2012/245431
  • Majūsī, AA. Kāmil al-Ṣanā‘a al-Ṭibbiyya, Vol 2. New Delhi: Idara Kitab al-Shifa; 2010. p. 503-14.
  • Sīnā I. Al-Qānūn fi’l Ṭibb, Vol 3 (Urdu Translation by Kantoori GH). New Delhi: Ejaz Publishing House; 2010. p. 1117-32.
  • Al-Qamarī AM. Ghinā Munā (Urdu translation by CCRUM). New Delhi: CCRUM, Ministry of Health and Family Welfare, Government of India; 2008. p. 339-53.
  • Khan A. Aksīr-i-Azam (Urdu translation by Kabiruddin M). New Delhi: Idara Kitab al-Shifa; 2011. p. 836-45.
  • Baitār I. Kitāb al-Jāmiʿ li Mufradāt al-Adwiya wa’l Aghdhiya, Vol 2. New Delhi: CCRUM, Ministry of Health and Family Welfare, Government of India; 1995. p. 235.
  • Ghani N. Khazā’in al-Adwiya. 3rd Ed. New Delhi: Idara Kitab al-Shifa; 2011. p. 521-22, 934-35.
  • Mercier B, Prost J, Prost M. The essential oil of turpentine and its major volatile fraction (alpha- and beta-pinenes): A review. Int J Occup Med Environ Health. 2009; 22(4):331-42. https://doi.org/10.2478/v10001-009-0032-5
  • Baitār I. Kitāb al-Jāmiʿli Mufradāt al-Adwiya wa’l Aghdhiya, Vol 3. New Delhi: CCRUM, Ministry of Health and Family Welfare, Government of India; 1999. p. 75-7.
  • Prasad MN, Sanjay KR, Prasad DS, Vijay N, Kothari R, Swamy SN. A Review on nutritional and nutraceutical properties of sesame. J Nutr Food Sci. 2012; 2:2. https://doi.org/10.4172/2155-9600.1000127
  • Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006; 15 Suppl 1(Suppl 1):S17-24. https://doi.org/10.1007/s00586-005-1044-x
  • Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev. 2018; 2(3). https://doi.org/10.5435/JAAOSGlobal-D-17-00088
  • Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018; 9:754. https://doi.org/10.3389/fimmu.2018.00754
  • Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): Reliability, validity, and utilization. Health Qual Life Outcomes. 2003; 1:60. https://doi.org/10.1186/1477-7525-1-60
  • Noh ASM, Ismail CAN. A review on chronic pain in rheumatoid arthritis: A focus on activation of NR2B subunit of N-methyl-D-aspartate receptors. Malays J Med Sci. 2020; 27(1):6-21. https://doi.org/10.21315/mjms2020.27.1.2
  • McDougall JJ. Arthritis and pain. Neurogenic origin of joint pain. Arthritis Res Ther. 2006; 8(6):220. https://doi.org/10.1186/ar2069
  • Morden A, Jinks C, Ong BN. Understanding help seeking for chronic joint pain: implications for providing supported self-management. Qual Health Res. 2014; 24(7): 957-68. https://doi.org/10.1177/1049732314539853
  • Saxena AK, Jain PN, Bhatnagar S. The prevalence of chronic pain among adults in India. Indian J Palliat Care. 2018; 24(4):472-77. https://doi.org/10.4103/IJPC.IJPC_141_18
  • Jurjānī I. Dhakhīra Khawārazm Shāhī, Vol 6, (Urdu translation by Khan HH). New Delhi: Idara Kitab al-Shifa; 2010. p. 637-648.
  • Fillingim RB, Loeser JD, Baron R, Edwards RR. Assessment of chronic pain: Domains, methods, and mechanisms. J Pain. 2016; 17(9 Suppl):T10-20. https://doi.org/10.1016/j.jpain.2015.08.010
  • Neugebauer V, Han JS, Adwanikar H, Fu Y, Ji G. Techniques for assessing knee joint pain in arthritis. Mol Pain. 2007; 3:8. https://doi.org/10.1186/1744-8069-3-8
  • van Nies JA, Alves C, Radix-Bloemen AL, Gaujoux-Viala C, Huizinga TW, Hazes JM, et al. Reappraisal of the diagnostic and prognostic value of morning stiffness in arthralgia and early arthritis: Results from the Groningen EARC, Leiden EARC, ESPOIR, Leiden EAC and REACH. Arthritis Res Ther. 2015; 17(1):108. https://doi.org/10.1186/s13075-015-0616-3
  • Taylor WJ, Redden D, Dalbeth N, Schumacher HR, Edwards NL, Simon LS, et al. Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout. J Rheumatol. 2014; 41(3):574-80. https://doi.org/10.3899/jrheum.131245
  • Renskers L, van Uden RJJC, Huis AMP, Rongen SAA, Teerenstra S, van Riel PLCM. Comparison of the construct validity and reproducibility of four different types of patient-reported outcome measures (PROMs) in patients with rheumatoid arthritis. Clin Rheumatol. 2018; 37(12):3191-99. https://doi.org/10.1007/s10067-018-4285-x
  • Ganguly A. Efficacy of phytotherapeutic protocol for the risk factor of elevated level of Serum C- Reactive protein in knee osteoarthritis: Part I. A systematic meta-analysis. Int Arch BioMed Clin Res. 2018; 4(2):59-67. https://doi.org/10.21276/iabcr.2018.4.2.20.
  • Ghasemian M, Owlia S, Owlia MB. Review of Anti-inflammatory herbal medicines. Adv Pharmacol Sci. 2016; 2016. https://doi.org/10.1155/2016/9130979
  • Gülçin I, Büyükokuroglu ME, Oktay M, Küfrevioglu OI. Antioxidant and analgesic activities of turpentine of Pinus nigra Arn. subsp. pallsiana (Lamb.) Holmboe. J Ethnopharmacol. 2003; 86(1):51-8. https://doi.org/10.1016/S0378-8741(03)00036-9
  • Musharraf MU, Ahmad Z, Yaqub Z. Comparison of topical capsaicin and topical turpentine Oil for treatment of painful diabetic neuropathy. J Ayub Med Coll Abbottabad. 2017; 29(3):384-7.
  • Monteiro EM, Chibli LA, Yamamoto CH, Pereira MC, Vilela FM, Rodarte MP, et al. Antinociceptive and anti-inflammatory activities of the sesame oil and sesamin. Nutrients. 2014; 6(5):1931-44. https://doi.org/10.3390/nu6051931
  • Hsu DZ, Chen SJ, Chu PY, Liu MY. Therapeutic effects of sesame oil on monosodium urate crystal-induced acute inflammatory response in rats. Springerplus. 2013; 2. https://doi.org/10.1186/2193-1801-2-659
  • Shamloo MBB, Nasiri M, Dabirian A, Bakhtiyari A, Mojab F, Majd HA. The effects of topical sesame (Sesamum indicum) oil on pain severity and amount of received non-steroid anti-inflammatory drugs in patients with upper or lower extremities trauma. Anesth Pain Med. 2015; 5(3). https://doi.org/10.5812/aapm.25085v2
  • Lee YC. Effect and treatment of chronic pain in inflammatory arthritis. Curr Rheumatol Rep. 2013; 15(1):300. https://doi.org/10.1007/s11926-012-0300-4
  • Saccò M, Meschi M, Regolisti G, Detrenis S, Bianchi L, Bertorelli M, et al. The relationship between blood pressure and pain. J Clin Hypertens (Greenwich). 2013; 15(8):600-5. https://doi.org/10.1111/jch.12145

Abstract Views: 145

PDF Views: 71




  • Roghan Mālish ‘A Topical Formulation’ Attenuates Joint Pain, Down-Regulates C-Reactive Protein Level and Improves Quality of Life in Patients with Waja‘ al-Mafāṣil (NUMC: L-4) (Arthralgia) – A Pilot Clinical Study

Abstract Views: 145  |  PDF Views: 71

Authors

Noman Anwar
Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
Noor Zaheer
Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
A. Farhath Fathima
Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
Athar Parvez Ansari
Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
K. Mohammed Farhan
Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India
Ammu Jayanthi Viswanathan
Ammu Jayanthi Viswanathan Regional Research Institute of Unani Medicine, Chennai – 600013, Tamil Nadu, India

Abstract


Roghan Mālish is a cost effective topical application recommended for joint pain management. This prospective pilot study evaluated the safety, analgesic, and anti-inflammatory effect of Roghan Mālish in patients with arthralgia to validate the therapeutic claim and generate evidence for further studies. The study was conducted in patients with joint pain as chief complaint, with or without swelling and morning stiffness. The study was approved by Institutional ethic committee prior to initiation. Patients were advised to apply Roghan Mālish (2.5 mL/joint) followed by gentle massage in circular motion for 5 mins twice daily for 14 days. The efficacy was calculated from the reduction in Visual Analogue Scale (VAS), C-Reactive Protein (CRP) level and improvement in Quality of Life Scale (QOLS). Relevant pathological and biochemical indices and the observation of adverse events were used to evaluate the safety. A total number of 58 patients completed the trial with the mean age of 46.2 years and the majority (70.7%) being female. The overall therapeutic response was 93%. A significant (P<0.05) decrease in VAS score and CRP level, and significant improvement in QOLS was observed after treatment with Roghan Mālish. No significant difference in pathological and biochemical indices was observed before and after treatment. Roghan Mālish was well tolerated upon topical application with no any undesirable side effects. The study results indicate that the topical application of Roghan Mālish is safe and may be used successfully to treat arthralgia.

Keywords


Arthralgia, Joints Pain, Roghan Mālish, Sesame Oil, Turpentine Oil, Waja‘ al-Mafāṣil

References





DOI: https://doi.org/10.18311/jnr%2F2023%2F32427