Topical herbal remedies for treatment of joint pain according to Iranian Traditional Medicine

Document Type: Review

Authors

1 Department of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Department of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Joint pain is one of the most common complaints with many possible causes.Some medicines used for joint pain relief such as NSAIDs have substantial and frequent side effects. Topical route possibly reduces adverse reactions by maximizing local delivery and minimizing systemic toxicity. Throughout history, plants have been the most important sources of medicines for human health and Iranian Traditional Medicine (ITM) is well known for its extensive use of herbal medicines to treat diseases accompanied with joint pain for centuries. In the present study, the plants used topically for relieving joint pain in ITM were searched. Moreover, their pharmacological effectiveness in modern medicine was reviewed. The terms “Waja mafasil” (joint pain), “Waja-ol-mafasil” (joint pain), “Irq-on-nasa” (sciatica), “Waja-ol-warik” (coxalgia), ‘Waja-ol-zahr” (back pain), “Waja-ol-rakbah” (knee pain) and “Niqris” (gout) were searched in three important Iranian traditional books including “Canon”,Al-Hawi and “Tohfat al-mu’mininand topical preparations introduced as “Tela” and “Zemad” were selected. The scientific literatures were searched for their effectiveness related to the analgesic and anti-inflammatory activities. Thirty five plants were selected on the basis of their topical use to relief joint pain. Among these plants, 22 species have been found to exhibit anti-inflammatory and analgesic activities.

Keywords


[1] Fauci S, Kasper DL, Longo DL, Braunwald E, Hauser SL. Harrison’s internal medicine. 17th   ed. New York: McGraw-Hill, 2008.

[2] Ong CKS,  Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res. 2007; 5(1): 19-34.

[3]  Mc Caughey W. Adverse effects of local anaesthetics. Drug Safty. 1992; 7(3):178-189.

[4] Ardekani MS, Mohebbi A, Shajari E. A survey of Iranian ethnomedicine.1st ed. Tehran: Sahbaye danesh, 2011.

[5] Savage-Smith E. Islamic culture and medical arts. Maryland: National Library of Medicine, 1994.

[6] Tashani OA, Johnson MI. Avicenna’s concept of pain. Libyan J Med. 2010; Article ID 5: 5253.

[7] Al-rhazes. Al havi [liber continent]. 1st ed. Afsharipour S, Ed. Tehran: Academy of medical sciences publication, 2005.

[8] Tonkaboni MM, Tohfeh alMomenin. 1st ed Rahimi R, Shams Ardekani MR, Farjadmand F, Ed. Tehran:  Shahid Beheshti University of Medical Sciences, 2007. 

[9] Avicenna. The Canon of medicine. 2nd ed. Sharafkandi A, Ed. Tehran: Soroush press, 1997.

[10] Aghili khorasani MH. Makhzan-al-advia. 1st ed. Shams ardekani MR, Rahimi R, Farjadmand F, Ed. Tehran: Rahe kamal, 2009.

[11] Heravi M. Bahr al javaher. Ghom: Jalal al din, 1387.

[12] Abdul Hameed H. A comprehensive glossary of Avicena’s canon of medicine. NewDelhi: Hamdard foundation press, 1998.

[13] Shirzad M, Irannejad Sh, Cheraqi  Niroumand M, Sham ardekani M. Iranian traditional medicine a dictionary (Arabic-Persian-English).1st ed. Tehran: Traditional medicine and Materia Medica Research Center, 2014.

[14] Zargari A. Medicinal plants. 6th ed. Tehran: Tehran University of Medical Sciences, 2005.

[15] Ghahreman A. Matching the old descriptions of medicinal plants with the scientific ones. 1st ed. Tehran: University of Tehran press, 2010.

[16] Ghahraman A, Okhovvat A. Matching the old medicinal plant names with scientific terminology. 1st ed. Tehran: Tehran University press, 2004.

[17] Soltani A. Dictionary of medicinal plants. 1st ed. Tehran: Arjmand press, 2004.

[18] Mozaffarian V. Dictionary of Iranian plant names. 1st ed. Tehran: Farhang Moaser press, 2006.

[19] Amin G. Popular medicinal plants of Iran. 1st ed. Tehran: Tehran University press, 2005.

[20] Ali Khan MA,  Torequl Islam M. Analgesic and cytotoxic activity of Acorus calamus L., Kigelia pinnata L., Mangifera indica L. and Tabernaemontana divaricata L. J Pharm Bioallied Sci. 2012; 4(2): 149-154.

[21] Jayaraman R, Anitha T, Joshi VD. Analgesic and anticonvulsant effects of Acorus calamus roots in mice. Int J Pharm Tech Res. 2010; 2(1): 552-555.

[22] Subramoniam A, Madhavachandran V, Gangaprasad A. Medicinal plants in the treatment of arthritis. Ann Phytomed. 2013; 2(1): 3-36.

[23] Kim H, Han TH, Lee SG. Anti-inflammatory activity of a water extract of Acorus calamus L. leaves on keratinocyte HaCaT cells. JEthnopharmacol. 2009; 12(1): 149-156.

[24] Muthuraman A,  SinghN,  Singh Jaggi A. Protective effect of Acorus calamus L. in rat model of vincristine induced painful neuropathy: An evidence of anti-inflammatory and anti-oxidative activity. Food Chem Toxicol. 2011; 49(10): 2557-2563.

[25] Arreola R, Quintero-Fabián S, López-Roa RI, Octavio Flores-Gutiérrez E. Immunomodulation and anti-Inflammatory effects of garlic compounds. J Immunol Res. 2015; Article ID 401630.

[26] Hodge G, Hodge S, Han P. Allium sativum (garlic) suppresses leukocyte inflammatory cytokine production in vitro: potential therapeutic use in the treatment of inflammatory bowel disease. Cytometry. 2002; 48(4): 209-215.

[27] Gudej J. Determination of flavonoids in the leaves, flowers and roots of Althaea officinalis L. Farm Polska. 1990; 46(5): 153-155.

[28] Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol. 2011; 49(3): 327-333.

[29] Al-Snafi AE. The pharmacological importance of Brassica nigra and Brassica rapa grown in Iraq.J Pharm Biol. 2015;5(4): 240-253.

[30] Kiasalari Z, Khalili M,  Roghani M, Sadeghian A. Antiepileptic and antioxidant effect of Brassica nigra on pentylenetetrazol-induced kindling in mice. Iran J Pharm Res. 2012; 11(4): 1209-1217.

[31] Haidari MR, Abbasifard M. Evaluation of the analgesic effect of Brassica nigra in mice. J Mazandaran Univ Med sci. 2002; 12(34): 18-27.

[32] Nagariya K. Anti-inflammatory and analgesic activity of whole plant of Brassica oleracea linn var. capitata f. rubra (red cabbage) in rats. J Global Pharma Tech. 2010; 2(8): 256.

[33] Chandran PK,  Kuttan R. Effect of Calendula officinalis flower extract on acute phase proteins, antioxidant defense mechanism and granuloma formation during thermal burns. J Clin Biochem Nutr. 2008; 43(2): 58-64.

[34] Chandran PK, Kuttan G, Kuttan R. Anti-inflammatory activity of flower extract of Calendula officinalis Linn. and its possible mechanism of action. Indian J Exp Biol. 2009; 47(2): 688-694.

[35] Ilavarasan R, Mallika M,Venkataraman S. Anti-inflammatory and antioxidant activities of Cassia fistula Linn. bark extracts. Afr J Tradit Complem. 2005; 2(1): 70-85.

[36] Ashraf Ali M, Sagar HA, Sultana Khatun C, Azad AK, Begum K, Ibne Wahed MI. Antihyperglycemic and analgesic activities of ethanolic extract of Cassia fistula L. stem bark. Int J Pharm Sci Res. 2012; 3(2): 416-423.

[37] Chang YH. Mechanism of action of colchicine. III. Anti- inflammatory effects of colchicine compared with phenylbutazone and indomethacin. Arthritis Rheum. 1975; 18(5): 493-496.

[38] Prasad SH,  Ewigman B. Acute gout: Oral steroids work as well as NSAIDs. J Fam Practice. 2008; 57(10): 655-657.

[39] Schep LJ, Slaughter RJ, Beasley DM. Nicotinic plant poisoning. Clin Toxicol. 2009;47(8): 771-781.

[40] Madaan R, Kumar S. Screening of alkaloidal fraction of Conium maculatum L. aerial parts for analgesic and anti-inflammatory activity. Indian J Pharm Sci. 2012; 74(5): 457-460.

[41] Ahmad agil M, Risco S, Miro M, Navarro MC, Ocete MA, Jimenez JA. Analgesic and antipyretic effects of Ecballium elaterium (L.) A. Richard. extract in rodents. Phytother Res. 1995; 9(2): 135-138.

[42] Yesilada E, Tanaka S, Sezik E, Tabata M. Isolation of an anti-inflammatory principle from the fruit juice of Ecballium elaterium.J Nat Prod.1988; 51(3): 504-508.

[44] Nithya V. Anti-inflammatory activity of  Lawsonia ulba Linn., in wistar albino rats. Asian J Sci Tech. 2011; 4: 001-003.

[45] Alia B, Bashir A. Anti-Inflammatory, antipyretic, and analgesic effects of Lawsonia inermis L. (Henna) in rats. Pharmacology. 1995; 51(6): 356-363.

[46] Chaudhary G, Goyal S, Poonia P. Lawsonia inermis L.: a pharmacological review. Int J Pharm Sci Drug Res. 2010; 2(2): 91-98.

[47] Raval ND, Ravishankar B. Analgesic effect of Lepidium sativum Linn. (Chandrashura) in experimental animals. Ayu. 2010; 31(3): 371-373.

[48] Raval ND, Ravishankar B, Ashok BK. Anti-inflammatory effect of Chandrashura (Lepidium sativum Linn.) an experimental study. Ayu. 2013; 34(3): 302-304.

[49] Zibbu G, Batra A. A Review on chemistry and pharmacological activity of  Nerium oleander L. J Chem Pharm Res. 2010; 2(6): 351-358.

[50] Erdemoglu N, Küpel E, Yeşilada E. Antiinflammatory and antinociceptive activity assessment of plants used as remedy in Turkish folk medicine. J Ethnopharmacol. 2003; 89(1): 123-129.

[51] Chebbi Mahjoub R,Khemiss M, Dhidah M, Dellaï M, Bouraoui A.Chloroformic and methanolic extracts of Olea europaea L. leaves present anti-Inflammatory and analgesic activities. ISRN Pharmacology. 2011; Article ID 564972.

[52] Süntar IPAkkol EKBaykal T. Assessment of anti-inflammatory and antinociceptive activities of Olea europaea L. J Med Food. 2010; 13(2): 352-356.

[53] Huang  FC,  Kutchan TM. Distribution of morphinan and benzo[c]phenanthridine alkaloid gene transcript accumulation in Papaver somniferum. Phytochemistry. 2000; 53(5): 555-564.

[54] Kapoor LD. Opium poppy: botany, chemistry, and pharmacology. Florida: Taylor & Francis, 1995.

[55] Calixto JB, Beirith A, Ferreira J, Santos AR, Filho VC, Yunes RA. Naturally occurring antinociceptive substances from plants. Phytother Res. 2000; 14(6): 401-418.

[56] Mani D, Dhawan SS. Scientific basis of therapeutic uses of Opium Poppy (Papaver somniferum) in Ayurveda; ISHS Acta Horticulture 1036: International Symposium on Papaver. 2014; Lucknow, India.

[57] Lipp J. Possible mechanisms of morphine analgesia. Clin Neuropharmacology. 1991; 14(2): 131-147.

[58] Haider SNazreen SAlam MMHamid HAlam MS. Anti-inflammatory and anti-nociceptive activities of Platanus orientalis Linn. and its ulcerogenic risk evaluation.J Ethnopharmacol. 2012; 143(1): 236-240.

[59] Xu Q,  Wang Y,  Guo S,  Shen Z. Anti-inflammatory and analgesic activity of aqueous extract of Flos populi. J Ethnopharmacol. 2014; 152(3): 540-545.

[60] Loonat FAmabeoku GJ. Antinociceptive, anti-inflammatory and antipyretic activities of the leaf methanol extract of Ruta graveolens L. (Rutaceae) in mice and rats. Afr J Tradit Complem. 2014; 11(3): 173-181.

[61] Rahman MM, Chowdhury JA, Habib R, Saha BK. Anti-Inflammatory, anti-Arthritic and analgesic activity of the alcoholic extract of the plant Urginea Indica Kunth.‏ Int J Pharm Sci Res. 2011; 2(11): 2915-2919.

[62] Garg VK, Jain M, Sharma PK, Garg G. Anti inflammatory activity of Spinacia oleracea. Int J Pharmacogn Phytochem Res. 2010; 1(1): 1-4.

[63] Taherian AABabaei MVafaei AAJarrahi MJadidi MSadeghi H. Antinociceptive effects of hydroalcoholic extract of Thymus vulgaris. Pak J Pharm Sci. 2009; 22(1): 83-89.

[64] Gorji A. Pharmacological treatment of headache using traditional persian medicine. Trends Pharmacol Sci. 2003; 24(7): 331-334.

[65] Mozaffarian V. Identification of medicinal and aromatic plants of Iran. 3rd ed. Tehran: Farhang Moaser, 2013.

[66] Government of India, Ministry of Health and Family welfare. The Ayurvedic pharmacopoeia of India. New Delhi: Department of Ayush,2008.

[67] Government of India, Ministry of Health and Family welfare. The Unani pharmacopoeia of India. New Delhi: Department of Ayush, 2011.

[68] Woolf AD. Musculoskeletal conditions. In: Major and chronic diseases. Bussels: European commission, 2008.

[69] L Jorge L, C Feres C,  EP Teles V. Topical preparations for pain relief: efficacy and patient adherence.  J Pain Res. 2011; 4: 11-24.