Introduction

Osteoarthritis (OA) is the most common chronic joint condition, affecting millions worldwide. It is characterized by progressive degeneration of articular cartilage, leading to joint pain, stiffness, swelling, and reduced mobility. Conventional medicine often manages OA with painkillers, anti-inflammatories, and in severe cases, joint replacement surgeries. While these measures provide symptomatic relief, they do not always address the root causes of degeneration and inflammation.

This is where the Unani system of medicine offers a holistic perspective. Rooted in Greco-Arabic traditions, Unani medicine views osteoarthritis—classified as Wajaʾ al-Mafāsil—as a result of humoral imbalance, particularly dominance of cold and moist qualities in the joints. Unlike symptomatic approaches, Unani treatment aims to restore humoral balance, strengthen joint structures, and relieve pain naturally through dietary regulation, Unani herbs, and regimental therapies.

As modern research begins to validate the anti-inflammatory and cartilage-protective effects of classical Unani treatments, interest in this system is steadily growing worldwide.

Understanding Joint Pain in Unani Medicine

In Unani medicine, joints (Mafāsil) are vulnerable sites where imbalance in humors manifests quickly. Wajaʾ al-Mafāsil is broadly categorized into:

• Niqris (Gout): Pain due to accumulation of morbid matter in joints, often linked with dietary excess.
• Irq al-Nasā (Sciatica): Pain radiating due to nerve involvement.
• Wajaʾ al-Rukbat (Knee Pain): Specific inflammation and degeneration of the knee joint, akin to osteoarthritis.

Osteoarthritis is considered a chronic cold and moist condition, aggravated by sedentary lifestyle, aging, obesity, excessive intake of moist/heavy foods, and poor digestion (Su-e-Hazm). The Unani system of medicine emphasizes not only reducing pain but also correcting digestion, regulating metabolism, and clearing morbid humors from the joints.

Thus, Unani treatment for OA includes:

1. Strengthening bones and cartilage.
2. Reducing inflammation and stiffness.
3. Using Unani herbs to improve circulation and humoral balance.
4. Employing regimental therapies to restore mobility.

Key Unani Herbs for Osteoarthritis Relief

The pharmacopoeia of Unani medicine includes numerous Unani herbs known for their analgesic, anti-inflammatory, and cartilage-protective effects. Some of the most effective ones for osteoarthritis are:

1. Suranjan Shirin (Colchicum autumnale)

A cornerstone herb in classical Unani treatments for joint disorders. It reduces inflammation and pain in Wajaʾ al-Mafāsil by clearing morbid humors. Modern research confirms colchicine derivatives reduce gouty inflammation and stiffness.

2. Asgandh (Withania somnifera)

Known for its strengthening and rejuvenating properties, Asgandh is prescribed in OA for reducing swelling, stiffness, and fatigue. Recent studies show it modulates inflammatory pathways and protects cartilage.

3. Methi (Trigonella foenum-graecum)

Fenugreek seeds, warm and dry in temperament, reduce cold and moist humoral imbalances. They alleviate stiffness, improve joint flexibility, and enhance digestion, which indirectly benefits joint health.

4. Roghan-e-Suranjan (Colchicum oil)

An external application used in Unani treatment for knee osteoarthritis. It reduces local pain, swelling, and stiffness when massaged regularly.

5. Majoon Suranjan

A polyherbal formulation prescribed in OA combining Suranjan with other herbs. Traditionally indicated for both gout and osteoarthritis, it relieves chronic joint pain and stiffness.

These Unani herbs not only act as pain relievers but also strengthen musculoskeletal tissues, which makes Unani medicine a comprehensive approach to joint health.

Classical Unani Treatments for Osteoarthritis

Classical Unani treatments address OA through multiple approaches, ensuring both symptom relief and long-term tissue repair.

Pharmacological Preparations

• Majoon Suranjan: Anti-inflammatory and analgesic; widely prescribed for chronic joint pain.
• Habb-e-Suranjan: Tablet form for long-term use in arthritis.
• Qairooti-e-Kushta-e-Sadaf: Strengthens bones and cartilage.

Regimental Therapies (Ilaj bil Tadbeer)

• Massage (Dalk): With medicated oils like Roghan-e-Suranjan and Roghan-e-Asgandh. Improves circulation and reduces stiffness.
• Hammam (Bath Therapy): Steam baths with herbal decoctions to ease pain and stiffness.
• Hijama (Cupping): Removes morbid humors from inflamed joints, improving mobility.

Dietary Modifications (Ilaj bil Ghiza)

Patients are advised to avoid moist, heavy, and cold foods such as curd, rice, and excess meat. Instead, warm and dry foods like barley, lentils, spices, and light meats are recommended.

This combination ensures holistic relief—unlike painkillers, Unani treatment works on restoring balance, preventing progression, and strengthening joints.

Modern Relevance of Unani Medicine in Osteoarthritis

The global burden of osteoarthritis is immense, with rising cases due to aging populations and sedentary lifestyles. Conventional drugs, while effective for pain, often carry long-term side effects like gastric irritation or kidney damage. Here, the Unani system of medicine offers safer, sustainable alternatives.

Modern science now validates many Unani herbs for OA:

• Suranjan shows strong anti-inflammatory effects.
• Withania somnifera improves pain, stiffness, and mobility in clinical trials.
• Majoon Suranjan demonstrates anti-arthritic potential in animal models, comparable to NSAIDs.

By integrating classical Unani treatments with modern physiotherapy and lifestyle interventions, OA patients can achieve better mobility, reduced pain, and slower progression of joint damage.

Conclusion

Osteoarthritis is more than just “wear and tear” — it reflects systemic imbalances that modern painkillers alone cannot correct. The Unani system of medicine recognizes this and offers a holistic framework through humoral balance, Unani herbs, diet, and regimental therapies.

From Suranjan and Asgandh to Majoon Suranjan and external oils, classical Unani treatments provide pain relief, reduce inflammation, and strengthen joints. Unlike quick fixes, Unani treatment restores long-term health and mobility while minimizing side effects.

As science increasingly confirms the benefits of Unani medicine, its role in osteoarthritis management is gaining global recognition. Patients seeking holistic, sustainable solutions can find relief in this centuries-old tradition.

Evidence-Backed Validation of Unani Treatment for Joint Pain

Recent clinical and preclinical studies strongly support the effectiveness of the Unani system of medicine and its Unani herbs in managing joint pain and osteoarthritis. For instance, a randomized, double-blind trial of Withania somnifera (Ashwagandha) showed that dosages of 250 mg twice daily significantly reduced pain, stiffness, joint swelling, and disability in knee osteoarthritis over 12 weeks compared to placebo. (PubMed) Animal studies combining Ricinus communis and W. somnifera demonstrated reductions in inflammatory cytokines (IL-1β, IL-6, TNF-α), oxidative stress, and tissue damage. (PubMed) Human evaluations of Unani herb formulas (e.g. Asarun, Tukhme karafs, Filfil daraz, etc.) showed a ~71 % reduction in functional impairment and pain in knee osteoarthritis patients after 40 days of Unani treatment. (DOAJ) Moreover, traditional compound Unani medicines like Ḥabb-e-Sūranjān paired with Roghan-e-Sūranjān showed measurable relief in joint swelling, tenderness, and restricted motion within two weeks. (Hippocratic Journal of Unani Medicine) Together, these findings bridge classical Unani treatments with modern science, confirming that Unani treatment is not just historical practice but has empirical foundation for joint pain relief via anti-inflammatory, analgesic, and immune-modulating mechanisms.