E-ISSN:2456-3110

Research Article

Musculoskeletal Pain

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 6 June
Publisherwww.maharshicharaka.in

To evaluate safety and efficacy of Arthrohills oil in subjects with Musculoskeletal Pain

Mandlecha A.1, Shaukatali Mujawar G.2*
DOI: http://dx.doi.org/10.21760/jaims.8.6.3

1 Ajitkumar Mandlecha, Medical Director, Vishwanand Kendar, Pune, Maharashtra, India.

2* Gous Shaukatali Mujawar, Research Head, Vishwanand Kendar, Pune, Maharashtra, India.

Musculoskeletal pain affects bones, joints, ligaments, tendons or muscles. An injury such as a fracture may cause sudden, severe pain. According to the World Health Organization (WHO), 20-33% of the world’s population has some form of chronic musculoskeletal pain, translating to 1.75 billion people globally. Outdoor patients, having chronic pain of musculoskeletal origin were advised Arthrohills oil external application locally as few drops for small joints and up to 2–3 ml for the larger joints once in a day for external application with gentle massage for 15 min up to 6 weeks were used in this study. Assessment points were Pain, Tenderness, Swelling and Joint motility. We can conclude that, effect observed in all parameters is significant. Arthohills oil was safe and effective in musculoskeletal pain.

Keywords: Musculoskeletal pain, Arthohills oil external application

Corresponding Author How to Cite this Article To Browse
Gous Shaukatali Mujawar, Research Head, , Vishwanand Kendar, Pune, Maharashtra, India.
Email: 		Ajitkumar Mandlecha, Gous Shaukatali Mujawar, To evaluate safety and efficacy of Arthrohills oil in subjects with Musculoskeletal Pain. J Ayu Int Med Sci. 2023;8(6):13-18.
Available From
https://jaims.in/jaims/article/view/2533

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-04-25 2023-04-27 2023-05-04 2023-05-11 2023-05-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Ajitkumar Mandlecha, Gous Shaukatali Mujawarand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Mandlecha A et al: Safety and Efficacy of Arthrohills oil with Musculoskeletal Pain

Introduction

Health is the situation of a living thing when its vital functions are functioning properly and harmoniously, contributing to its preservation and to the normal growth of its inhabitants.[1].

Musculoskeletal pain affects bones, joints, ligaments, tendons or muscles. An injury such as a fracture may cause sudden, severe pain.

Musculoskeletal pain can be acute, meaning it is sudden and severe. Or the pain can be chronic (long-lasting). You may have localized pain (in one area of your body), or it may affect your entire body. Chronic musculoskeletal pain (in particular, low back pain) is the main contributor to disability worldwide.[2]

According to the World Health Organization (WHO), 20 to 33% of the world’s population has some form of chronic musculoskeletal pain, translating to 1.75 billion people globally.[3] The most prevalent forms of musculoskeletal pain are chronic low back pain, neck pain, and the pain associated with osteoarthritis and rheumatoid arthritis, but musculoskeletal pain also includes sprained muscles, pain associated with fracture, shoulder pain, and others. Advancing age increases the risk of musculoskeletal pain, although it may occur at any age. Chronic musculoskeletal pain is mainly a consequence of a complex reciprocation of biochemical, mechanical, psychological, and social components.[4] The patterns of musculoskeletal pain problems vary greatly by age and sex, e.g., knee pain from osteoarthritis is extremely common in the elderly, affecting over one-third of people over age 60, while the prevalence of pain is about 1.5 to 2 times more common in women than in men, and the ratio is over four females to one male for fibromyalgia.[5]

Common causes of musculoskeletal pain include:

  • Bone fractures
  • Joint dislocation (when something forces a joint out of its proper position).
  • Direct blows to muscles, bones or joints.
  • Overuse injuries
  • Poor posture
  • Sprains


What are the symptoms of musculoskeletal pain?

Your symptoms may vary depending on the cause of your musculoskeletal pain. Common symptoms include:

  • Aching and stiffness.
  • Burning sensations in the muscles.
  • Fatigue.
  • Muscle twitches.
  • Pain that worsens with movement.
  • Sleep disturbances

Materials and Methods

Inclusion criteria

1. Outdoor patients, having chronic pain of musculoskeletal origin (e.g., low backache, knee, shoulder, elbow, wrist, ankle, and neck pain for more than 12 weeks).

2. Patients of either sex aged between 25 and 65 years.

Exclusion criteria

1. History of any trauma/fractured joint/surgical/diagnostic intervention with reference to the affected joint(s)

2. Gross disability in performing daily normal routine, i.e., bed-ridden patients or confined to a wheelchair

3. Patients with co-morbidities such as gouty arthritis, rheumatoid arthritis, and psoriatic arthritis

4. Patients having any deformity of knee hip or back altering their gait and posture

5. Patients with uncontrolled hypertension (>160/100 mm of Hg)

6. Patients with uncontrolled diabetes mellitus (HbA1c >9%)

7. Patients with evidence of malignancy

8. Patients on prolonged (>6 weeks) medication with corticosteroids, antidepressants, anticholinergics, etc., or any other drugs that may have an influence on the outcome of the study

9. Patients who have a history of atrial fibrillation, acute coronary syndrome, myocardial infarction, stroke, or severe arrhythmia in the last 6 months


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Mandlecha A et al: Safety and Efficacy of Arthrohills oil with Musculoskeletal Pain

10. Patients with any severe renal or hepatic or any other disorder which may interfere in the study

11. Pregnant/lactating woman.

12. Patients who are currently participating in any other clinical trial

13. Any other condition which the Principal Investigator thinks may jeopardize the study

Trial intervention: Arthrohills oil external application advised to apply locally as few drops for small joints and up to 2–3 ml for the larger joints once in a day for external application with gentle massage for 15 min up to 6 weeks were used in this study.

First visit (on 1st week), second visit (on 2nd week), third visit (on 3rd week), fourth visit (on 4th week), and last visit (on 6th week)

Final follow up after 6 weeks regarding safety and efficacy

Assessment points: Pain, Tenderness, Swelling and Joint motility

The patients were examined weekly, and suitable scoring pattern and objective signs were recorded to assess any change present in the patients. The initial findings were considered as baseline score, and subsequent scores at first visit (on 1st week), second visit (on 2nd week), third visit (on 3rd week), fourth visit (on 4th week), and last visit (on 6th week) were recorded. After completion of 6 weeks of the treatment, the efficacy of the therapy was assessed on the basis of the subjective criteria as stated below.

A validated modified version of the WOMAC questionnaire suitable for Indian patients and available in several Indian languages was used. Patients provided categorical answers for scoring (none = 0, mild = 1, moderate = 2, severe = 3, extreme = 4)

For nature of swelling assessment was carried out as follows

Joint swelling to a maximity abnormal degree= 4, markedly abnormal swelling=3, joint swelling obvious even on casual observation=2, joint swelling which may not be apparent on casual inspection, but should be recognizable to experienced examine=1, no swelling=0.


Oil ingredients: Arthrohills oil / Ayurvedic proprietary medicine (for external use only)

Each 100 ml oil contains – (BPN- Bhavprakash Nighantu)

SN Contents Latin name Reference
1. Nirgundi oil Vitex negundo BPN pg. No. 329 (20 ml)
2. Nilgiri oil Eucalyptus globulus BPN pg. No. 804 (6.6ml)
3. Dhatura oil Datura stramonium BPN pg. No. 304 (5ml)
4. Erand oil Ricinus communis BPN pg. No. 286 (5.5 ml)
5. Lemon grass oil Cymbopogon citratus BPN pg. No.370 (5 ml)
6. Kalonji oil Nigella sativa BPN pg. No. 32 (5 ml)
7. Proprietary blend Syzygium aromaticum, Cinnamomum zeylanicum, Myristica fragrans, Cinnamomum tamala, Trachyspermum ammi, Sesamum indicum BPN pg. No. 209, 216, 206, 218, 25, 639 (5ml)
8. Kapur oil Cinnamomum camphora BPN pg. No. 168 (10ml)
9. Gandhapura Tail Gaultheria fragrantissima BPN pg. No. 809 (28 ml)
10. Gandhabiroja tail Pinus longifolia (sap) BPN pg.no. 189 (5 ml)
11. Til oil Sesamum indicum BPN pg. No. 639 (4.9 ml)

Results and Discussion

The key objective of this study was to evaluate the efficacy of Arthohills oil external application in the management of musculoskeletal pain.

Table 1: Age wise distribution

Age Group Frequency Percentage
20-30 Years 11 22.92%
31-40 Years 20 41.67%
41-50 Years 11 22.92%
51-60 Years 5 10.42%
> 60 Years 1 2.08%
Total 48 100.00%

Table 2: Gender wise distribution

Gender Frequency Percentage
Male 26 54.17%
Female 22 45.83%
Total 48 100.00%

Table 3: Occupation wise distribution

Occupation Frequency Percentage
Housewife 1 2.08%
Service 31 64.58%
Student 15 31.25%
Retired 1 2.08%
Total 45 93.75%



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Mandlecha A et al: Safety and Efficacy of Arthrohills oil with Musculoskeletal Pain

Table 4: Effect on subjective parameters

Parameters Mean Median SD Wilcoxon W P-Value % Effect Result
BT AT BT AT BT AT
Pain 3.73 0.42 4.00 0.00 0.49 0.50 -6.308b 0.0000028 88.83 Sig
Tenderness 2.77 0.00 3.00 0.00 0.81 0.00 -6.135b 0.0000085 100.00 Sig
Swelling 3.02 0.17 3.00 0.00 0.64 0.38 -6.402b 0.0000015 94.48 Sig
Joint motility 4.00 0.63 4.00 1.00 0.00 0.57 -6.207b 0.0000054 84.38 Sig
Stiffness 2.81 0.00 3.00 0.00 0.79 0.00 -6.127b 0.0000090 100.00 Sig

Since observations are on ordinal scale (gradations), we have used Wilcoxon Signed Rank Test to test efficacy. From above table, we can observe that, P-Value for all parameters is less than 0.05. Hence, we can conclude that, effect observed in all parameters is significant.

jaims_2533_01.JPGFigure 1: Efficacy Post Treatment

Table 5: Pain assessment during follow-ups.

Pain Mean SD % Change
1 week 3.73 0.49 -
2 weeks 3.33 0.69 10.61
3 weeks 2.67 0.66 28.49
4 weeks 1.85 0.58 50.28
5 weeks 0.88 0.57 76.54
6 weeks 0.42 0.50 88.83

jaims_2533_02.JPGFigure 2: Follow Up wise improvement in Pain


Table 6: Tenderness assessment during follow-ups.

Tenderness Mean SD % Change
1 week 2.77 0.81 -
2 weeks 2.29 0.85 17.29
3 weeks 1.54 0.50 44.36
4 weeks 0.75 0.44 72.93
5 weeks 0.31 0.47 88.72
6 weeks 0.00 0.00 100.00

jaims_2533_03.JPGFigure 3: Follow Up wise improvement in Tenderness

Table 7: Swelling assessment during follow-ups.

Swelling Mean SD % Change
1 week 3.02 0.64 -
2 weeks 2.25 0.53 25.52
3 weeks 1.42 0.82 53.10
4 weeks 1.02 0.56 66.21
5 weeks 0.21 0.41 93.10
6 weeks 0.17 0.38 94.48

jaims_2533_04.JPGFigure 4: Follow Up wise improvement in Swelling.

Table 8: Joint mobility assessment during follow-ups.

Joint Mobility Mean SD % Change
1 week 4.00 0.00 -
2 weeks 4.00 0.00 0.00
3 weeks 3.04 0.20 23.96
4 weeks 2.00 0.00 50.00
5 weeks 2.00 0.00 50.00
6 weeks 0.63 0.57 84.38

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Mandlecha A et al: Safety and Efficacy of Arthrohills oil with Musculoskeletal Pain

jaims_2533_05.JPGFigure 5: Follow Up wise improvement in Joint Mobility

Table 9: Stiffness assessment during follow-ups.

Stiffness Mean SD % Change
1 week 2.81 0.79 -
2 weeks 2.21 0.77 21.48
3 weeks 1.58 0.54 43.70
4 weeks 0.79 0.46 71.85
5 weeks 0.31 0.47 88.89
6 weeks 0.00 0.00 100.00

jaims_2533_06.JPGFigure 6: Follow Up wise improvement in Stiffness

Composition of Arthohills oil is collectively having properties of reduction of pain, reduction of inflammation properties.

Conclusion

Arthohills oil was safe and effective in musculoskeletal pain.

Reference

1. Vidya Ratan, Hand book of preventive and social medicine, 9th edition, New Delhi: Jaypee Brother’s Medical publishers (p) Ltd; 2010.


2. Vos T, Abajobir AA, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–1259.

3. WHO. Musculoskeletal Conditions. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions. Published 2019. Accessed July 17, 2020.

4. Uhl RL, Roberts TT, Papaliodis DN, Mulligan MT, Dubin AH. Management of chronic musculoskeletal pain. J Am Acad Orthop Surg 2014;22:101 10.

5. Bedson J, Mottram S, Thomas E, Peat G. Knee pain and osteoarthritis in the general population: what influences patients to consult? Fam Pract. 2007;24:443–453.


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