Management of Knee Osteoarthritis with integrative approach using Regimenal therapy (Massage and Medicated Steam Fomentation) and Pharmacotherapy (Habb-e -Muqil): A Case Study

Osteoarthritis (OA) is the most common progressive musculoskeletal disorder, that is characterized by pathological changes in cartilage, bone, synovium, ligament, muscle, and periarticular fat, leading to joint dysfunction, pain, stiffness, functional limitation, and loss of day to day life activities. It affects an estimated more than 240 million people worldwide. It can involve almost any joint but typically affects the hands, knees, hips, and feet. In India, 28.7% of adults ≥ 40 years of age and 45.5% of adults ≥ 60 years of age have KOA. The annual incidence rate of KOA in India is 2.4%. The management of KOA involves a comprehensive approach, including non pharmacological management, pharmacological management, and surgical management. In Unani medicine, KOA comes within the domain of a broader term, “Waja-ul-Mafasil”, which refers to joint pain. It occurs due to quantitative and qualitative derangement of Akhlat (humors) and derangement of optimal temperament (Mizaj). We present the case of a 48 year old male patient, who was presented to the OPD of Regimenal therapies at National Institute of Unani Medicine, Bengaluru. Patient complains of bilateral knee pain, stiffness, limited mobility and difficulty in daily activities since 3 years. Pain exaggerates on walking for more than 50 minutes and standing continuously for more than 30 minutes. The patient was assessed and examined clinically prior to intervention and was diagnosed with bilateral KOA, which was further accentuated by radiological investigations. The patient received treatment for 6 weeks. The patient was assessed using multiple assessment parameters at baseline, 3rd and 6th week. The patient reported improvement in both subjective and objective parameters. The study found that massage therapy and steam fomentation along with pharmacotherapy can be an effective approach in treatment for KOA, however it merits further research. Keywords: Osteoarthritis, joint pain, bilateral knee pain, stiffness, limited mobility