Indigenous knowledge and treatment practices for post-traumatic joint stiffness and soft tissue contracture using ischial callosities of Papio hamadryas in rural and urban communities of Tigray-Ethiopia

Immobilization of human joints for extended periods, often lasting weeks or longer, can lead to stiffness and contracture. In recent years, various modern treatment modalities have been developed to address joint stiffness and soft tissue contracture. However, in many developing countries, traditional treatments involving plants and animal products remain popular due to their accessibility and affordability. The present study aims to assess the indigenous knowledge and treatment practices for post-traumatic joint stiffness and soft tissue contracture, using the ischial callosities of Papio hamadryas, among residents in both rural and urban communities of Tigray. A survey was conducted across two zonal areas between October 1 and January 30, 2023. A total of 34 male traditional healers, selected based on their expertise in treating musculoskeletal disorders with Papio hamadryas's ischial callosities, were interviewed using a structured questionnaire. The questionnaire collected information on the preparation process, dosage, efficacy, duration of treatment, and any adverse side effects experienced by patients. According to the survey responses, the age distribution of the traditional healers was as follows: 2.9% were aged 41–50, 67.6% were aged 51–60, and 29.4% were over 60 years old. Educationally, 50% of the healers had no formal education, 35.3% had completed primary school, 11.8% had secondary education, and 2.9% had post-secondary qualifications. In terms of the treatment methods used, 8.8% of the healers applied the ischial callosities as a defined ointment, 32.4% used the whole material along with its skin, and 58.8% applied pieces of the callosities along with the skin, securing them with available coverings. Regarding monitoring the progress of treatment, 58.8% of the healers checked the range of motion twice a week, 26.5% checked three times a week, and 14.7% checked daily until the maximum range of motion restored. Based on the responses, 76.5% of the healers reported that patients showed significant improvement (near-complete healing) within one month, while 23.5% noted progress within two months. Regarding the potential adverse effects associated with the use of the material, 28.6% of respondents replied 'yes,' providing some form of justification, while 71.4% responded 'no,' opposing any adverse side effects (absence of significant observable harm) from the material. These data show that a system of indigenous knowledge in a particular traditional culture, may disprove or potentially utilized as an alternative for managing post-traumatic joint stiffness and soft tissue contracture, Therefore, it is crucial to conduct further scientific research to validate these traditional claims.