Changes in Inflammatory and Haematological Markers Following Castor Oil Pack Therapy in a Woman with Rheumatoid Arthritis: A Case Report

Aims: To describe the clinical and laboratory course of a woman with rheumatoid arthritis treated with castor oil packs for four weeks. Presentation of Case: A 36-year-old woman with a one-year history of polyarthritis, positive for rheumatoid factor and meeting the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria, declined conventional pharmacological treatment and chose naturopathic care. She applied castor oil packs at home to the abdomen with hot fomentation and to the affected joints with a hot, moist cloth, for 1 hour per session, 5 days a week for 4 weeks, alongside a balanced diet and pranayama. Between baseline and week 4, the erythrocyte sedimentation rate decreased from 65 to 24 mm/h, C-reactive protein from 1.2 to 0.3 mg/dL and total leucocyte count from 11,290 to 5,200 cells/mm³, and haemoglobin rose from 10.4 to 12.5 g/dL. Joint swelling resolved, and tenderness remained only in the elbows. Pain on the visual analogue scale decreased from 7 to 2. She reported less morning stiffness, and no adverse events were reported. She was then referred for rheumatological reassessment. Discussion: The changes observed suggest that inflammation subsided, but no composite disease-activity score was calculated. Experimental data on topical ricinoleic acid, and the lack of effect of heat alone on these markers in controlled trials, make a contribution from the oil plausible; natural fluctuation, diet and pranayama could also explain the changes. Conclusion: These observations do not establish efficacy or disease control. They justify controlled evaluation of castor oil packs as a complementary measure alongside, not instead of, standard rheumatological care.