Abstract

Introduction: Knee osteoarthritis (OA), the most common type of age-related degenerative arthritis, affects more than fourteen million people in the United States. Due to the unavailability of an optimum safe, and effective medication for the disease and the global trend toward natural medicaments originating from Complementary and Alternative Medicine (CAM), we aimed to formulate and investigate a topical formulation from Traditional Persian Medicine (TPM) known as Brassica nigra oil in patients with knee OA.

Methods: Brassica nigra oil obtained from the direct cold press method was formulated as a topical cream. Thirty patients with knee OA participated in the study one week after receiving an intra-articular injection of Hyaluronic acid 2% as standard treatment. Fifteen patients used 5 g of Brassica nigra cream topically twice daily for one month, while the 15 patients used cold cream as a placebo similarly. Patients were evaluated clinically and were asked to fill in the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and McGill Pain Questionnaire (MPQ) at the beginning and 4, 12 weeks later.

Results: Although there were significant differences between VAS, WOMAC, and MPQ between baseline and 4th week within both groups, a significant improvement was observed between the 4th and 12th week just in the drug group. Moreover, there was a remarkable difference between groups in both of the time intervals (p < 0.001). No adverse effects were reported during the study interval.

Conclusion: This study confirms the efficacy and safety of Brassica nigra cream in knee OA. Brassica nigra phenolic and flavonoid content might be responsible for analgesic and antiinflammatory properties. This formulation can be considered a natural product in the management of patients with knee OA after more in vitro and in vivo studies.

Keywords: Osteoarthritis, Brassica nigra, persian medicine, clinical trial, McGill Pain Questionnaire (MPQ), patients