Ethnobotanical Insights into Medicinal Plants Used for Joint Pain Management by the Indigenous Population of Ilam Province, West of Iran
Abstract
Joint pain is a prevalent symptom affecting millions worldwide, often resulting from inflammatory or non-inflammatory conditions such as arthritis and arthralgia. Conventional treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, often lead to adverse effects, increasing the demand for alternative therapies. Ethnobotanical studies provide valuable insights into traditional medicinal practices, helping to bridge the gap between folk medicine and modern pharmacology. This study aimed to document medicinal plants used by the indigenous population of Ilam Province, Iran, for joint pain management. A cross-sectional ethnobotanical survey was conducted in Ilam City between April and November 2024. Data were collected through face-to-face interviews and structured questionnaires administered to 25 traditional healers, selected based on their expertise and long-standing practice in herbal medicine. Herbarium specimens of the cited plants were collected and authenticated at the Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences. Quantitative analyses, including the Usage Report Index (UR) and Relative Frequency of Citation (RFC), were employed to evaluate the cultural significance and therapeutic relevance of the identified species. The results revealed 20 medicinal plant species across 15 botanical families used in joint pain management. The Asteraceae family emerged as the most frequently utilized, with aerial plant parts being predominantly employed (29%) and decoction (35%) as the primary method of preparation. Notable species include Syzygium aromaticum (L.) Merr. & L.M.Perry, Olea europaea L., Nigella sativa L., and Salvia Rosmarinus Spenn., each recognized for their anti-inflammatory, analgesic, and antioxidant properties. This study documented the rich ethnobotanical heritage of Ilam Province, highlighting its potential as a source of effective, natural treatments for joint pain. The findings underscore the urgent need for conservation of traditional knowledge and further phytochemical and pharmacological investigations to validate and potentially commercialize these herbal remedies, bridging traditional practices with modern evidence-based medicine.
Ekediegwu EC, Akpaenyi CE, Nwosu IB, Onyeso OK. Demographic and disease characteristics associated with pain intensity, kinesiophobia, balance, and fall self-efficacy among people with osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2022;23:544.
Gates LS, Cherry L, Grønne DT, Roos EM, Skou ST. The prevalence of foot pain and association with baseline characteristics in people participating in education and supervised exercise for knee or hip osteoarthritis: a cross‐sectional study of 26,003 participants from the GLA: D® registry. J Foot Ankle Res 2023;16:83.
Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Casp J Intern Med 2011;2:205-210.
Fan Z, Yan L, Liu H, Li X, Fan K, et al. The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Res Ther 2023;25:51.
Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 2009;11:1-16.
World Health Organization. Osteoarthritis. 2023 [cited 2025 Jan 24]. Available from: https://www.who.int/news-room/fact-sheets/detail/osteoarthritis.
World Health Organization. Musculoskeletal Health. 2022 [cited 2025 Jan 24]. Available from: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions.
Long H, Liu Q, Yin H, Wang K, Diao N, et al. Prevalence trends of site‐specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019. Arthritis Rheumatol 2022;74:1172-1183.
Asghari KM, Zahmatyar M, Seyedi F, Motamedi A, Zolfi M, et al. Gout: global epidemiology, risk factors, comorbidities and complications: a narrative review. BMC Musculoskelet Disord 2024;25:1047.
Adamson J, Ebrahim S, Dieppe P, Hunt K. Prevalence and risk factors for joint pain among men and women in the West of Scotland Twenty-07 study. Ann Rheum Dis 2006;65:520-524.
Kidd BL. Osteoarthritis and joint pain. Pain 2006;123:6-9.
Kawai K, Kawai AT, Wollan P, Yawn BP. Adverse impacts of chronic pain on health-related quality of life, work productivity, depression and anxiety in a community-based study. Fam Pract 2017;34:656-661.
Agaliotis M, Fransen M, Bridgett L, Nairn L, Votrubec M, et al. Risk factors associated with reduced work productivity among people with chronic knee pain. Osteoarthritis Cartilage 2013;21:1160-1169.
Conduah AH, Baker III CL, Baker Jr CL. Managing joint pain in osteoarthritis: safety and efficacy of hylan GF 20. J Pain Res 2009;2:87-98.
Palmer T, Toombs JD. Managing joint pain in primary care. J Am Board Fam Pract 2004;17(Suppl 1):S32-S42.
Lindler BN, Long KE, Taylor NA, Lei W. Use of herbal medications for treatment of osteoarthritis and rheumatoid arthritis. Medicines 2020;7:67.
Ziaei A, Sahranavard S, Faizi M. Topical herbal remedies for treatment of joint pain according to Iranian Traditional Medicine. 2016.
Joshi K, Harjpal L, Singh S. Ayurvedic approach to managing Joint Disorders: Case Studies. J Ayurveda Integr Med Sci 2024;9:239-246.
Banga P, Sarodea S, Bhosalea M. Ayurvedic approaches to joint pain management: a Kayachikitsa perspective.
Arnold MD, Thornbrough LM. Treatment of musculoskeletal pain with traditional Chinese herbal medicine. Phys Med Rehabil Clin N Am 1999;10:663-671.
Chen W-h, Liu X-x, Tong P-j, Zhan H-s. Diagnosis and management of knee osteoarthritis: Chinese medicine expert consensus (2015). Chin J Integr Med 2016;22:150-153.
Wang M, Liu L, Zhang CS, Liao Z, et al. Mechanism of traditional Chinese medicine in treating knee osteoarthritis. J Pain Res 2020;13:1421-1429.
Abolhassanzadeh Z, Aflaki E, Yousefi G, Mohagheghzadeh A. Medicinal plants for joint pain in traditional Persian medicine. Trends Pharm Sci 2016;2:2.
Wang Z, Efferth T, Hua X, Zhang X. Medicinal plants and their secondary metabolites in alleviating knee osteoarthritis: a systematic review. Phytomedicine 2022;105:154347.
Hooshmand Garehbagh L. An ethnobotanical review of medicinal plants traditionally used for diabetes management in southern Iran. J Biochem Phytomed 2025; 4:23-30.
J Alkhatib A, Abdi F. ethnobotanical study of medicinal plants used by traditional therapists for headache treatment in the Tafila Region, Jordan. Plant Biotechnol Persa 2026;8.
Baharvand-Ahmadi B, Bahmani M, Naghdi N, Saki K, Baharvand A, et al. Medicinal plants used to treat infectious and non-infectious diseases of skin and skin appendages in city of Urmia, northwest Iran. Der Pharmacia Lettre 2015;7:189-196.
Patel V, Acharya S. In vitro anti-urolithiatic activity of aqueous extract of macrotyloma uniflorum. Plant Biotechnol Persa 2025;7:140-149.
Kravchenko I, Eberle L, Nesterkina M, Kobernik A. Anti-inflammatory and analgesic activity of ointment based on dense ginger extract (Zingiber officinale). J Herbmed Pharmacol 2019;8:126-132.
Siddiqui MZ. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci 2011;73:255.
Afshar A. Concepts of orthopedic disorders in Avicenna's Canon of Medicine. Arch Iran Med 2011;14.
Ghasemi PA, Momeni M, Bahmani M. Ethnobotanical study of medicinal plants used by Kurd tribe in Dehloran and Abdanan districts, Ilam province, Iran. Afr J Tradit Complement Altern Med 2013;10:368-385.
Mirhashemi H, Pourbabaei H, Mezbani A. The effect of altitude on diversity and Species Importance Value (SIV) of herbaceous species in forests of Kabirkouh, Ilam. J Plant Res (Iran J Biol) 2020;33:1025-1036.
Poorbabaei H, Heydari M, Najafifar A. The relationship between plant diversity and physiographic factors in Ghalarang protected area, Ilam, Western Iran. In: Proc Global Conf Global Warming (GCGW). 2008.
Razmjoue D, Ezati M, Abbasi N, Pirhadi M, Shojaei B, et al. Ethnobotanical study of medicinal plants used by local population of Ilam city on back pain, West of Iran. Trad Integr Med 2024;9:289-297.
Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol 2014;4:177.
Mosavat SH, Pasalar M, Joulaei H, Ameli V. Complementary and alternative medicine use among people living with HIV in Shiraz, Southern Iran. Front Public Health 2023;11:1206665.
Nahin RL, Straus SE. Research into complementary and alternative medicine: problems and potential. BMJ 2001;322:161-164.
Jahromi B, Pirvulescu I, Candido KD, Knezevic NN. Herbal medicine for pain management: efficacy and drug interactions. Pharmaceutics 2021;13:251.
Hasan MK, Zanzabil KZ, Ara I, Rahman T, Kieu A. Herbal therapies for pain management: a scoping review of the current evidence. Phytochem Rev 2024;1-52.
Ishtiaq M, Sardar T, Hussain I, Maqbool M, Waqas Mazhar M, et al. Traditional ethnobotanical knowledge of important local plants in Sudhnoti, Azad Kashmir, Pakistan. Sci Rep 2024;14:22165.
Gentile C, Spampinato G, Patti M, Laface VLA. Contribution to the ethnobotanical knowledge of Serre Calabre (Southern Italy). Res J Ecol Environ Sci 2022;35:35-55.
Balkrishna A, Sharma N, Srivastava D, Kukreti A, et al. Exploring the safety, efficacy, and bioactivity of herbal medicines: bridging traditional wisdom and modern science in healthcare. Future Integr Med 2024;3:35-49.
Dasgupta SC. Bioactive compounds from medicinal plants and its therapeutic uses in the traditional healthcare system. In: Medicinal Plants: Biodiversity, Biotechnology and Conservation. Springer; 2023. pp. 525-537.
Anadka Y, Gulimane K. Ethnobotanical investigation on herbal remedies for musculoskeletal disorders in Dakshina Kannada district, Karnataka, India. Ethnobot Res Appl 2024;29:1-48.
Teng Y, Guo H, Liang Z, Shu Z. Ethnobotanical survey of medicinal plants and their utilization in Shaanxi Province, China. J Med Plants Res 2011;5:1762-1778.
Wambugu SN, Mathiu PM, Gakuya DW, Kanui TI, Kabasa JD, et al. Medicinal plants used in the management of chronic joint pains in Machakos and Makueni counties, Kenya. J Ethnopharmacol 2011;137:945-955.
Widyowati R, Purwitasari N, Ekasari W, Agil M, Sahu RK, et al. An ethnomedicinal study; joint pain therapy by traditional healers of Solo City. Trad Integr Med 2024;3:3-12.
Cortés-Rojas DF, de Souza CRF, Oliveira WP. Clove (Syzygium aromaticum): a precious spice. Asian Pac J Trop Biomed 2014;4:90-96.
Pramod K, Ansari SH, Ali J. Eugenol: a natural compound with versatile pharmacological actions. Nat Prod Commun 2010;5:1934578X1000501236.
Frumuzachi O, Gavrilaș LI, Vodnar DC, Rohn S, Mocan A, et al. Systemic health effects of oleuropein and hydroxytyrosol supplementation: a systematic review of randomized controlled trials. Antioxidants 2024;13:1040.
Bulotta S, Celano M, Lepore SM, Montalcini T, Pujia A, et al. Beneficial effects of the olive oil phenolic components oleuropein and hydroxytyrosol: focus on protection against cardiovascular and metabolic diseases. J Transl Med 2014;12:1-9.
Zielińska M, Dereń K, Polak-Szczybyło E, Stępień AE. The role of bioactive compounds of Nigella sativa in rheumatoid arthritis therapy—current reports. Nutrients 2021;13:3369.
Shaterzadeh-Yazdi H, Noorbakhsh M-F, Hayati F, Samarghandian S, Farkhondeh T, et al. Immunomodulatory and anti-inflammatory effects of thymoquinone. Cardiovasc Haematol Disord Drug Targets 2018;18:52-60.
Oresanya IO, Orhan IE. Deciphering neuroprotective effect of Rosmarinus officinalis L. (syn. Salvia rosmarinus Spenn.) through preclinical and clinical studies. Curr Drug Targets 2024;25:330-352.
Brindisi M, Bouzidi C, Frattaruolo L, Loizzo MR, Tundis R, et al. Chemical profile, antioxidant, anti-inflammatory, and anti-cancer effects of Italian Salvia rosmarinus Spenn. methanol leaves extracts. Antioxidants 2020;9:826.
Patil K, Sanjay C, Doggalli N, Devi KR. A review of Calendula officinalis—magic in science. J Clin Diagn Res 2022;16:2.
Olennikov DN, Kashchenko NI. Marigold metabolites: diversity and separation methods of Calendula genus phytochemicals from 1891 to 2022. Molecules 2022;27:8626.
Ukiya M, Akihisa T, Yasukawa K, Tokuda H, Suzuki T, et al. Anti-inflammatory, anti-tumor-promoting, and cytotoxic activities of constituents of marigold (Calendula officinalis) flowers. J Nat Prod 2006;69:1692-1696.
Noreen S, Tufail T, Ul Ain HB, Awuchi CG. Pharmacological, nutraceutical, and nutritional properties of flaxseed (Linum usitatissimum): an insight into its functionality and disease mitigation. Food Sci Nutr 2023;11:6820-6829.
Shiekh RAE, Atwa AM, Elgindy AM, Mustafa AM, Magdy Senna M, et al. Therapeutic applications of eucalyptus essential oils. Inflammopharmacology 2025;33:163-182.
Alsamri H, Athamneh K, Pintus G, Eid AH, Iratni R. Pharmacological and antioxidant activities of Rhus coriaria L. (Sumac). Antioxidants 2021;10:73.
Kosar M, Bozan B, Temelli F, Baser K. Antioxidant activity and phenolic composition of sumac (Rhus coriaria L.) extracts. Food Chem 2007;103:952-959.
Akhtar MF, Raza SA, Saleem A, Hamid I, Ashraf Baig MMF, et al. Appraisal of anti-arthritic and anti-inflammatory potential of folkloric medicinal plant Peganum harmala. Endocr Metab Immune Disord Drug Targets 2022;22:49-63.
Moloudizargari M, Mikaili P, Aghajanshakeri S, Asghari MH, Shayegh J. Pharmacological and therapeutic effects of Peganum harmala and its main alkaloids. Pharmacogn Rev 2013;7:199-212.
El Khomsi M, Hmamou A, El Oubbadi R, El Houda Tahiri N, Kara M, et al. HPLC analysis and anti-inflammatory, antinociceptive, healing and antidepressant properties of Anchusa italica Retz extracts. Phytomed Plus 2024;4:100518.
Farsam H, Amanlou M, Dehpour AR, Jahaniani F. Anti-inflammatory and analgesic activity of Biebersteinia multifida DC. root extract. J Ethnopharmacol 2000;71:443-447.
Caliskan H, Argon M, Sabudak T. The genus Isatis L.: a review on its flavonoid and phenolic compound profile. Rec Agric Food Chem 2023;2:75-83.
Serafini M, Peluso I, Raguzzini A. Flavonoids as anti-inflammatory agents. Proc Nutr Soc 2010;69:273-278.
Yang LY, Li X, Huang W, Rao X, Lai Y. Pharmacological properties of indirubin and its derivatives. Biomed Pharmacother 2022;151:113112.
Alviri M, Bahadori MB, Bahadori S. Flavonoid and diterpenoid components from Teucrium orientale subsp. orientale and their radical scavenging activity. Biointerface Res Appl Chem 2022;12:682-689.
Jarić S, Mitrović M, Pavlović P. Ethnobotanical features of Teucrium species. Teucrium Species: Biology and Applications. 2020;111-142.
Saati S, Dehghan P, Azizi-Soleiman F, Mobasseri M. The effect of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in type 2 diabetes women: a blinded randomized controlled trial protocol. Trials 2023;24:35.
Browicz K, Zohary D. The genus Amygdalus L. (Rosaceae): species relationships, distribution and evolution under domestication. Genet Resour Crop Evol 1996;43:229-247.
Kaur M, Kalia A. Convolvulus arvensis: a useful weed. Int J Pharm Pharm Sci 2012;4:38-40.
Pirbalouti AG, Amirkhosravi A, Bordbar F, Hamedi B. Diversity in the chemical composition of essential oils of Ziziphora tenuior as a potential source of pulegone. Chemija 2013;24:234-239.
Šmejkal K, Malaník M, Zhaparkulova K, Sakipova Z, Ibragimova L, et al. Kazakh Ziziphora species as sources of bioactive substances. Molecules 2016;21:826.
Ayromlou A, Masoudi S, Mirzaie A. Chemical composition, antioxidant, antibacterial, and anticancer activities of Scorzonera calyculata Boiss. and Centaurea irritans Wagen. J Rep Pharmaceutical Sci 2020;9:118-127.
| Issue | Vol 10, No 4, 2025 -In Press- | |
| Section | Research Article(s) | |
| Keywords | ||
| Joint pain Arthralgia Arthritis Ethnobotany Medicinal plants Traditional medicine Iran | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
