Unani Regimenal Approaches for Pain, Function and Quality of Life in Knee Osteoarthritis: A Rapid Scoping Review of Current Evidence

Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disorder that leads to chronic pain and disability. Conventional therapies provide only limited long-term relief and are often associated with adverse effects and high cost. In Unani medicine, KOA is closely related to Wajaʹ al-Rukba, categorized under joint disorders, and managed through various regimenal therapies. Objective: This scoping review aimed to evaluate the effectiveness of Unani regimenal therapies in the management of KOA. Methods: A systematic search was conducted across PubMed, Google Scholar, and other relevant databases for studies published between January 2009 and March 2024. Keywords included “Knee osteoarthritis, Wajaʹ al-Rukba, Unani medicine, Greco-Arab medicine.” Eligible studies consisted of clinical trials, observational studies, and case studies assessing outcomes such as the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: A total of relevant Unani regimenal therapies were identified, including Hijama (cupping), Dalk (massage), Tadhīn (oiling), Takmīd (fomentation), Ḍimād (poultice), Irsaal-e-‘Alaq (leech therapy), and Qai (emesis). Across multiple studies, these therapies demonstrated statistically significant improvements in pain reduction and functional outcomes (p<0.001 in several trials). Notably, no major adverse effects were reported. Conclusion: Existing evidence suggests that Unani regimenal therapies are effective and safe in improving pain and function among KOA patients. However, most studies to date are small-scale, single-center, and methodologically heterogeneous. Larger, well-designed randomized controlled trials are needed to validate these findings and establish Unani therapies as cost-effective, complementary options in KOA management. Keywords: Wajaʹ al-Rukba, Unani medicine, Cupping, Massage, Fomentation, Traditional medicine