Concept of Waja al-Mafasil (Osteoarthritis) in the Unani system of medicine

Osteoarthritis is the second most common musculoskeletal problem in the world (30%) after backache (50%), and the leading cause of disability, especially in the elderly, with a high prevalence rate. It affects over 250 million people worldwide. It is more common in women than in men. In India, nearly 80% of the population shows osteoarthritis among the patients who complained of knee pain, out of which approximately 20% reported incapability in daily activities, and around 11% need specialized care. The incidence of Knee osteoarthritis increased 10-fold between the ages of 30 and 65 years. The clinical picture of osteoarthritis strongly resembles Waja al-Mafasil , which is an Arabic term that stands for Waja’ , meaning Pain and Mafasil , the joints. Hence, the literal meaning of Waja al-Mafasil is pain in joints. Generally, the cause of this pain is Su-e-mizaj (impaired temperament) ; this Su-e-mizaj is either Sada (only qualitative imbalance in humour) or Mad’di (abnormal substantial temperament). Clinical features of Waja al-Mafasil mainly depend upon the predominance of Akhlat (humours). In the Unani system of medicine, Waja-ul-Mafasil are treated by nonpharmacological and pharmacological measures. The general principle of management is Ta’adil-e-Mizāj (normalization of temperament), Tanqiya-e-Mawād-e-Fāsida (evacuation of morbid matter), and Taqwiyat-e-A ‘ḍā-e-Marīḍa (strengthening of the affected organs). A comprehensive review of classical Unani literature and contemporary medical texts, supported by peer-reviewed research articles from indexed journals, was undertaken to explore the concept of Osteoarthritis in Unani medicine.