The Efficacy of Different Modalities of External Oleation Therapy on Pain in Patients of Osteoarthritis of the Knee Joints: A Randomized, Open-Label, and Parallel-Groups Clinical Trial

Introduction: This clinical trial assessed the effectiveness of four Ayurvedic external oleation ( Bahya Snehana ) therapies, including Abhyanga (oil massage), Seka (oil pouring), Pichu (oil-soaked cloth), and Bahaya Basti (localized oil pooling) in managing pain and disability in osteoarthritis (OA) of the knee, based on the Ayurvedic concept of Sandhigatavata (OA). Methods: An open-label randomized clinical trial was conducted on 120 patients diagnosed with knee OA, who were randomly allocated into four groups of 30 each. Each group received one type of external oleation therapy for 14 consecutive days, following standard Panchakarma procedures. The follow-ups were done on the 15 th and 30 th days. The outcome measures included the Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI), and the Medical Outcomes Study Short Form-36 (SF-36). Results: The average age of participants was 52.6 years (±7.43 standard deviation). All groups showed statistically significant improvement ( P < 0.05) in pain and functional outcomes. Percentage improvement in VAS was: Abhyanga 29.93%, Seka 32.38%, Pichu 45.17%, and Bahaya Basti 45.59%. ODI scores improved most in the Pichu group (42.84%), with moderate changes in others (around 21.82%). SF-36 scores also reflected improved quality of life. No adverse events were reported. Conclusion: Topical oleation therapies are effective and safe for managing knee OA, with Pichu and Bahaya Basti offering superior results. These findings suggest a potential role for integrating Ayurvedic external therapies into comprehensive OA knee management strategies across the healthcare systems.