Efficacy of Habb-e-Hindi in low back pain: a comparative clinical trial with historical control
Background: Low Back Pain is one of the common conditions encountered in clinical practice. An estimated 65% to 80% of population will experience it during lifetime. As far as the various documented side effects of analgesics and NSAIDs have been concerned, complementary and alternative treatment options have, therefore, gained popularity. In Unani classical literature, Habb-e-Hindi is being indicated for joint’s pain in general and can be evaluated as safe, effective and alternative treatment of LBP.
Methods: This historical control clinical trial testing the superiority of Habb-e-Hindi with Unani formulation used in previous study carried out at NIUM Hospital, Bengaluru. The comparison of the efficacy was made between the test group and historical control group. Primary outcome measures were improvement in LBP (VAS in NRS) and the secondary outcome measures included improvement in QOL (ODI scores and QBPDS scores). Data were analyzed by using Fisher’s Exact/Chi-Square/Repeated measures and One-way ANOVA with Tukey post hoc multiple comparison test for both intergroup and intragroup comparisons.
Results: The test and the control group both equally had significant results. Test drug showed better results (in VAS). LBP associated disability (in ODI) got reduced significantly in control group as compared to the test group. The Significant Disability Change (in QBPDS) was recorded in all 20 patients of the control group as compared to that of the test group where only 4 patients showed significant reduction.
Conclusions: The results of this study suggest that the Unani formulations are effective in the treatment of Low back pain.
Aruna N, Rajeshwari T, Rajangam S. Transmission of the weight through the neural arch of lumbar vertebrae in man. J Anat Soc India. 2003;52(2):128-31.
Asmussen E. The weight-carrying function of the human spine. Acta Orthopaedica Scandinavica. 1959;29(1-4):276-90.
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.
Ly DP. Evaluation and Treatment Patterns of New Low Back Pain Episodes for Elderly Adults in the United States, 2011–2014. Medical Care. 2020;58(2):108-13.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis Care Res. 2011;63(S11):S240-52.
Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000.
Kopec JA, Esdaile JM, Abrahamowicz M, Abenhaim L, Wood-Dauphinee S, Lamping DL, et al. The Quebec back pain disability scale: conceptualization and development. Journal of clinical epidemiology. 1996;49(2):151-61.
Tadayon M, Movahedi S, Abedi P, Syahpoosh A. Impact of green tea extract on serum lipid of postmenopausal women: A randomized controlled trial. J Traditional Complementary Med. 2018;8(3):391-5.
Munjal YP. API Text Book of Medicine. 9th ed. Mumbai: The Association of Physicians of India; 2012:1813-1814,1816,1817.
Williams NS, Bulstrode CJK, O’Connell PR, Bailey & Love’s Short Practice of Surgery. 25th ed. London: Hodder Education, Hachette UK company; 2008:467-471.
Fauci AS, Kasper DL, Longo DL, Braunwala E, Hauser SL, Jameson JL. Harrison’s principles of internal medicine. Vol-I 19th Edition. New Delhi: McGraw-Hill Companies; 2015:107-115.
Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Vol. 2nd. New Delhi. Ajanta Offset; 2004:2376.
Biglarian A, Seifi B, Bakhshi E, Mohammad K, Rahgozar M, Karimlou M, et al. Low back pain prevalence and associated factors in Iranian population: findings from the national health survey. Pain research and treatment. 2012.
Henn L, Schier K, Brian T, Hardt J. Back pain in Poland and Germany: a survey of prevalence and association with demographic characters. BioMed Research International. 2014,
Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Revista de saude publica. 2015;49:73.
Jurjani I. Zakhira Khawarizm Shahi. (Urdu translation by Khan HH). Vol-6. Lucknow: Munshi Naval Kishore; 1903.
Ibn Sina Abu Ali. Al-Qanoon fil Tibb (Urdu translation by Ghulam Ḥasnain Kanturi). New Delhi: Idara Kitabus Shifa; YNM: 165-206, 373-375, 1117-1129.
Anthony SF, Dennis LK, Dan LL, Eugene B, Stephen LH, Larry JJ, et al. Harrison's Principles of Internal Medicine. 17th ed. USA. The Mc Graw-Hill Companies; 2008:207-209.
Chawla J. Low back pain and sciatica. Medscape. Aug. 2018;22.
Chou YC, Shih CC, Lin JG, Chen TL, Liao CC. Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: a population-based study. J Rehabilitation Med. 2013;45(1):76-80.
Jablonska B, Soares JJ, Sundin Ö. Pain among women: associations with socio-economic and work conditions. European J Pain. 2006;10(5):435-47.
Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine. 2003;28(11):1195-202.
Chou L, Brady SR, Urquhart DM, Teichtahl AJ, Cicuttini FM, Pasco JA, et al. The association between obesity and low back pain and disability is affected by mood disorders: a population-based, cross-sectional study of men. Medicine. 2016;95(15).
Dijken CB, Fjellman-Wiklund A, Hildingsson C. Low back pain, lifestyle factors and physical activity: a population-based study. J Rehabilitation Med. 2008;40(10):864-9.
Humes HD, DuPont HL, Gardner LB, editors. Kelley's textbook of internal medicine. 4th ed. Philadelphia (USA): Lippincott Williams & Wilkins; 2000:1332-38.
Baghdadi IH. Kitab al-Mukhtarat Fil Tibb (Urdu Translation). Part 4. New Delhi: CCRUM; 2004:96-98.
Andersson GBJ. The Epidemiology of Spinal Disorders. In Frymoyer JW (ed.) The Adult Spine: Principles and Practice. Philadelphia, Lippincott-Raven, 1997:93-141.
Bishwajit G, Tang S, Yaya S, Feng Z. Participation in physical activity and back pain among an elderly population in South Asia. J Pain Res. 2017;10:905.
Bindra S, Sinha AG, Benjamin AI. Epidemiology of low back pain in Indian population: a review. Int J Basic Appl Med Sci. 2015;5(1):166-79.
Maseehi AAIQ. Kitabul Umda fil Jarahat (Urdu translation by CCRUM). Vol-I. New Delhi: Ministry of Health and Family Welfare, Govt. of India. YNM:36-39.
Firestein GS, Budd RC, Gabriel SE, Mclnnes LB, O’ Dell JR. Kelly’s Textbook of Rheumatology. 9th ed. Vol-1. Philadelphia: Elsevier; 2013:665.
Sebastian D. Principles of Manual Therapy. 2nd ed. City. Jaypee Brothers Medical Publishers (P) LTD; 2013:96.
Allegri M. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000 Research. 2016;5.
Apkarian AV. Definitions of nociception, pain, and chronic pain with implications regarding science and society. Neuroscience letters. 2019;702:1-2
Da Silva JAP, Rheumatology in Practice. Springer-Verlag, London, 2010:19-22.
Sina I. Kulliyate Qanoon Vol-1 (Urdu Translation by HKM Kabeeruddin) Aijaz Publication House; New Delhi. 2006:200-207.
Sina I. Al-Qanoon Fit-Tib (English Translation by Department of Islamic Studies Jamia Hamdard). Book I. Hamdard University, New Delhi, 1983:177-181.
Tashani O, Johnson M. Avicenna’s concept of pain. Libyan Journal of Medicine. 2010;5(1):5253.