Assessment of Systemic Inflammatory and Metabolic Markers in Patients of Waja’ al-Rukba (Knee Pain): A Clinical Laboratory-Based Study

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Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability in older adults. Knee osteoarthritis, a major subtype, closely resembles Waja’-al-Rukba described in Unani medicine, both sharing chronicity, pain, stiffness, and restricted mobility. Unani scholars attribute its origin to Sū’-i-Mizāj (abnormal temperament) and accumulation of Mawād-e-Fuzūni (morbid material) in joints.

Our aim is to evaluate the relationship between Mizāj (temperament) and biochemical markers of inflammation and metabolism (CRP, uric acid, BMI) in patients with Waja’-al-Rukba (knee pain), and to assess their role in disease risk and progression.

A cross-sectional study was conducted on 75 patients (aged 40–80 years) attending the OPD and IPD of of Ilaj bit Tadbeer and Moalejat in Ajmal Khan Tibbiya College and hospital, Ajmal Khan Tibbiya College, AMU, Aligarh. Mizāj was assessed using standard Unani parameters. Laboratory investigations included ESR, CRP, uric acid and BMI.

In our study we have find that most of the patients (76%) were aged between 40–50 years with females predominance (89%). Balghamī Mizāj (phlegmatic) was the most common temperament (41%), followed by Ṣafrāwī (27%), Damawī (20%), and Sawdāwī (12%). Balghamī individuals had the highest mean BMI (27–29.6 kg/m²) and mean uric acid level (5.98 ± 0.9 mg/dl). CRP positivity was also highest in the Balghamī group (12 cases). These findings indicate a strong association of Balghamī Mizāj with obesity, hyperuricemia, and inflammation.

The study demonstrates a significant correlation between Mizāj (temperament) and metabolic–inflammatory markers, validating Unani concepts through modern biomedical parameters. Balghamī temperament predisposes individuals to inflammatory and metabolic derangements such as osteoarthritis, supporting the integration of Unani temperament-based assessment in preventive and therapeutic frameworks.