Baneh (P. atlantica) Ointment Improves Pain Associated with Knee Osteoarthritis

by | Mar 25, 2025 | 2025, Arthritis, Botanicals, Joint Health, Recent Articles

Written by Chrystal Moulton, Science Writer. Researchers observed as significant improvement in pain among those in the Baneh group compared to standard care (P=0.002).

kneeOsteoarthritis is a prevalent condition affecting older adults1. Symptom and pain relief is the most common method to manage osteoarthritis2,3. However, continued use of pain relievers such as NSAIDs have unwanted side effects long-term4. Pistacia atlantica Desf. (also known as Baneh or wild pistachio) has been used in Persian medicine to treat joint pain. Studies have shown that P. atlantica contains about 110 compounds that provide antioxidant, anti-inflammatory, and anti-nociceptive effects5. In the current trial, researchers investigated the effect of Baneh ointment versus standard topical treatment (diclofenac) on pain associated with osteoarthritis of the knee6.

The study was designed as a randomized, double-blind, placebo-controlled trial. Patients with knee osteoarthritis between 50-80 years old, who were suffering from knee pain for 3months were recruited for this study. Patients must not have been prescribed or using traditional or conventional medicines to be included in this study. They also needed to Visual Analog Scale (VAS) score between 3 to 8 and an osteoarthritis grade between 1 to 3 osteophytes based on Kellgren-Lawrence classification. Patients were excluded if they had rheumatic diseases, cognitive or mental disorders, skin diseases, and major chronic disease of the heart, liver, or kidney. Eligible participants were randomly assigned to standard treatment with diclofenac or Baneh ointment. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analog scale (VAS) was used to measure osteoarthritis symptoms (including stiffness/swelling [indicated as knee symptoms], pain intensity, difficulty performing activities of daily life [ADL’s], difficulty doing recreational activities, and change in quality of life) at baseline, 4th week of treatment, as well as 4 and 8 weeks after trial completion. The primary outcome was pain and secondary outcome was knee symptoms, physical activity, and quality of life. Safety assessments were completed at baseline, week 2 and 4 during treatment, and 4weeks after completion of the trial.

Ninety-two patients were randomly assigned to the treatment with Baneh ointment (n= 46) or standard treatment (n= 46) and 84 patients completed the trial [Baneh= 43, diclofenac= 41]. At baseline, no significant differences were observed between the groups. Four weeks into the study, researchers observed as significant improvement in pain among participants within each of their assigned group (P<0.001). Those in the Baneh group, however, had significantly better improvement in pain in both the VAS and KOOS scales (P≤ 0.001). Both groups had a significant improvement in quality of life (P<0.001). However, quality of life scores were significantly better in the Baneh group (P<0.009). Furthermore, within group values for knee symptoms as well as the ability to perform ADL’s and recreational activities were significant for both the Baneh and diclofenac group (P<0.001). However, no significant difference was observed in between groups for physical activity [ADLs and recreational activities] or knee symptoms[stiffness/swelling]. The use of painkillers during the trial did not differ significantly. Four weeks post-trial, all benefits gained during treatment period were no longer apparent, however, researchers noted it was still significantly better than baseline values. Specifically, measurements at 8 weeks was still significantly better than baseline, however, pain and ADLs were significantly better among patients in the Baneh group compared to standard of care (diclofenac). Participants reported itching following use of Baneh ointment and diclofenac. One patient in the diclofenac group reported increased pain.

Overall, the study demonstrated that Baneh ointment was more effective in reducing pain while improving physical activity and quality of life in patients with osteoarthritis of the knee. Additional studies will be needed to verify these findings.

Source: Azizi, Fatemeh, Narjes Gorji, Rahmatollah Jokar, Maedeh Rezghi, Hoda Shirafkan, and Reihaneh Moeini. “The effects of Pistacia atlantica Desf. fruit oil on primary knee osteoarthritis: A randomized controlled clinical trial.” Journal of Ethnopharmacology (2025): 119387.

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Posted March 25, 2025.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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