Synergistic effect of Majoon-e-Suranjaan and isometric exercises in improving rheumatoid arthritis

The study aimed to evaluate the synergistic effects of Majoon-e-Suranjaan with and without isometric exercises in patients with rheumatoid arthritis (RA).

A prospective, pragmatic, community based, parallel group, single blinded randomized controlled trial conducted at Muhammad Physical Therapy and Rehabilitation Clinic and Rehabilitation Centre, Multan, from May to October 2023. The trial was approved and registered in the Iranian Registry of Clinical Trials (IRCT20230202057310N5). Ninety-five patients were randomly assigned to two groups. Group A received Majoon-e-Suranjaan (5 g orally, twice daily). Group B received the same dosage of Majoon-e-Suranjaan along with The isometric exercises. The exercise protocol for group B consisted of three weekly sessions, each lasting 40 minutes. Patients were evaluated at baseline and at the 24^th week based on serological markers, including rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), disease activity score (DAS), and C-reactive protein (CRP), as well as X-ray findings such as nodules and bone degeneration in affected joints. Pain, morning stiffness, and functional activities were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Numerical Pain Rating Scale (NPRS).

Of the 95 patients randomized, 90 completed the 24-week treatment. Among them, 60 (66.6%) were female, and 30 (33.3%) were male. Group B showed significantly greater improvements compared to Group A in in WOMAC activities of daily living (P=0.001), WOMAC stiffness (P=0.004), WOMAC pain and DAS (P=0.000), NPRS (P=0.001). Additionally, Group B demonstrated significant improvements in RF (P=0.001), ESR (P=0.002), and CRP (P=0.003) compared to group A.

This study demonstrated the synergistic effect of Majoon-e-Suranjaan and isometric exercises in RA patients, highlighting the potential for more effective RA treatment strategies.