Ethnomedicinal Plants Used for Arthritis Management: A Critical Global Review

Abstract

Arthritis, encompassing osteoarthritis, rheumatoid arthritis and related inflammatory joint disorders, remains one of the principal causes of chronic pain and disability worldwide, with prevalence rising in tandem with population ageing and increasing rates of obesity. Conventional pharmacotherapy, while effective for many patients, is constrained by incomplete symptom control, treatment non-response and a recognised burden of gastrointestinal, hepatic, renal and cardiovascular adverse effects associated with long-term use of non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, glucocorticoids and biologic agents. Against this backdrop, ethnomedicinal plant use for arthritis management persists across virtually every inhabited continent and continues to inform both complementary practice and pharmaceutical innovation. This review synthesises evidence drawn from ethnobotanical surveys, phytochemical investigations, preclinical pharmacology and clinical trials concerning plants traditionally used for joint disorders, with particular attention to South Asia, East and Southeast Asia, sub-Saharan Africa, Latin America, and the Middle East and North Africa. Recurrent taxa across geographically and culturally distinct healing traditions include turmeric, frankincense, ginger, devil's claw, guduchi and ashwagandha, among numerous regionally specific species. Mechanistic convergence is evident at the level of nuclear factor-kappa B signalling, cyclooxygenase and lipoxygenase inhibition, cytokine modulation and osteoclastogenic suppression, suggesting that independently developed traditions have, in many instances, identified pharmacologically plausible remedies. Clinical evidence for several priority species is encouraging, although heterogeneity in extract standardisation, dosing and trial design limits definitive conclusions. Safety considerations, herb–drug interaction risk, sustainability of wild-harvested resources and the absence of harmonised quality control remain substantial barriers to safe integration into mainstream rheumatological care. The review concludes that ethnomedicinal knowledge constitutes a scientifically valuable, though still incompletely validated, resource for arthritis management, warranting rigorous, adequately powered clinical investigation and parallel efforts in conservation and standardisation.