Comparing the Effects of Oleoresin of Pistacia atlantica Tree and Diclofenac Gel on the Knee Osteoarthritis Improvement

Background: Osteoarthritis (OA) is one of the most common chronic rheumatoid diseases, which affects the cartilage and tissue surrounding the joints. OAcauses pain and disabilityamongthe old population in most of the developing and developed countries. This disease does not have a definitive treatment, and a conventional treatment only controls the symptoms and pain. Pistacia atlantica cream can inhibit many of the enzymes involved in the inflammation process of OA. Objectives: The current study aimed at evaluating the effect of the topical cream of P. atlantica oleoresin on pain relief in patients with knee OA. Methods: P. atlantica cream formulated in the current study was used to reduce the pain, inflammation, and problems of patients with knee OA; it also descended the serious side effects of conventional therapies. The present clinical trial was conducted on 84 patients with knee OA (grade 2 or 3) parallelly for three-month periods, and diclofenac gel was used as a control drug in the same dosage and period. The formulation was analyzed for standardization with the gas chromatography–mass spectrometry apparatus. TheWestern Ontario and McMaster universities OA index questionnaire was used to assess the treatment trends. Results: The improvement trend was observed in both groups, while patients who received P. atlantica cream had a significantly higher rate of symptoms improvement than those receiving diclofenac gel (P < 0.05). Conclusions: P. atlantica cream significantly reduced pain and stiffness of joints in patients while performing daily living activities. High analgesic effect of -pinene and the anti-inflammatory effect of P. alantica were the main reasons for the high inflammatory effect of P. atlantica. Finally, the topical use of P. atlantica cream formulated in the current study, along with other common drugs, can be suggested.