Development of Hydrogel Herbal Knee Patch for the Relief of Knee Pain Caused by Wind and Blood-Wind Obstruction

Abstract

Introduction and Objectives: Thailand is currently entering a complete aged society, as such, the prevalence of illnesses, particularly musculoskeletal diseases, among the elderly increase. According to the National Health Statistics in 2022, the elderly accounted for 22.15% of all patients with musculoskeletal diseases.  This physical health problem causes suffering and affecting the quality of life of the elderly. In 2024, the Thai Traditional Medicine Demonstration Hospital, under the School of Traditional and Alternative Medicine, Chiang Rai Rajabhat University treated over 100 cases of knee pain resulting from Lom (wind) and Lueat Lom (blood-wind) Tit Khat (wind and blood-wind obstruction), out of a total of 1,010 patients seeking services for musculoskeletal disorders. This study aims to 1) develop a new knee poultice formula for treating knee pain caused by wind and blood-wind obstruction, and 2) develop a new form of hydrogel herbal knee patch product suitable for treating knee pain due to wind and blood-wind obstruction.

Methodology: This research is a developmental study involving the selection of poultice formulas from Thai traditional medicine (TTM) textbooks and the development of the most suitable formula into a new form of hydrogel herbal knee patch product. Fifteen TTM experts were selected to review the selection of traditional poultice formulas and evaluate the physical properties and quality of the newly developed hydrogel herbal knee patch via focus group discussion process. Research tools for data collection were (1) record form of knee poultice recipes found in Thai traditional medicine textbooks, (2) record forms of the first and the second rounds of focus group discussions with TTM experts, and (3) product quality evaluation form. Knee poultice recipes were selected from TTM textbooks, namely, the Royal Medical Textbooks of King Rama V, Volumes 1 and 2; Phaetsat Songkhro, Royal Edition, Volumes 1 and 2; the General Traditional Medicine Textbooks, Medicine Section, Volumes 1, 2, and 3; the General Traditional Medicine Textbook, Pharmacy Section, General Traditional Medicine Textbook, Midwifery Section; and books on traditional medicine formulas. One formula was then selected from the list based on the predetermined criteria, i.e., has spicy taste, has pain- and swelling-relieving and wind dispelling properties, and its herbal components are locally available and easily obtained. Such herbal formula was then developed into a new form of hydrogel herbal knee patch using an automatic face mask machine. The newly developed product was further improved upon the evaluation of the physical characteristics and ease of use of the product by TTM experts and their comments.

Results: Upon the consideration of herbal poultice formulas listed in classical TTM textbooks using pre-determined criteria, "Ya Phok Kho Mue Kho Thao" (Hand and Ankle Poultice) from Phaetsat Songkhro, Royal edition, Volume 1, page 226 was selected. The formula consists of one part each of Nat Luang (Blumea balsamifera), giant lily (Crinum asiaticum), ginger (Zingiber officinale), long pepper (Piper retrofractum Vahl.), garlic (Allium sativum), Phlai (Zingiber montanum), Wan Nam (Acorus calamus), and assafoetida gum (Ferula assa-foetida). Traditionally, the ground ingredients are mixed with lime juice and liquor and placed on affected wrists and ankles. This traditional poultice formula was then developed into a novel hydrogel herbal knee patch suitable for treating knee pain due to wind and blood-wind obstruction using an automatic face mask machine and a mixture of 20 ml of herbal solution prepared from the poultice formula, 60 ml of water, and 2 collagen peptide tablets (100 g/tablet). Physical characteristic evaluation showed that: 1) regarding physical characteristics of the products, 80% of reviewers rated materials used for the hydrogel herbal knee patch product as appropriate; 86.7% found the product size suitable; and 93.3% reported no skin irritation caused by the product. 2) regarding usability, 66.7% found the product easy and convenient to use; 53.3% found the scent pleasant and not pungent. The researchers have improved the hydrogel herbal knee patch according to expert recommendations, including adjusting the scent and using waterproof plaster to prevent the solution from leaking out.

Discussion: For the development of the hydrogel herbal knee patch formula, the recipe containing Nat Luang, giant lily, ginger, long pepper, garlic, phlai, and Wan Nam was selected as most herbal ingredients are spicy, possess antioxidant, anti-inflammatory, and analgesic properties, as well as easily accessible and locally available. When these herbs were developed into a novel hydrogel herbal knee patch, it was found that the new product was a suitable form of hydrogel patch, non-irritating to the skin and convenient to use.

Conclusion and Recommendations: The hydrogel herbal knee patch can be an alternative product for those who want to take care of their health by maximizing the benefits of locally available herbs. However, this is only a preliminary study, clinical trials to assess the efficacy and safety of the hydrogel herbal knee patch, as well as patients’ satisfaction are still needed in the next steps.