Reporting a Case of Nine-Year Resistant Toe Joint Pain Treated Based on Principles of Iranian Traditional Medicine

Document Type : Case reports or series


1 1 PhD student, Student Research Office, School of Persian Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 PhD student, Student Research Office, School of Persian Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: musculoskeletal problems are among the most common complaints in outpatient visits. Treatment of joint pain in Iranian traditional medicine includes eliminating the cause, cleansing the body ot phfootm or the probable substance, transforming humors, and tonifying organs to prevent relapse and accepting loss of substance.
Introducing the patients: The patient was a 32-year-old thin man, without abdominal obesity and a relatively dark complexion with a history of more than nine years of pain in the right  toe, which initiated as occasional pains and persisted almost continuously for the past three years. In spite of numerous medical follow-ups and two surgical operations since 2012, his condition did not improve and the patients had to consume painkiller constantly, such that he finally was recommended to amputate the affected toe.
The patient’s pain at the time of visit was very severe. The pain was more severe at nights, which awakened the patient, and was stiff in the morning. Exertion of any strike (of any intensity) caused pain intensification in the joint. Further, in some cases the pain was followed by inflation, redness, and warmness of the joint.
In examination, inflammatory factors of the patient were negative. In bone scan, a lesion was reported in the first metatarsal bone of the right foot.
The patient was irritable, with rapid irritability and late relief along with symptoms of aggression, anger suppression and its resulting mental traffic, obsession (mental and occupational), meticulous, huge mental traffic, stress, anxiety, worry, and sensitivity to the surrounding noises.   
Conclusion: Accumulation of black bile in the first metatarsal joint of the right foot caused development of severe pain in the patient’s foot. Through time, gradual condensation of the substance occured, making treatment more difficult. Accordingly, it was necessary that in addition to modifying the patient’s humors, the substance accumulated in the  joint be transformed to facilitate its excretion. Therefore, pharmacological treatment, topical unction, and following measures along with benefiting from the Fateh traditional manipulative treatment and leech therapy were used. The overall outcome was diminished pain, such that over the past five months, the patient did not report any kind of pain


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