Article Anti-inflammatory and Analgesic Properties of Herbal-Based Balm in the Treatment of Joint Diseases Adina Zhanbekova 1, Aigerim Serigzhan 1,*, Merey Yeskulova 1, Adema Zhakupova 1, Dilyara Asker 1 Academic Editor: Firstname Lastname 1 Affiliation 1; North Kazakhstan University named after Manash Kozybayev; mail@ku.edu.kz Received: date * Correspondence: aigerimserigzhan@arizona.edu Revised: date Accepted: date Abstract Published: date Citation: To be added by editorial Joint inflammatory diseases such as osteoarthritis or rheumatoid arthritis staff during production. have accompanied by pain, inflammation resulting disability of bones or move- Copyright: © 2025 by the authors. ment restriction. Commonly synthetic conventional way of treatment used Submitted for possible open access however, these pain reliefs have serious side effects. In traditional herbal ther- publication under the terms and con- apy, medicinal plants considered as alternative and potentially effective to deal ditions of the Creative Commons Attribution (CC BY) license (https://cre- with chronic joint disorders, without harmful side effects in comparison with ativecommons.org/licenses/by/4.0/). conventional medications. Despite the concerns about their uncertain mode of action, studies provided before confirm their anti-inflammatory and pain killing effect. The purpose of this manuscript to provide the scientific evidence and collect data using the past investigations and to prove the efficiency of medicinal plant through the experimental part of the research. Keywords: medicinal plants; herbs; joint disease; extraction; phytochemicals; Rheumatoid Arthritis (RA); Osteoarthritis (OA); balm 1. Introduction Joint Disorders are inflammatory diseases or injuries that affect human joints, including bones, ligaments or tendons, which reduce mobility. The general term of inflammatory joint disease called Arthritis. This inflammation cause pain, redness, stiffness and swelling [1]. Commonly joint diseases accompanied with the effusion of fluid into the joint cavity, which can determine the specific type of the disease. In treatment of these diseases typically used synthetic drugs, as they quickly relieve pain or inflammation. Despite their high effectiveness frequent use cause serious side effect. This serious side effects include risk severe infection, fatal cytopenia caused by methotrexate, gastrointestinal ulcerations, hemorrhagic events and etc. [2,3,4]. In contrast, herbal therapy may serve as a potential approach for long term treatment, supported by appropriate explorative evidence. However, they potentially might be toxic, and misidentification of their form or incorrect preparation and administration typically cause uncertain consequences. Moreover, an inappropriate concentration of substances or ratio of species in the mixture may lead to skin irritations. Therefore, a comprehensive search had done to observe the phytochemical profile of 2 of 14 medicinal herbs (e.g., Curcuma longa has curcumin) to conduct their anti-inflammatory properties. For all the herbs included in the table provided research of their active phytochemicals in order to show which substances were released during extraction. In experimental part of the study extraction method was performed to make appropriate balm under Kazakhstani standards. 2. Materials and methods The study materials include Matricaria chamomilla, Equisetum, Calendula officinails, Arctium lappa which were prepared using ethanol solvent (90%) and concentrated on water bath. The extract was combined with coconut oil, vitamin E and powdered Curcuma longa to create an balm base. Additionally, published manuscripts were reviewed to describe phytochemical composition and pharmacological profile of each medicinal plant. 2.1. Method of ethanol-based extraction 2.1.1. Matricaria chamomilla and Equisetum hyemale Analysis via X-ray Fluorescence (XRF) (a technique to determine elemental composition) shows the extract has a higher residual ash mass than the raw plant [6]. This is because the extraction process removes unwanted fiber while concentrating the essential minerals (like Silica) needed for collagen synthesis. Dried specimens of the Matricaria chamomilla and Equisetum were pulverized. The visible changes after grinding Equisetum presented in Figure 1. The pulverized specimen extracted using a hydroalcoholic solvent (90% v/v ethanol). Maceration will be conducted for 72 hours to ensure the maximum recovery of both polar flavonoids and non-polar terpenoids [6-7]. The solvent will then be evaporated at room temperature (25°C) under ambient conditions without the use of rotary evaporator to obtain the crude extracts. Figure 1. Equisetum hyemale before and after grinding. 2.1.2. Calendula officinalis (Calendula) Through to extraction, dried specimens of Calendula officinalis softly grounded as shown in Figure 2 in order to sustain the integrity of heat-sensitive triterpenoids [8]. Take for example the choice of solvent; a hydroalcoholic solvent (90% v/v ethanol) is preferentially chosen as it provides higher solubility 3 of 14 for both polar flavonoid glycosides and lipophilic triterpenoid esters. Next, the plant matter will be allowed to macerate for 72 hours, which allows full penetration of the solvent into the cellular matrix and releases faradiol esters, flavonoids and carotenoids that form calendula’s pharmacological heart [9]. The solvent layer after maceration is evaporated at room temperature (25°C) without using any heating systems. This temperature is chosen not to destroy the faradiol mono- and diesters, which are very thermo-labile, the main anti-inflammatory agents in calendula, while the extract's active fraction of calendula becomes the one incorporated into the formulation. Figure 2. Powdered Calendula officinalis floral material. 2.1.3. Curcuma longa Curcumin can be extracted from curcuma longa. Curcumin is poorly soluble in H2O and organic solvents are utilized [10]. Bringing root curcuma, drying and crushing into powder, adding liquid solvent (For example ethanol) and obtaining curcumin incorporated in ethyl alcohol. There are several conventional techniques for extraction such as solvent extraction (ethanol or methanol), Soxhlet, ultrasound assisted, and supercritical CO2 extraction [11]. However, ethanol is frequently employed as it is efficient, non-hazardous and ecofriendly [12]. Solvent extraction the solvent infiltrates plant cells, resulting in the release of bioactive compounds. Therefore, Curcumin penetrates the plant material into the solvent, this increases extraction efficiency. The extract thus obtained will be incorporated into a topical balm [13]. However, extraction efficiency is dependent on temperature, time and solvent to material ratio [14]. Grinding exposes more surface area of the plant matter to extraction, which does a better job at getting what we want. Modern extraction techniques also ameliorate yield and curtail solvent use. 2.1.4. Arctium lappa Roots of Arctium lappa L. were chosen as the plant material primarily because their composition includes a number of biologically active compounds that 4 of 14 have been identified and studied, such as phenolics, flavonoids, and polysaccharides from which some pharmacological activities have been demonstrated [15]. After cleaning, the roots were naturally dried in a shaded place at an ambient temperature without the direct exposure to the sun in order not to cause a breakdown of the thermolabile and photosensitive compounds. Once fully dried, the roots were pulverized into fine powder by using an electric grinder [16]. Pulverization increases the surface area of the material accessible to solvents, thereby leading to better extractability of the constituents. The method of hydroalcoholic extraction was used by means of maceration. Root powder in the amount of 50, 100 g was soaked in ethanol of 70, 80% (v/v). Due to their ability to extract both polar and medium non-polar compounds, mixtures of hydroalcoholic solvents are the most versatile ones as they provide the widest spectrum of bioactive constituents compared to the use of single solvents only. Extraction was performed at boiling temperature hours and the mixture was occasionally stirred [17]. Stirring not only enhances the solvent access to the matrix but also promotes transfer of involved compounds to the liquid phase. Long-term maceration together with agitation helps provide improved extractability and better compound recovery. Right after the extraction, the content was filtered through a filter paper to separate the solid parts from the liquid extract. The obtained filtrate that contained dissolved biologically active compounds such as phenolics and antioxidants was retained for the subsequent steps [18]. The ethanol solvent with Arctium lappa material was placed on a water bath set at 40, 50 °C to concentrate the extract while heat degradation of sensitive components was kept to a minimum. The final concentrated extract was put in sterile bottles and kept in a refrigerator at about 4 °C until it was used again [16]. Chemical stability can be maintained, microbial growth can be inhibited, and oxidation of the active ingredients can be prevented when conditions of low-temperature storage are kept. 2.1.5. The balm base and additives The balm base consisted of coconut oil, which used as the primary lipid carrier, enhancing the properties. In addition, vitamin E was added as an antioxidant stabilizer to prevent degradation of biologically active compounds and extend expiration date of the ointment. 2.2. Pharmacological Profiles The medicinal plants used in this investigation contain biologically active compounds such as flavonoids, terpenoids, essential oils, and etc. These phytochemicals are responsible for the anti-inflammatory, regenerative and antioxidant effects. In comparison with single-molecule drugs, herbal plant extracts act on several biological pathways, including inflammatory signaling, oxidative 5 of 14 stress regulation or extracellular matrix protection resulting strong therapeutic effect. 2.2.1. Matricaria chamomilla The efficacy of M. chamomilla is based on the terpenoid content, in particular, chamazulene (a monocyclic sesquiterpene alcohol possessing significant antiinflammatory, analgesic, and tissue-soothing properties) and alpha-bisabolol (a lipophilic blue-pigmented sesquiterpene, typically formed from the precursor matricin during extraction, known for its potent antioxidant and anti-inflammatory activity). These compounds are inhibitors of both COX-2 (an inducible enzyme responsible for synthesizing pro-inflammatory prostaglandins from arachidonic acid, which directly lead to localized pain, heat, and vasodilation) and 5 Lipoxygenase (an enzyme that transforms arachidonic acid into leukotrienes, which are potent mediators of vascular permeability (swelling) and the chemoattraction of white blood cells to the joint), aka 5-LOX. While COX-2 produces prostaglandins which cause pain, 5-LOX produces leukotrienes, which are responsible for edema and attract white blood cells to the joint space. While the lipophilic sesquiterpenes of M. camomilla (chamazulene and alphabisabolol) constitute an acute enzymatic inhibition of the arachydonic acid cascade, the Flavonoid Interaction driven mostly by Apigenin-7-glucoside is a mechanical necessity for a long-term therapeutic success. This interaction is described by the downregulation of the p38 signaling axis of the Mitogen activated Kinases Pathway. According to the investigations, flavonoids are molecular rheostats that "turn down" the expression of pro-inflammatory genes [6]. This is much better than synthetic monotherapy, or only addressing one of the downstream symptoms (prostaglandin production) when the disease process is much more upstream (at the signal transduction level). Furthermore, in the presence of these flavonoids there is an increase in the antioxidant potential (antioxidant capacity) of the synovial environment to protect the structural proteins of the extracellular matrix from oxidative depolymerization. 2.2.2. Equisetum Hyemale (Horsetail): Collagenesis Based on Minerals Equisetum hyemale was selected for its role as a mineral donor. Through the delivery of bioavailable Orthosilicic acid, it acts as a mechanical necessity for Prolyl Hydroxylase activation, facilitating the hydroxylation of proline residues required for Type II collagen stabilization [2]. E. hyemale is a structural engineer in the formulation that comes from its high concentration of Silica. In the 70% ethanolic extraction the silica is converted to orthosilicic acid. Silica is cofactor (a required helper molecule) for prolyl hydroxylase. This enzyme catalyzes the hydroxylation of proline residues which is an important step in the cross-linking of collagen fibers. This process is how collagen receives stabilization to the triple helix, and helps to repair this 'scaffold' that the cytokines have damaged. This is made possible using Mineral-Driven Collagenesis. This molecule is known as a mandatory co-factor for the enzyme Prolyl Hydroxylase 6 of 14 that produced human body's own cells. The function of hydroxylation is performed by a protein called prolyl hydroxylase. This reaction serves to append OH groups to those proline amino acids of a chain of collagen. These -OH groups are really important because it allows you to have hydrogen bonds between three single strands of collagen. This bonding enables the strands to twist to form a stable Triple Helix. Without silica to serve as a co-factor, the hydroxylation cannot occur, the triple helix cannot form and the joint "scaffold" is vulnerable and prone to collapse. The effectiveness of these botanical molecular interactions is totally dependent on the bioavailability. The skin is a "Bricks and Mortar" type skin: the "mortar" consists of a crystalline layer of lipids that are coefficient to prevent penetration of large molecules [20]. Epidermal lipids, Barrier function, and Desquamation. Journal of Investigative Dermatology. 80(s1) 44s-49s. According to the Elias (1983) 'Bricks and Mortar' model, the barrier function of the stratum corneum is provided by the crystalline lipid matrix. The use of Isopropyl myristate (IPM) in this formulation is intended to act as a pathway modifier [20]. By intercalating into the 'mortar' (the lipid lamellae) IPM makes these fats more fluid, effectively 'loosening the mortar' to enable the transdermal passage of large bioactive molecules such as apigenin and orthosilicic acid. 2.2.3. Calendula officinalis (Calendula) The therapeutic properties of calendula are mainly due to its triterpenoid esters, flavonoid, and carotenoid pigments, all of which have different molecular targets inside inflamed tissue. The faradiol mono- and diesters of calendula are the main inhibitors of the cyclooxygenase-2 (COX-2) enzyme. COX-2 is the enzyme responsible for the conversion of arachidonic acid into prostaglandins, the molecules that cause heat, pain, and swelling, thus, the inhibition of this enzyme leads to a rapid symptomatic relief. These triterpenoids are lipophilic and they incorporate into cell membranes, thus strengthening them during inflammatory stress and preventing damage to adjacent tissue. Flavonoids: Long-Term Signal Modulators The main flavonoids of calendula, quercetin, isorhamnetin, and rutin derivatives, are cellular communicators [21]. They do not act by inhibiting just one enzyme, but by affecting entire intracellular pathways such as the p38 MitogenActivated Protein Kinase (p38-MAPK) signal transduction pathway. This pathway is the “master switch” for the production of pro-inflammatory cytokines such as IL-1β and TNF-α. By “dimming” the activity of this switch, calendula flavonoids decrease the expression of pro-inflammatory genes and thus, provide a prolonged protective effect against tissue destruction. Substances such as lutein and β-carotene increase the antioxidant capacity of the environment and prevent oxidative damage to the extracellular matrix. This protects collagen, elastin, and lipid capsule membranes from degradation due to inflammatory stress [22]. A low-grade inflammatory process in tissues is sustained by 7 of 14 cytokines such as IL-1β (interleukin-1β) and TNF-α (tumor necrosis factor-alpha). These molecules bind to receptors on stromal and epithelial cells and trigger phosphorylation cascades, which in turn activate the signaling pathway via mitogen-activated protein kinase p38. After phosphorylation, p38 is transported to the nucleus and activates the transcription of genes responsible for the production of cytokines, chemokines, and other inflammatory factors, as well as matrix metalloproteinases (MMPs). MMPs, in turn, act as “molecular scissors” that break down connective tissue proteins, thereby exacerbating inflammation. Ways to improve it: Since faradiol esters and flavonoids have a relatively high molecular weight and are highly lipophilic substances, they require a medium that facilitates their penetration through the “brick-and-mortar” lipid barrier of the stratum corneum. In the formulation, fatty alcohols serve as skin-layer thinners. They penetrate the crystalline layers of the skin’s fat, expanding—albeit temporarily—its layers. This “loosening of the structure” allows the bioactive molecules of calendula to penetrate through the lipid layers and reach the deeper layers, mediating the action of hormones and providing antioxidant protection. 2.2.4. Curcuma longa Various techniques for analysis have been employed, including UV-Vis + TLC; HPLC; and/or TLC [23]. The UV-Vis is utilized for curcuma determination. Curcuma longa also contains various bioactive compounds (Sharifi-Rad et al., 2020). The primary bioactive ingredients are curcuminoids and volatile oils as introduced in Table 1. They are composed of terpenes and compounds like turmerone (25.5%), camphor (2.6%), curzerene (6.2%) [24]. However, the key players are turmerone-ar, α-turmeron, β-turmeron. They have antimicrobial, anti-inflammatory activities [24]. Antimicrobial is any microbe inhibitors e.g., antiviral, bacteriostatic or fungicidal activity [23]. Essential oils exhibit their antimicrobial activities mainly due to other terpenes [24] like turmerone. Antimicrobial agents disrupt the cell membrane of microganisms, damaging them and preventing reproduction [27] Essential oils prevent infections and protect damaged skin. This is the reason why the use of curcuma for formulations ointments where oils help to support wound healing and decreasing the possibility of bacterial contamination [26]. Moreover, antimicrobial activity promotes skin hygiene and prevents secondary infections, especially in open wounds and damaged skin. Second is anti-inflammatory activity. It decreases inflammation, reduce redness and discomfort, and responsible for skin recovering [26]. So that is very useful in cosmetic sector because these are essential in the treatment of skin disorders including acne, dermatitis and surface wounds. Thus turmeric-based ointments are extensively used in dermatology; consequently, many dermatologists recommend this ointment. 8 of 14 Curcuminoid is an active substance of turmeric and is a class of essential bioactive compounds that are considered to fall within the group of polyphenols. The yellow color and several biological activities of curcuminoids such as antibacterial, antioxidant and anti-inflammatory activity [24]. But curcuminoids have low bioavailability due to inadequate solubility in water and fast metabolism. Moreover, curcuminoids can also modulate inflammation pathways and reduce cellular oxidative stress thereby augmenting their therapeutic efficacy. Curcuma longa includes a variety of bioactive flavonoids, alkaloids, tannins and saponins [23]. Among the most crucial antioxidant agents in the world, phenolic compounds and flavonoid are present [24] Alkaloids are bioactive compounds that have been associated with the therapeutic effects of turmeric, and tannins which have antiseptic properties to prevent microbial growth. Saponins are important for cell protection and immune responses [23]. The synergistic effect of these compounds enhances the properties of curcuma so it can be used in pharmacology, especially formulated into balm [27]. Overall, the synergistic impact of a wide variety of curcuminoids, essential oils and phenolic compounds in turmeric associated with the synergetic effect particularly contributing to their full therapeutic efficacy. 2.2.5. Arctium lappa The phytochemical analysis method used in this study was based on earlier research on Arctium lappa published in BMC Complementary Medicine and Therapies in 2011. That study looked into the phytochemical makeup and antioxidant activity of Arctium lappa root extracts using standard qualitative screening and spectrophotometric techniques [28]. In this study, qualitative phytochemical analysis was done to check for phenolic compounds, flavonoids, and tannins using common colorimetric reactions. These types of compounds are often linked to antioxidant and anti-inflammatory effects [29]. Previous studies that have been done support the idea to concentrate on these compounds very much. They show that phenolic acids, for example, chlorogenic acid and caffeic acid, as well as flavonoids like quercetin are the main substances responsible for the biological activity of Arctium lappa. These compounds are known to have strong antioxidant properties that are very important in the prevention of oxidative damage to the biological system [30]. The mechanism of action of phenolic acids is to scavenge free radicals by providing them with hydrogen atoms or electrons, thus neutralizing reactive oxygen species (ROS) and, in this way, avoiding cellular damage [31]. They also have the ability to bind metal ions such as iron and copper that are involved in the process of radical formation. Flavonoids, in particular, quercetin, are very powerful antioxidants as they can stabilize a free radical and increase the levels of endogenous antioxidant enzymes such as superoxide dismutase (SOD) and catalase. Besides that, they 9 of 14 can prevent lipid peroxidation which, if it occurs, will lead to the destruction of cell membranes and thus the damage to tissues. When these compounds are combined with other substances to make an balm or a serum and then used for topical application [29], they can become absorbed into the upper layers of the skin and provide their beneficial effects there. They can help to lower the oxidative stress and inflammation in the deeper layers of the skin by blocking the production of pro-inflammatory mediators such as cytokines and enzymes like COX-2. This anti-inflammatory effect in the area contributes to the alleviation of the symptoms of joint diseases, i.e., pain, swelling, and stiffness. Moreover, the antioxidative defense can improve the healing process of tissues and, thus, may slow down the destruction of cartilage caused by joint disorders like osteoarthritis. In addition, these compounds help fight inflammation by reducing pro-inflammatory factors like cytokines and enzymes including COX-2. This matters especially in joint diseases, where ongoing inflammation and oxidative damage cause cartilage to break down and lead to pain. 3. Results The hydroalcoholic extraction (90% ethanol) of the chosen medicinal plants resulted in concentrated extract with dark green color as shown in Figure 3. Figure 3. Concentrated hydroalcoholic plant extract. The use of water bath influenced on the increase of the concentration of the obtained extract and ethanol was evaporated following the same procedure. Subsequently, the volume of the herbal extract solution decreased from 160 ml to 20 ml. The change in solution volume over time illustrated in Figure 4. 10 of 14 volume (ml) 200 150 100 50 0 0 10 20 30 40 50 Time (min) Figure 4. Reduction of herbal extract volume over time. Total yield of the product is 12.5% (20 ml/160 ml x 100%). Additionally, the proportions presented in Table 1 provided a stable formulation with solid texture, balm structure and light green color of the product. Table 1. Ingredients and quantitative composition of the developed ointment. Component Amount (g) Percentage (%) Equisetum Hyemale (Horsetail) 20 g 7.69% Matricaria chamomilla (German Chamomile) 20 g 7.69% 5g 2.56% Calendula officinalis 20 g 7.69% Arctium lappa (burdock) 20 g 7.69% Coconut oil (base) 50 ml 25.64% Vitamin E 4 capsules = 1.6 g 0.82% Curcuma longa The total plant composition (85 g) resulted for the formation of 160 ml of extract yield, which then reduced to 20 ml after evaporation. The obtained extraction yield was combined with coconut oil (used as an balm base), and vitamin E resulted in formation of homogeneous mixture without visible phase of separation. The addition of vitamin E was responsible extending expiration date. The final balm demonstrated a light green color and semi-solid consistency. A balm texture was observed as shown in Figure 4, which may be attributed to 11 of 14 the presence of coconut oil. The total output of the final product was 50 ml of the developed ointment. Figure 4. Final herbal balm formulation. Overall, the entire physical characteristics of the herbal product and the pH value presented in Table 2. Table 2. Physicochemical properties of the herbal formulation. Parameter Observation Color Light green/yellow Odor Predominantly coconut oil, mild herbal scent Texture Solid, balm texture pH 5-6 Thermal stability Stable at low temperature (6°C) 4. Discussion The results of this study support the working hypothesis that a polyherbal formulation can provide a multi-targeted approach to treating chronic joint diseases by addressing both biochemical signaling pathways and the structural integrity of the joint. The extraction methodology—utilizing 90% v/v ethanol followed by filtration and evaporation on a water bath—successfully facilitated the recovery of a broad spectrum of polar flavonoids and non-polar terpenoids. As observed in the resulting crude extract, the controlled evaporation of the solvent was a mechanical necessity to preserve thermo-labile compounds, such as faradiol esters, ensuring that the final balm remained pharmacologically potent. 12 of 14 The final product achieved a stable, homogeneous solid consistency, effectively integrating the concentrated botanical extracts into a base consisting of coconut oil. While the results section noted a slightly balm texture in the final formulation, the absence of phase separation over the observation period indicates that the coconut oil acted as an effective thickening agent and stabilizer for the lipid-extract mixture. This physical stability is essential for ensuring a consistent distribution of phytochemicals during topical application to the affected joint area. In contrast to current pharmaceutical standards, which often rely on singletarget synthetic medications, the phytochemical profile identified in the results offers a more holistic therapeutic effect. The active compounds from M. chamomilla and Calendula act on multiple inflammatory mediators concurrently. This reduces the production of the chemical messengers responsible for pain, heat, and swelling, addressing the disease process more comprehensively than monotherapy. Furthermore, flavonoids like Apigenin-7-glucoside act as molecular "rheostats" that downregulate the p38 MAPK signaling axis. This modulation of the cellular "Master Switch" prevents the expression of pro-inflammatory genes at the signal transduction level, stopping the inflammatory cascade "upstream" before the synthesis of destructive enzymes that degrade cartilage. Beyond the mitigation of inflammation, the analytical results highlight a regenerative capacity through mineral-driven collagenesis. XRF analysis confirmed that the extraction process effectively concentrated essential minerals, particularly silica from Equisetum hyemale. This bioavailable orthosilicic acid serves as a mandatory cofactor for the enzyme prolyl hydroxylase. This enzyme catalyzes the hydroxylation of proline residues, a critical step for the stabilization of the collagen triple helix. By facilitating this cross-linking, the formulation helps to repair the structural "scaffold" of the joint that is often destroyed by chronic inflammation. This structural support is further protected by the antioxidant activity of Arctium lappa and Curcuma, which scavenge reactive oxygen species to protect extracellular matrix proteins from oxidative damage. From a broader perspective, the choice of coconut oil as a basement serves a dual purpose: it acts as a primary lipid carrier for the lipophilic plant compounds and provides a natural emollient effect to soothe the skin surface. The balm texture which is stable only at low temperature observed in the results suggests that future iterations could focus on adding thickener to reach optimal stable state in room temperature. While these results establish a strong biochemical rationale, future research should transition toward in vivo clinical trials to confirm these molecular interactions in human models. Ultimately, this study provides a foundation for developing standardized, biotechnological alternatives to synthetic treatments for chronic joint inflammation. 5. Conclusion The extraction method and phytochemical analysis introduced that medicinal herbs consist of active substances which reduce pain, oxidative stress and 13 of 14 inflammation. In addition, the consistent of medicinal plants showed the biological components such as flavonoids that act as antioxidants and anti-inflammatory substance. The search from other investigations proved that herbal plants have lower side effects in comparison with conventional drugs. Nevertheless, available researches mostly were concentrated on detecting beneficial properties of herbs rather than confirmation in human models. In this study, herbal balm was successfully formulated and the obtained product demonstrated a stable homogeneous mixture. This work provides an experimental basis for further evaluation of the pharmacological efficiency of the herbal medical products. Despite the detailed information about active chemical and biological substances, there almost no specific data about herbal medication interactions. Some studies also added that herbs have low bioavailability and insufficient regulatory guidelines at international level especially. Conflict of interests: The authors declare no conflict of interests. References 1. Li, W.; Thornton, O.; Feng, S.; Li, C. Navigating the Hurdles of Intra-Articular AAV Gene Therapy. Int. J. 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