Pain and inflammation imposes an enormous problem globally

Pain and inflammation imposes an enormous problem globally. The global prevalence of pain indicated that 20% of adults suffer from pain. The World Health Organization has estimated that 22% of the world’s primary care patients have chronic debilitating pain. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health (Goldberg and McGee, 2011). It is considered a major clinical, social, and economic problem in communities around the world (Henschke et al., 2015; Azevedo et al., 2016).
Pain and inflammatory disorders are associated with a range of deleterious consequences such as, disability, temporary or permanent work discontinuation, reduced quality of life, heightened risk of other physical and mental health comorbidities and greatly increased health care costs, and death (Vietri et al., 2015; Bertin et al., 2016; Kawai et al., 2017)
Thus, any type of pain should be managed with optimal pain relief approaches for optimizing post-operative recovery and reducing morbidity and convalescence. In line with managing pain and inflammation as a target of priority, proposed recommendations such as, weighing the analgesic efficacy and potential risks and provide optimal analgesia with minimal adverse events should be considered (Joshi et al., 2016).
Presently, a number of drug classes are available to manage inflammation and pain. Anti-inflammatory drugs, muscle relaxants, antiepileptic medicines, antidepressants, opioids, and local anesthetics are used through different routes of administration (WHO, 2012; Mathew et al., 2016)
However, the clinical use of anti-inflammatory and analgesic agents is limited by their affordability, accessibility, adverse drug reactions and many medicines are not effective as expected in all patients (Croff, 2013). Another major challenge is development of tolerance and dependence particularly with the chronic use of opioids (Martini and Whistler, 2007).
A meta-analysis comparing the effectiveness of different NSAIDS showed that despite their clinical utility against pain associated with osteoarthritis, their benefit has to be weighed against their potential harmful effects and not all NSAIDS were effective in the pain resolution (Baigent et al., 2013). Diclofenac was superior in efficacy but highly associated with cardiovascular risks (Asadbeigi et al., 2014). Naproxen substantially increased the likelihood of upper gastrointestinal complications (Adebayo et al., 2014). Occurrence of serious adverse effects impedes dose increment according to the extent of pain (Asadbeigi et al., 2014)
Therefore, patients are increasingly interested to explore other options for the disease management using natural products with good effectiveness and fewer side effects. Despite it is inconclusive, herbal medicines are believed and considered to be safe and effective agents as compared to synthetic medicine. Hence people every year turn to use herbal medicine because they believe plant remedies are free from undesirable side effects (Nasri and Shirzad, 2013).
One of the medicinal plants believed to have anti-inflammatory and analgesic activity is Cucumis ficifolius (Cucurbitaceae). In Ethiopia, the plant has been used in the treatment of different ailments including, stomachache, wound, (Chekole et al., 2015); joint pain and tooth ache (Teklay et al., 2013).
Investigation of the plant might contribute for the search of novel bioactive compounds which might serve as a lead compound in the discovery of new analgesic and anti-inflammatory agents.