Musculoskeletal disorders result in the loss of function and pain. This is generally associated with joint irregularities (hypermobility, instability, arthrosis, bony proliferation, and ligamentous thickening) and muscle changes (spasms; both acute and chronic, and atrophy). Many elements of the physiological and pathological processes of musculoskeletal illnesses have been linked to inflammation. The inflammatory process comprises immune, vascular, and cell biochemical reactions, involving different cells, enzymes, cytokines, eicosanoids, and transcription factors. Inflammation begins with a coordinated activation of several signaling pathways and the recruitment of pro-/anti-inflammatory factors such as macrophages and neutrophils to the damage site, initiating tissue repair. Recruited and resident immune cells of injured muscle secrete pro-inflammatory cytokines such as IL-1, IL-8, IL-6, and TNFα, triggering a cascade of downstream inflammatory signaling pathways. NF-κB represents one of the most significant signaling molecules activated upon injury in skeletal muscle. NFκB target genes encode cytokines, chemokines, cell adhesion molecules, growth factors, and several enzymes associated with the ubiquitin-proteasome system. Cytokines IL-1 and TNFα are also shown to increase circulating levels of interferon-γ, which initiates a cascade of events to clear myofiber debris, regulate regeneration (via activation of the JAK1/2-STAT1 pathway), and control myogenesis (via CIITA repression of myogenin).

The currently available drugs for controlling and suppressing inflammatory crises, namely, steroids, non-steroid anti-inflammatory drugs (NSAID), and immunosuppressants, are only partly effective and are associated with adverse side effects. Therefore, safer and more effective strategies with minimum effective doses need to be developed to properly manage the most common chronic inflammatory affections of the musculoskeletal system. Medicinal plants have been the main therapeutic source to solve various ailments for a long time and in the present day many drugs have been developed from traditional medicines. Naturally occurring anti-inflammatory compounds used in combination with conventional anti-inflammatory drugs or even solely may help to achieve increased pharmacological response and the lowest degree of unwanted side effects.

The aim of this Special Issue is to contribute to improving knowledge and incite progress on the benefits of medicinal plants in chronic inflammatory conditions of skeletal muscles, while providing harmonious and cheaper sources of active principles to treat inflammation. We welcome both original research and review articles.

Potential topics include but are not limited to the following:

• Bioactivity studies of plant extracts in skeletal muscle inflammation
• Target identification and mechanism studies in inflammation against inflammatory pathways
• Photochemistry and biochemistry of natural anti-inflammatory compounds
• New insights into clinically relevant mechanistic actions of promising anti-inflammatory herbal ingredients in musculoskeletal system diseases
• Critical reviews of the historical, clinical, and legal status of medicinal plants used in the management of skeletal muscle inflammation