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Efficacy of Homeopathic Arnica

Clinical bottom line: There is no evidence to show that Arnica montana is more effective than placebo for a number of clinical conditions related to tissue trauma. Existing trials are of poor methodological quality and on small numbers of patients.


Systematic review

Ernst E and Pittler M.H. Efficacy of Homeopathic Arnica: A Systematic Review of Placebo-Controlled Clinical Trials. Arch Surg. 1998; 133:1187-1190

This review seeks to determine the efficacy of homeopathy by looking at trials of one type of remedy rather than trials of different homeopathic remedies for a single disease or condition. Arnica montana is the homeopathic remedy most frequently studied in controlled trials. It is recommended by the Homeopathic Pharmacy as the treatment of choice for bruising, bleeding and dislocation due to soft-tissue injuries.

Date review completed: October 1997

Number of trials included: 8

Number of patients: A total of 467 in active and control groups, group sizes ranged from 6 to 41

Control group: placebo

Main outcomes: pain intensity, edema, wound healing, bleeding, serum creatine kinase, and bruising

Inclusion criteria were published, controlled clinical trials of any potency of homeopathic Arnica with a placebo group. There was no restriction to language of publication.

The authors conducted a comprehensive search including relevant databases, and hand searched 28 specialised homeopathic journals and reference lists of retrieved reports. Methodological quality of included studies was assessed using the Oxford Rating Scale (scale, 1 to 5) (Jadad et al., 1996). Reviewers provided a descriptive summary of trial findings.

Findings

Arnica was administered orally in various potencies ranging from D2 (mother tincture diluted 1 in 10, twice) to M10 (diluted 1 in 1000, 10 times), and administration schedules. The conditions treated were delayed-onset muscle soreness, post-operative complications, experimentally induced bruising, acute trauma and stroke. Overall the trials were of poor methodological quality. The four trials of the highest quality (randomised and double-blind) showed no difference between Arnica and placebo.

Two trials showed Arnica more effective than placebo that was statistically significant. One of the positive trials was not randomised although stated it was double-blind, had only six patients in each treatment group, no raw data was presented in the paper and an inappropriate statistical test was used. The other positive trial reported a significant reduction in pain in the Arnica group, however, the validity of this finding was severely compromised by 41 out of 59 patients dropping out of the study. It is unclear from the review how the data was analysed to account for this.

Two trials of poor methodological quality were reported to have numerically positive outcomes for bruising and subjective symptoms, but were not supported by statistical tests in the original papers. It was not stated if these trials were randomised by the reviewer, one was described as double-blind, one single-blind, both had group sizes less than 10 patients and outcomes were not clearly defined.

Adverse effects were not reported on in this review

Further reading

Related topics

Homeopathy for Delayed Onset Muscle Soreness