Homeopathy National Knowledge Week, 11-15 June 2007
Robert T Mathie, PhD
British Homeopathic Association
The treatment of trauma and injury often involves the use of Arnica montana, for which the main homeopathic symptom indication is ‘painful bruising’. A wide range of specific conditions has been the subject of published research on the efficacy of homeopathic Arnica, and it is this diverse literature that was systematically reviewed by Lüdke & Hacke in 2005.1 All prospective, controlled trials on homeopathic Arnica were included in the review. Overall effectiveness was assessed by meta-analysis and meta-regression techniques. Sixty-eight comparisons from 49 clinical trials showed significant effectiveness of Arnica in traumatic injuries in meta-analysis (odds ratio (OR), 0.36; 95% confidence interval (CI), 0.24-0.55), but not in meta-regression models (OR, 0.37; CI, 0.11-1.24). There was no evidence for publication bias. Studies from MEDLINE-listed journals and high-quality studies were less likely to report positive results. The authors were unable either to accept or to reject the hypothesis that homeopathic Arnica is effective.
Four new research articles in this area have been published in the peer-review literature since the above review: Oberbaum et al., 20052; Brinkhaus et al., 2006 (reporting 3 separate trials)3; Seeley et al., 2006 4; Robertson et al., 2007 4. If these recent studies are included in an overview of just the peer-reviewed research literature of perioperative trauma where Arnica was the only homeopathic medicine used (as opposed to being part of a complex formulation of two or more medicines), and restricting the review to placebo-controlled trials that were explicitly randomised and double-blinded, the following more detailed picture emerges. Trials on Arnica for stroke 6, 7, and for muscle soreness 8, 9, 10, 11 have been omitted from this specific update:
Total number of trials: 12
No. with positive findings: 3 3, 5, 4
No. with negative findings: 1 15
No. with non-statistically significant differences: 8 3, 13, 14, 15, 16, 17, 18
Thus, the positive evidence for homeopathic Arnica in perioperative trauma comprises 25% of the research literature in this area, and is limited to postoperative swelling and pain after cruciate ligament reconstruction 3, post-tonsillectomy analgesia 5, and postoperative haematoma (ecchymosis) 4. The effectiveness of Arnica in other perioperative situations is equivocal.
References
1. Lüdtke R, Hacke D. [On the effectiveness of the homeopathic remedy Arnica montana]. Wiener medizinische Wochenschrift. 2005, 155: 482–490. [PubMed abstract]
2. Oberbaum M, Galoyan N, Lerner-Geva L, Singer SR, Grisaru S, Shashar D, Samueloff A. The effect of the homeopathic remedies Arnica and Bellis perennis on mild postpartum bleeding – a randomized, double-blind, placebo-controlled study –preliminary results. Complementary Therapies in Medicine. 2005, 13(2): 87–90. [PubMed abstract]
3. Brinkhaus B, Wilkens JM, Lüdtke R, Hunger J, Witt CM, Willich SN. Homeopathic arnica therapy in patients receiving knee surgery: results of three randomised double-blind trials. Complementary Therapies in Medicine. 2006, 14(4): 237–246. [PubMed abstract]
4. Seeley BM, Denton AB, Ahn MS, Maas CS. Effect of homeopathic Arnica montana on bruising in face-lifts: results of a randomized, double-blind, placebo-controlled clinical trial. Archives of Facial Plastic Surgery. 2006, 8(1): 54–59. [PubMed abstract]
5. Robertson A, Suryanarayanan R, Banerjee A. Homeopathic Arnica montana for post-tonsillectomy analgesia: a randomised placebo control trial. Homeopathy. 2007, 96(1): 17–21. [PubMed abstract]
6. Savage RH, Roe PF. A double blind trial to assess the benefit of Arnica montana in acute stroke illness. British Homeopathic Journal. 1977, 66: 207–220.
7. Savage RH, Roe PF. A further double blind trial to assess the benefit of Arnica montana in acute stroke illness. British Homeopathic Journal. 1978, 67: 210–222.
8. Tveiten D, Bruseth S, Borchgrevink CF, Norseth J. Effects of the homoeopathic remedy Arnica D30 on marathon runners: a randomized, double-blind study during the 1995 Oslo Marathon. Complementary Therapies in Medicine. 1998, 6: 71–74.
9. Tveiten D, Bruseth S, Borchgrevink CF, Løhne K. [Effect of Arnica D30 on hard physical exertion. A double-blind randomized trial during the 1990 Oslo Marathon]. Tidsskrift for den Norske Lœgeforening. 1991, 111(30): 3630–3631. [PubMed abstract]
10. Vickers AJ, Fisher P, Smith C, Wyllie SE, Lewith GT. Homoeopathy for delayed onset muscle soreness: a randomized double blind placebo controlled trial. British Journal of Sports Medicine. 1997, 31(4): 304–307. [PubMed abstract]
11. Vickers AJ, Fisher P, Smith C, Wyllie SE, Rees R. Homeopathic Arnica 30X is ineffective for muscle soreness after long-distance running: a randomized, double-blind, placebo-controlled trial. Clinical Journal of Pain. 1998, 14(3): 227–231. [PubMed abstract]
12. Kaziro GS. Metronidazole (Flagyl) and Arnica montana in the prevention of post-surgical complications, a comparative placebo controlled clinical trial. British Journal of Oral & Maxillofacial Surgery. 1984, 22(1): 42–49. [PubMed abstract]
13. Hofmeyr GJ, Piccioni V, Blauhof P. Postpartum homoeopathic Arnica Montana: a potency-finding pilot study. British Journal of Clinical Practice. 1990, 44(12): 619–621. [PubMed]
14. Hart O, Mullee MA, Lewith G, Miller J. Double-blind, placebo-controlled, randomized clinical trial of homoeopathic arnica C30 for pain and infection after total abdominal hysterectomy. Journal of the Royal Society of Medicine. 1997, 90(2): 73–78. [Full text]
15. Kennedy CO. A controlled trial. British Homeopathic Journal. 1971, 60: 120–127.
16. Ramelet AA, Buchheim G, Lorenz P, Imfeld M. Homoeopathic arnica in postoperative haematomas: a double-blind study. Dermatology. 2000, 201(4): 347–348. [PubMed abstract]
17. Stevinson C, Devaraj VS, Fountain-Barber A, Hawkins S, Ernst E. Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery. Journal of the Royal Society of Medicine. 2003, 96(2): 60–65. [Full text]
18. Wolf M, Tamaschke C, Mayer W, Heger M. [Efficacy of Arnica in varicose vein surgery: results of a randomized, double-blind, placebo-controlled pilot study]. Forschende Komplementär-medizin und Klassische Naturheilkunde. 2003, 10(5): 242–247. [PubMed abstract]
