Clinical Briefs: Homeopathic Arnica and Surgery
Source: Stevinson C, et al. Homeopathic arnica for prevention of pain and bruising: Randomized placebo-controlled trial in hand surgery. J R Soc Med 2003;96:60-65.
Goal: To determine whether homeopathic arnica can reduce post-operative complications and promote recovery.
Design: Double-blind, randomized, placebo-controlled trial with three parallel arms.
Subjects: Sixty-four adults (62 included in final analysis) ages 18-70 years undergoing elective surgery for carpal tunnel syndrome.
Methods: Patients were given placebo, arnica 6C, or arnica 30C to be taken three times daily for seven days preoperatively and 14 days postoperatively. Primary outcome measures were pain (questionnaire including a visual analogue scale) and bruising (digital evaluation of photographs); secondary measures were swelling (measurement of wrist circumference) and use of analgesics (tablet counts).
Results: No differences were found between any of the groups on the primary outcome measures of pain and bruising; swelling and use of analgesics also revealed no difference between the arnica groups and placebo.
Conclusion: Homeopathic arnica is no better than placebo in reducing postoperative complications such as pain, swelling, and bruising.
Study strengths: Trial design; manner in which outcome measures of pain and bruising were determined.
Study weaknesses: Minimal swelling or bruising was noted in any of the groups; unusually frequent administration and lengthy duration of use of homeopathic arnica; poor adherence to the trial regimen seen in more than one-third of the sample; the sample size is relatively small, although there presently exists insufficient literature to drive sample size calculations.
Of note: Compared with the placebo group, a greater proportion of participants in both arnica groups guessed what they had received.
Did you know? If taken orally at all, arnica should only be taken internally in the form of a homeopathic remedy.
Clinical import: The results of this small, but well-done, study support the majority of published data that suggest little or no benefit from the peri-operative use of homeopathic arnica; however, patients continue to use, and some practitioners regularly recommend, arnica in such a circumstance. The good news is that a container of homeopathic arnica costs approximately $7 in your neighborhood health food store, is typically taken once or twice daily for a short period of time, and does not appear to interfere with medications. Although available data point to a lack of benefit of homeopathic arnica in the peri-operative period, there seems little reason to actively recommend against its use for those patients so inclined.
What to do with this article: Keep the abstract on your computer.
Dr. Greenfield is Executive Editor of Alternative Medicine Alert and Medical Director of Carolinas Integrative Health, Carolinas Healthcare System, Charlotte, NC.