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ALTERNATIVE MEDICINES - THE NEED FOR CAREFUL EVALUATION
(January 2004)

Arnica is an alpine plant. It is said to be useful after surgery or trauma in reducing pain, bruising, and swelling. Despite a substantial amount of support from anecdotal reports and uncontrolled studies, there was no properly controlled study. Now, there is one and the results are completely negative. Investigators in England studied 62 patients undergoing surgery for carpal tunnel syndrome; one-third were given a high dose of arnica starting seven days before and continuing for fourteen days after surgery; one-third were given a lower dose, and one-third were given an inactive placebo and served as controls. No reduction in pain, swelling, or bruising was seen in the arnica treatment groups. The investigators concluded “the results of this trial do not suggest that homeopathic arnica has any advantage in reducing post-operative pain, bruising, and swelling in patients undergoing elective hand surgery”.

This study is reviewed because it emphasizes an important point.

Uncritical advocacy, favorable anecdotes, and inadequately controlled studies cannot be allowed to substitute for well-conducted controlled trials. Most alternative and complementary medicines have never been tested properly.

Arnica joins a growing group of such medicines that have failed the controlled study test and can no longer be considered useful. That list includes chelation for treatment of coronary heart disease; St John’s wort for moderately severe or severe depression (it is okay for mild depression); Coenzyme Q10 for heart failure, milk thistle to keep the liver healthy, ginseng for psychological well being or mood elevation, and probably eichinacea for treatment of colds, and ginkgo for improving memory in normal adults.

Stevinson, C., et al. Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery. Journal of the Royal Society of Medicine. Vol 96 (February) Pgs 60-65. 2003.