Cochrane review in their own words

Topical herbal therapies for treating osteoarthritis

Melainie Cameron
University of the Sunshine Coast, School of Health and Sport
Sciences, Queensland, Australia

The original Cochrane Review was published in 2000 (1), and

the separation of its updating into orally and topically used
herbal medicines partly reflects the fact that some topical
herbal medicines have a skin irritating effect that contributes
to their mechanism of action, or they are toxic when used
orally.
We found seven studies for this review (2), investigating
seven herbal medicines: Arnica montana, Capsicum species,
Symphytum officinale (that is, comfrey), Urtica dioica (stinging nettle), and three polyherbal mixtures. These are two Chinese herbal mixtures: Fufang Nanxing Zhitong Gao (FNZG)
and Shangshi Jietong Gao (SJG), and Marhame-Mafasel.
This research evidence suggests that there might be some
benefits for some of these treatments, but further studies are
needed to confirm the effects beyond doubt.
We have found that the proprietary gels from Arnica, and
comfrey, and adhesive patches containing the Chinese herbal
mixtures may alleviate osteoarthritic complaints, based on
single studies with a confirmatory study design. The head-to-

200

head comparisons of the two Chinese herbal mixtures dont

show a preference for one over the other.
Considering the other treatments, the 0.0125% capsaicin
preparation used in the one included study of this treatment
is a lower dose than commonly used in clinical practice,
and the results did not show clinically relevant improvement. While, the low quality of the studies of nettle leaf
and the polyherbal compress Marhame-Mafasel mean that
they are inadequate to allow judgement of the clinical effectiveness of these products. Serious side effects were not
reported with any intervention, but skin irritations were common, particularly with stinging nettle leaf and Capsicum
extract gel.
In summary, when considering topical herbal medicines
for osteoarthritis, there is a need to increase the body of
evidence on their effects through new, high quality clinical
studies, and to conduct further research to identify their active
constituents and to better understand their mechanisms of
action.
1. Little CV, Parsons T, Logan S. Herbal therapy for treating
osteoarthritis. Cochrane Database of Systematic Reviews 2000,
Issue 4. Art. No.: CD002947.
2. Cameron M, Chrubasik S. Topical herbal therapies for treating
osteoarthritis. Cochrane Database of Systematic Reviews 2013,
Issue 5. Art. No.: CD010538.

C 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University
JEBM 6 (2013) 200 

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