Blending arnica oil with base oil poses no danger to patients. Fact or fiction?
Arnica is a very popular herbal remedy usually blended in cream, ointments, lotions and salves to alleviate a number of ailments such as bruises and similar injuries. In particular, sports men and women swear by this remedy whether used internally or topically to soothe muscle aches and relieve the pain and swelling of sprains. Also professional body workers such as therapeutic massage therapists, physiotherapists and even beauty therapists use arnica massage oil blends to treat muscle soreness caused by exercise and to reduce inflammation. Pre-mixed oil may be used neat or added to almond or grapeseed oil. Often this blend is used for all patients across the board.
So, how beneficial and how safe is it to use arnica in a massage base oil?
Evidence for the beneficial effects of Arnica Montana
One has to be careful when evaluating the evidence of arnica’s beneficial effects to distinguish between arnica as a homeopathic remedy (usually in the form of tablets or oral drops to be ingested) and arnica as a herbal remedy (presented as creams, ointments and in massage oil blends). According to Leivers (2005: 289) confusing the two has led to “the incorrect assumption that clinical research into homeopathic arnica may be used when assessing the evidence base of herbal arnica products.” The two types of remedies might share the same plant source but each stream uses very different formulae. He argues that the evidence base supporting each of them must therefore be reviewed separately.
According to Leivers there is considerable pharmacological data to justify the herbal use of arnica. He quotes non-clinical and clinical studies that indicate a number of benefits:
- Studies of the components of the plant and related compounds have been shown significant anti-inflammatory action.
- Improvement to the venous tone, oedema and ‘feeling of heaviness’ in legs (A second identical study however indicated improvement for both the active and the placebo group with no difference between the two)
- Decrease in pain and stiffness after using arnica gel in patients with mild to moderate osteoarthritis of the knee.
- Relief of muscle ache after using arnica gel.
A study by Widrig, Suter, Saller and Melzer titled Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study, demonstrated that arnica gel was similar to ibuprofen gel in terms of hand functional capacity, pain intensity, number of painful joints, duration and severity of morning. Topical application of Arnica montana was chosen because:
- it has published data from preclinical studies of some anti-inflammatory action,
- the preparation has published evidence of skin penetration and
- it is available as a gel that is similar to the ibuprofen gel, so it could not be distinguished from the control during the study.
Unproven Uses
Arnica has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. These include antibacterial, antifungal, antiseptic, bruises, carpal tunnel syndrome, chronic venous insufficiency, contusion, cramps, fibrositis, joint pain, marathon running, musculoskeletal injury, nerve pain and rheumatoid arthritis
Researchers Alonso, Lazarus and Baumann’s are however not convinced by the claims that topical arnica prevents bruising nor clears it away. In their study on the Effects of Topical Arnica Gel on Post-Laser Treatment Bruises, they note that “despite a lack of controlled studies demonstrating any positive effect, arnica-containing topical remedies are still being marketed for bruise prevention and clearing.” They argue that it “should be shelved, taking its place next to all of the other snake-oil remedies that flood the derma-cosmeceutical market”. Alonso and colleagues conducted a small placebo-controlled clinical trial in 19 patients receiving pulsed dye laser (PDL) treatment for facial telangiectases or red spots on the skin. Statistical analysis of arnica-treated vs placebo gel-treated skin revealed no difference between bruise severity nor duration in either pre-treatment or post-treatment groups. When investigators charted the mean VAS scores over time (day 0-day 17), placebo-treated and arnica-treated sides were essentially superimposable. They conclude that topical arnica gel does nothing to prevent PDL-induced purpura or bleeding under the skin that causes purplish blotches nor does it shorten the duration.
No studies involving arnica massage oil blends could be traced.
Sources:
1. Alonso, Lazarus and Baumann’s Effects of Topical Arnica Gel on Post-Laser Treatment Bruises, Dermatologic Surgery August 2002; 28:6
2. Harvard Medical School-InteliHealth Partnership, The http://www. intelihealth.com
3. Leivers, K. (2005). Unravelling the confusion around arnica’s herbal and homeopathic use. The Pharmaceutical Journal; 2005; 275: 289 -291. Downloaded from: http://www.pjonline.com/pdf/articles/pj_20050903_arnica.pdf
4. Widrig R, Suter A, Saller R, Melzer J. Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study. Rheumatol Int. 2007; 27:585-591.