Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain

Abstract

Treatment with herbal medicines is very popular in Europe. In order to get information on the evidence of effectiveness of oral herbal medicines in the treatment of pain in the joints or lower back, OVID(MEDLINE), PUBMED and COCHRANE COLLABORATION LIBRARY were searched back to 1985 for systematic reviews. The level of evidence of effectiveness was defined as strong - at least two confirmatory studies demonstrating a clinical relevant effect, moderate - one confirmatory study with a clinical relevant effect and/or multiple exploratory studies of good quality; otherwise the evidence was insufficient or conflicting in the case of inconsistent findings. Fifteen systematic reviews were identified. The evidence of effectiveness was strong for a proprietary unsaponifiable avocado soybean fraction and Harpagophytum preparations containing > 50 mg harpagoside in the daily dosage, moderate for ginger and a proprietary rose hip and seed powder, insufficient for Boswellia serrata gum resin and other herbal preparations and inconsistent for a proprietary willow bark extract. Further rigorous studies are required to confirm the usefulness of herbal medicines in the treatment of osteoarthritic complaints and chronic low back pain in order to enable acceptance of the herbal medicines into the treatment guidelines.

Effect of a blend of comfrey root extract (Symphytum officinale L.) and tannic acid creams in the treatment of osteoarthritis of the knee: randomized, placebo-controlled, double-blind, multiclinical trials

“…Botanicals such as stinging nettle, 39 devil's claw, turmeric, and ginger 40 have yielded positive results, whereas avocado soybean fraction, rose hip, and seed powder showed moderate positive results and Boswellia serrata gum resin registered poor outcomes. 41 Previous studies using comfrey have all suggested that the herb is effective in treating edema 15,22 and pain associated with OA. Previous studies have found a 46% 42,43 and a 54.7% 24 reduction in OA knee pain following a regimen of comfrey cream use compared with a 10.7% improvement in a placebo group.…”

Anti-Inflammatory Activity of Vitex leucoxylon L. Bark Extracts Against Freund's Complete Adjuvant Induced Arthritis in Sprague Dawley Rat

“…Unfortunately most of the anti-inflammatory drugs, particularly steroids and cyclooxygenase inhibitors are often associated with adverse side effects including, GI irritation, ulcers, hypertension and cardiac abnormalities [5][6] . The use of herbal remedies for arthritis treatment has been gaining momentum in recent years [7] . There has been some concern over the use of COX-2 inhibitors for therapeutic intervention, especially since some of the products based on COX-2 were either withdrawn or made to carry warning by the US FDA [8,9] .…”

5 Medicinal Plants Used in Iranian Traditional Medicine for Low Back Pain: A Quick Review

“…The patients have been randomly assigned to receive an oral willow bark extract with either 120 mg (low dose) or 240 mg (high dose) of salicin, or placebo, with tramadol as the sole rescue medication, in a 4-week blinded trial. This research has indicated that Willow bark extract may be a useful and safe treatment for low back pain [39].…”