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Abstract

Arnica, also known as mountain daisy, mountain tobacco, and leopard’s bane, is a perennial herb of the family Asteraceae.[1][1],[2][2] The herb, which has orange-yellow daisy-like flower heads, is native to the meadows and mountainous regions of Europe and western North America. Europeans and
... Treatment is available in the form of several homeopathic commercial products, including gels, creams, roll-ons, teas, pellets, liquids, and tablets [11]. These products are widely available in retail pharmacies ranging in strengths from 1 X to 30 X. Homeopathic medicine is dosed based on ten-fold dilutions, so a 30 X product has been diluted in a 1:10 ratio thirty times [12]. ...
... In the United States, Arnica is available in natural products, although varying concentrations can occur in these formulations due to less strenuous labeling and testing requirements [14]. In addition to pharmaceutic preparations, it is also used in cosmetic products, hair tonics, anti-dandruff products, and as natural flavorings in foods and beverages [11]. ...
... In the last few decades, clinical studies have been conducted to investigate the activity of Arnica on pain under different conditions, such as post-operation and with arthritis. The commonly used forms of Arnica are a diluted hydroalcoholic extract of flower heads or fresh plants, creams, ointments, and gels containing Arnica extract or Arnica oil [11]. ...
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Arnica has traditionally been used in treating numerous medical conditions, including inflammation and pain. This review aims to summarize the results of studies testing Arnica products for pain management under different conditions, including post-operation, arthritis, low back pain, and other types of musculoskeletal pain. Based on data from clinical trials, Arnica extract or gel/cream containing Arnica extract shows promising effects for pain relief. These medical benefits of Arnica may be attributed to its chemical components, with demonstrated anti-inflammatory, antioxidant, anti-microbial, and other biological activities. In conclusion, Arnica could be an adjunct therapeutical approach for acute and chronic pain management.
... Arnica is used a lot for self-care (10,11) and also in midwifery (12) and surgery (13). Meanwhile, some 30 studies have been conducted where homeopathic Arnica has been applied before or after surgery to improve wound healing, stop bleeding and swelling, and reduce pain. ...
... The variation in effect sizes is large. In some cases Arnica might be counter-indicated, especially if used in a preventive mode, as it might facilitate bleeding (11) and diminish fibrinogen (50). Only two trials were included in the sensitivity analysis of therapeutic use of Arnica with placebocontrolled trials. ...
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Background: Homeopathic Arnica montana is used in surgery as prevention or treatment for the reduction of pain and other sequelae of surgery. Our aim was to perform a metaanalysis of clinical trials to assess efficacy of Arnica montana to reduce the inflammatory response after surgery. Method: We conducted a systematic review and metaanalysis, following a predefined protocol, of all studies on the use of homeopathic Arnica montana in surgery. We included all randomized and nonrandomized studies comparing homeopathic Arnica to a placebo or to another active comparator and calculated two quantitative metaanalyses and appropriate sensitivity analyses. We used “Hegde's g,” an effect size estimator which is equivalent to a standardized mean difference corrected for small sample bias. The PROSPERO registration number is CRD42020131300. Results: Twenty-three publications reported on 29 different comparisons. One study had to be excluded because no data could be extracted, leaving 28 comparisons. Eighteen comparisons used placebo, nine comparisons an active control, and in one case Arnica was compared to no treatment. The metaanalysis of the placebo-controlled trials yielded an overall effect size of Hedge's g = 0.18 (95% confidence interval −0.007/0.373; p = 0.059). Active comparator trials yielded a highly heterogeneous significant effect size of g = 0.26. This is mainly due to the large effect size of nonrandomized studies, which converges against zero in the randomized trials. Conclusion: Homeopathic Arnica has a small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries. The effect is comparable to that of anti-inflammatory substances.
... Arnica is a genus of herbaceous plants native to Europe and the mountains of Western North America which has gained increasing popularity in complementary and alternative medicine. Due to its hematopoietic properties, arnica plays a key role in reducing edema and ecchymosis [3,4]. Although its exact mechanism in the reduction of edema and ecchymosis remains unclear, various theories have been proposed. ...
... Although its exact mechanism in the reduction of edema and ecchymosis remains unclear, various theories have been proposed. Among these, one theory posits that arnica reduces histamine release via mast cells and another theory proposes that arnica reduces the expression of proinflammatory cytokines as well [3][4][5][6][7]. On the other hand, some of the studies examining the efficacy of arnica have shown its favorable effects on edema, ecchymosis, and pain [8][9][10][11][12]. ...
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Purpose: The aim of this study to investigate the effect of bromelain-arnica gel combination on periorbital edema and ecchymosis seen after open septorhinoplasty. Methods: Sixty patients who performed open septorhinoplasty with osteotomies were included to the study. These patients were allocated into two groups: in group 1, 30 patients as control and in group 2, 30 patients as study group who were treated with topical bromelain-arnica gel after surgery. Scoring of eyelid edema and peroirbital ecchymosis were evaluated on the first, third and seventh postoperative days using scale of 0 to 4 used by observers. Results: We observed that the administration of topical bromelain-arnica gel after surgery was effective clinically and statistically in decreasing the score of both edema and ecchymosis in open septorhinoplasty with ostetomies. In group 2 patients, periorbital edema and ecchymosis scores were significantly lower compared to control group (p < 0.05). Conclusions: Our results support that topical administration of bromelain and arnica gel combination provided both clinically and statistically significant reduction in periorbital edema and ecchymosis following septorhinoplasty.
Chapter
Arnica montana, is a hemicryptophyte plant, belongs to the Asteraceae family. It is a medicinally significant herb that is used in traditional medicine systems in many countries. Flowers, roots, and rhizomes of Arnica are traditionally used for the topical treatments of various ailments such as bruises, sprains, backache, rheumatic arthritis, and phlebitis. Sesquiterpene lactones, flavonoids, fatty acids, thymol derivatives, and chlorogenic acid are the main bioactive phytochemicals. Extract and compounds from A. montana exhibited several pharmacological activities: anti-inflammatory, anticancer, antioxidant, antimicrobial, antiplatelets, and immunomodulatory activities. Helenalin and dihydrohelinalin are mainly responsible for their anti-inflammatory properties. The clinical trial using gel, cream, oil, ointment, and homeopathic dilutions revealed significant effects in relieving postoperative pains, surgical complications, swelling, edema, and ecchymosis. Different clinical trials using randomized placebo-controlled, randomized double-blinded, and open multicenter trials against different diseases reflect the medicinal importance of this plant. The aim of this chapter is to insight knowledge about the traditional uses, chemical compositions, pharmacological activities, and clinical trials of the plant Arnica montana. In vitro in in vitro.Keywords Arnica montana HomeopathySesquiterpene lactonesAnti-inflammatoryPlacebo-controlled
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Homeopathic and naturopathic supplementation has gained increasing popularity as complementary and alternative medicine (CAM) modalities. Arnica and Bromelain are 2 commonly used supplements thought to be effective in reducing ecchymosis. This study was designed to explore the impact of combination therapy with Arnica and Bromelain on postoperative ecchymosis in patients undergoing blepharoplasty. In total, 130 patients undergoing upper eyelid blepharoplasty were enrolled. Patients with bleeding diatheses or inability to comply with cessation of anticoagulants were excluded. Aspirin and all naturopathic and homeopathic treatments were discontinued 2 weeks prior to surgery. In all, 64 patients received oral Arnica and Bromelain treatment starting 7 days prior to surgery and extending 7 days postoperatively. Sixty-six patients received no supplementation. Upper eyelid blepharoplasty was performed with skin flap excision, hemostasis with electrocautery, and closure with running 6-0 fast absorbing plain gut. Postoperative photos were taken 7 days following surgery. Photos were analyzed by 2 blinded reviewers, who graded the severity of ecchymosis using a visual analog scale. All 130 patients were seen during the postoperative course. There were no patients lost to follow-up, and there were no adverse reactions to the treatment protocol that necessitated discontinuation of Arnica and Bromelain. Average ecchymosis in the treatment arm was 5.00 compared with 4.43 in the control arm (P = .67). At the conclusion of this study, the investigators find insufficient evidence that the combination of Arnica and Bromelain is effective at producing a statistically significant difference in ecchymosis following upper eyelid blepharoplasty.
Chapter
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Chapter
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Homeopathic arnica is widely believed to control bruising, reduce swelling and promote recovery after local trauma; many patients therefore take it perioperatively. To determine whether this treatment has any effect, we conducted a double-blind, placebo-controlled, randomized trial with three parallel arms. 64 adults undergoing elective surgery for carpal tunnel syndrome were randomized to take three tablets daily of homeopathic arnica 30C or 6C or placebo for seven days before surgery and fourteen days after surgery. Primary outcome measures were pain (short form McGill Pain Questionnaire) and bruising (colour separation analysis) at four days after surgery. Secondary outcome measures were swelling (wrist circumference) and use of analgesic medication (patient diary). 62 patients could be included in the intention-to-treat analysis. There were no group differences on the primary outcome measures of pain ( P=0.79) and bruising ( P=0.45) at day four. Swelling and use of analgesic medication also did not differ between arnica and placebo groups. Adverse events were reported by 2 patients in the arnica 6C group, 3 in the placebo group and 4 in the arnica 30C group. The results of this trial do not suggest that homeopathic arnica has an advantage over placebo in reducing postoperative pain, bruising and swelling in patients undergoing elective hand surgery.
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To determine whether homeopathic Arnica can reduce postoperative haematomas in venous surgery. Randomized, prospective, multicentric, double-blind placebo-controlled trial. 130 consecutive patients undergoing saphenous stripping (204 legs), hospitalized in a clinic. A homeopathic medicine (Arnica CH5) and an indistinguishable placebo, administered sublingually by a nurse the night before and immediately after the operation. Clinical evaluation of haematomas 6 days postoperatively. Groups were well matched (sex, age, history of bleeding or thrombosis, drug intake, previous intake of homeopathic drugs, type of operation and anaesthesia, operator). One drop-out has been replaced. No statistically significant difference in postoperative haematomas was found between the Arnica and placebo groups (p = 0.342). Subanalysis of all other items did not reveal any statistical difference either. In this study, with this dosage, we did not observe any preventive effect of homeopathic Arnica CH5 on poststripping haematomas.
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Arnica is commonly used by the public as a treatment for bruising and swelling. To assess whether Arnica administration affects recovery from hand surgery. Double-blind, randomized comparison of Arnica administration versus placebo. Specialist hand surgery unit at the Queen Victoria NHS Trust. Thirty-seven patients undergoing bilateral endoscopic carpal-tunnel release between June 1998 and January 2000. Homeopathic Arnica tablets and herbal Arnica ointment compared to placebos. Grip strength, wrist circumference, and perceived pain measured 1 and 2 weeks after surgery. No difference in grip strength or wrist circumference was found between the 2 groups. However, there was a significant reduction in pain experienced after 2 weeks in the Arnica-treated group (P<.03). The role of homeopathic and herbal agents for recovery after surgery merits further investigation.
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Alcoholic extracts prepared form Arnicae flos, the collective name for flowerheads from Arnica montana and A. chamissonis ssp. foliosa, are used therapeutically as anti-inflammatory remedies. The active ingredients mediating the pharmacological effect are mainly sesquiterpene lactones, such as helenalin, 11 alpha,13-dihydrohelenalin, chamissonolid and their ester derivatives. While these compounds affect various cellular processes, current data do not fully explain how sesquiterpene lactones exert their anti-inflammatory effect. We show here that helenalin, and, to a much lesser degree, 11 alpha,13-dihydrohelenalin and chamissonolid, inhibit activation of transcription factor NF-kappa B. This difference in efficacy, which correlates with the compounds' anti-inflammatory potency in vivo, may be explained by differences in structure and conformation. NF-kappa B, which resides in an inactive, cytoplasmic complex in unstimulated cells, is activated by phosphorylation and degradation of its inhibitory subunit, I kappa B. Helenalin inhibits NF-kappa B activation in response to four different stimuli in T-cells, B-cells and epithelial cells and abrogates kappa B-driven gene expression. This inhibition is selective, as the activity of four other transcription factors, Oct-1, TBP, Spl and STAT 5 was not affected. We show that inhibition is not due to a direct modification of the active NF-kappa B heterodimer. Rather, helenalin modifies the NF-kappa B/I kappa B complex, preventing the release of I kappa B. These data suggest a molecular mechanism for the anti-inflammatory effect of sesquiterpene lactones, which differs from that of other nonsteroidal anti-inflammatory drugs (NSAIDs), indomethacin and acetyl salicylic acid.
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This study investigates the effect on human platelet function of two sesquiterpene lactones from Arnica montana L., helenalin (H) and 11 alpha,13-dihydrohelenalin (DH). Both compounds inhibited collagen-induced platelet aggregation, thromboxane formation and 5-hydroxytryptamine secretion in a concentration-dependent manner at 3-300 microM. When arachidonic acid was used as stimulus, thromboxane formation remained unaffected despite of inhibition of platelet aggregation. Both H and DH reduced the number of acid-soluble sulfhydryl groups in platelets, by up to 78% at anti-aggregatory concentrations. Moreover, H- and DH-induced platelet inhibition could be prevented by the thiol containing amino acid cysteine. It is concluded that H and DH inhibit platelet function via interaction with platelet sulfhydryl groups, probably associated with reduced phospholipase A2 activity.
Article
Homoeopathic potencies of arnica have been used for many years to aid postoperative recovery. The effects of arnica C30 on pain and postoperative recovery after total abdominal hysterectomy were evaluated in a double-blind, randomized, controlled study. Of 93 women entered into the study, 20 did not complete protocol treatment: nine were excluded because they failed to comply with the protocol, nine had their operations cancelled or changed within 24 h and two had to be withdrawn because of the recurrence of previously chronic painful conditions. Those who did not complete protocol treatment were equally divided between the arnica (nine patients) and placebo groups (11 patients). 73 patients completed the study, of whom 35 received placebo and 38 received arnica C30. The placebo group had a greater median age and the arnica group had slightly longer operations; nevertheless, no significant difference between the two groups could be demonstrated. We conclude that arnica in homoeopathic potency had no effect on postoperative recovery in the context of our study.
Article
To determine whether homeopathic Arnica 30X can reduce muscle soreness following long-distance running more than a placebo. Randomized, double-blind placebo-controlled trial. Long-distance runs taking place in the community. A total of 519 runners anticipating delayed-onset muscles soreness after long-distance races. A homeopathic medicine (Arnica 30x) and an indistinguishable placebo. Subjects completed a visual analog scale and Likert scale of muscle soreness every morning and evening for the 5 days following their race. Race time was also recorded. The main outcome measure was mean 2-day visual analog scores. Results were obtained from 400 subjects. Groups were well matched at baseline. Mean 2-day visual analog soreness scores for Arnica and placebo were 45.2 mm and 41.0 mm, respectively. The 95% confidence interval was between 8.81 mm in favor of placebo and 0.51 mm in favor of Arnica. No differences were found for Likert scores or race time. Homeopathic Arnica 30x is ineffective for muscle soreness following long-distance running.
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Claims have been made suggesting that topical arnica prevents and speeds the resolution of bruises, yet there are no well-designed placebo-controlled studies to date evaluating topical arnica's effect on bruising. To compare the efficacy of topical arnica in the prevention and resolution of laser-induced bruising. Nineteen patients with facial telangiectases were enrolled in this randomized, double-blinded, placebo-controlled study and were divided into pretreatment and posttreatment groups. The pretreatment group applied arnica with vehicle to one side of the face and vehicle alone to the other side of the face twice a day for 2 weeks prior to laser treatment. The posttreatment group followed the same procedure for 2 weeks after laser treatment. On day 0, all patients were treated for facial telangiectases using a 585 nm pulsed dye laser. Bruising was assessed using a visual analog scale on days 0, 3, 7, 10, 14, and 17 by the patient and the physician. In addition, photographs taken at each of the follow-up visits were later assessed by a second physician using the visual analog scale. There was no statistically significant difference between the mean scores of arnica and vehicle (P = 0.496) and the mean scores of arnica and vehicle (P = 0.359) in the pretreatment and posttreatment groups, respectively. No significant difference was found between topical arnica and vehicle in the prevention or resolution of bruising.