Homeopathy for osteoarthritis
Clinical bottom line
There were only four randomised trials, of short duration, in which there was no convincing evidence that homeopathy was particularly beneficial for osteoarthritis.
Osteoarthritis is a common condition, and is often treated with NSAIDS. These can cause severe harmful effects through gastrointestinal bleeding, particularly in elderly people.
L Long & E Ernst. Homeopathic remedies for the treatment of osteoarthritis: a systematic review. British Homeopathic Journal 2001 90: 37-43.
Date review completed : August 2000
Number of trials included : 4 randomised controlled trials
Number of patients : 406 in active and placebo groups
Control group : placebo and active
Main outcomes : various
Computer searches of six electronic databases, plus manual searches.
There were four randomised studies. They were generally of short duration (2-5 weeks), and each used a different homeopathic remedy. Outcomes were different in each trial, though involved mainly pain on movement, or at rest, or joint tenderness.
One study showed no difference between intra-articular homeopathy and intra-articular hyaluronic acid.
One showed no difference between a sublingual homeopathic remedy and paracetamol.
One showed no difference between a homeopathic remedy and placebo, though fenoprofen was superior to both.
One showed no difference between a topical homeopathic remedy and topical piroxicam gel on one outcome, but did on another.
The main problem with these studies is that they were short. Major randomised trials comparing conventional therapy against placebo in studies where pain is severe because of a 'flare' in arthritis have shown that placebo is associated with reduction in pain. This can be due to patients using escape medicines (over-the-counter analgesics and NSAIDs). The ability of the studies to detect a true difference for continued treatment is low or non-existent. Individually or together these studies show that there is no convincing evidence that homeopathy is of any value for osteoarthritis.