Arnica and Bruising

Following a discussion with a colleague of mine last week and a thread on the the badscience fora I did a little bit of research into the effect of homeopathic Arnica gel on bruising. Basically my colleague, who shall be known as Catherine, was trying to persuade me that Arnica gel definitely aided the healing of bruises as she’d had two bruises on her knee, one which she treated with said gel and one that she didn’t and that one stayed for longer. She wouldn’t accept that this is anecdote, and that maybe that bruise was less severe in the first place etc etc.

Anyway a quick search of PubMed for “arnica bruising” found a grand total of 8 hits. The earliest 2 are general homeopathy reviews[1,2] from Professional Care of Mother and Child (now the Journal of Family Health Care) which not only do I have no access to, but doesn’t even appear in the ISI Journal Citation Reports suggesting it may not be the most well-respected of journals. The 3rd appears to be a well-designed trial,[3] but againI only have access to the abstract which states “The role of homeopathic and herbal agents for recovery after surgery merits further investigation” no more, no less.

The 4th [4] is another randomised, placebo-controlled, double-blinded trial and this time I have full access! This investigated the effect of pre and post-operatively applied arnica gel on bruising caused by facial laser surgery. Unfortunately the groups are very small (9 pre-op and 10 post-op) but the results… “No significant difference was found between topical arnica and vehicle [placebo] in the prevention or resolution of bruising”.

Refs 5-7 were another trial on the effect of homeopathic arnica and subsquent letters claiming the invalidity of the trial (the results were negative by the way). As this involves a lot toing and frowing over statistical methods that I don’t fully understand I will refrain on commenting on these.

The final trial was another trial into arnicas effect on post-operatve bruising from facial laser surgery. [8] Those given arnica were found to have smaller ecchymosis on the days they were examined (1, 5, 7 and 10 days after surgery), but this was only statiscally significant on days 1 and 7. Now this seems odd to me, because if arnica gel does have an effect on bruising why does this effect undulate over time? I would be more willing to accept this if it either had an effect at the beginning and then tailed off, suggesting it could only do so much to help, or if its effects were only seen in the latter stages, suggesting persistent usage was needed to see an effect.

So, from this what can we determine? Not a huge amount really, arnica gel appears to have some effect in some cases, but requires larger, well designed trials to determine if it really does.

Now the thing that really pissed me off with the discussion I had with Catherine was that she ended her side of the argument by stating (I’m paraphrasing here) that “well you’re obviously not going to be convinced whatever I say”. Funnily enough I pointed out to her that she’d offered me know evidence and that’s what I form an opinion from rather than using anecdote and basically a belief system. At the end of the day if she wishes to waste her money on buying something that has no proven efficacy then bully for her, just don’t accuse me of being the one acting on faith, I’ll stick to the evidence available at the time.

[1] Prof Care Mother Child. 1994 Aug-Sep;4(6):185-7

[2] Prof Care Mother Child. 1994 Oct;4(7):212-3.

[3] Altern Ther Health Med. 2002 Mar-Apr;8(2):66-8.

[4] Dermatol Surg. 2002 Aug;28(8):686-8.

[5] J R Soc Med. 2003 Feb;96(2):60-5.

[6] J R Soc Med. 2003 Apr;96(4):204; author reply 206-7.

[7] J R Soc Med. 2003 Apr;96(4):204-5; author reply 206-7.

[8] Arch Facial Plast Surg. 2006 Jan-Feb;8(1):54-9.

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