Homeopathy & knee osteoarthritis
local heat as prognostic value
To date, just two trials investigating the use of homeopathy in the treatment of knee osteoarthritis have been conducted.
Individualized Homeopathic Medicines in the Treatment of Knee Osteoarthritis: Double-Blind, Randomized, Placebo-Controlled Feasibility Trial1 concluded ‘the action of Individualized Homeopathic Medicine (IHM) was found to be superior to that of placebos in the treatment of knee Osteoarthritis.’ Conducted during COVID lockdowns this trial included forty patients, and sulphur was the most frequently prescribed IHM.
A Double-Blind Randomized Placebo-Controlled Feasibility Study Evaluating Individualized Homeopathy in Managing Pain of Knee Osteoarthritis2 found ‘homeopathy did not appear to be superior to placebo.’ The researchers suggested ‘further rigorous evaluation in this design involving a larger sample size seems feasible in future.’ Sixty patients were included, the most frequently prescribed IHM was bryonia.
Both studies included subjective Visual Analog Scale (VAS) measurements of pain, stiffness, and loss of function but with differing significance.
Koley et al., measuring at baseline and at two weeks recorded statistically significant VAS reduction as a primary outcome measure, whereas Bhattacharyya et al., measured VAS as part of two secondary outcome measures at baseline and at two months.
Interestingly, VAS were the only outcome measurements the studies had in common.
The Patient Response Assessment Tool after Homeopathic Treatment (PRATHoT) was used to assess outcomes after individualized homeopathy treatment in thirty seven knee osteoarthritis patients - a higher score was significantly associated with achieving pain VAS responses post the second follow-up visit.3
Drawing on two randomized trials of the use of topical homeopathic gel in the treatment of knee osteoarthritis, van Haselen4 found that symptom amelioration with local heat may be of prognostic value in musculoskeletal pain relief following use of a homeopathic product.
This study also illustrates that it is possible to quantitatively investigate aspects of individualized homeopathy treatment alongside carefully designed and executed randomized trials, in alignment with the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) Statement.5
Additional helpful reading
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Homeopathy & Pain
Millions of adults in the United States use complementary health approaches to manage painful conditions such as arthritis, and back pain, chronic musculoskeletal pain is a frequent reason for a medical visit, with US physicians found to be prescribing opioids at double the rate of physical therapy.
Global Day against Pain & Homeopathy
Worldwide one in five people suffer with moderate or strong chronic pain, which renders one in three incapable, or hardly capable, of leading an independent life. One in four state pain interferes with or destroys their relations with family and friends.
Homeopathy & thousands
This brief post is formed from comments on an earlier post Homeopathy, Cochineal, and Carmine - a case of coughing regarding long term, large cohort, chronic disease outcomes and homeopathy studies
(this article also links to Chabanov et al.,6 who followed a case of juvenile rheumatoid arthritis for 18 years.)
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Homeopathy & Arnica montana
Arnica montana L. (Asteraceae) is an herbaceous perennial plant growing wild across the mountains of Europe and included on the International Union for the Conservation of Nature endangered species list with regulated harvesting confined to just several areas in France and Germany.
(this article links to two case reports outlining treatment of bone marrow edema (BME) of the knee joint.)7
‘In contrast to frequent claims, the available MAs of homoeopathy in placebo-controlled randomised trials for any indication show significant positive effects beyond placebo. Compared to other medical interventions, the quality of evidence for efficacy of homoeopathy was similar or higher than for 90% of interventions across medicine.8 Accordingly, the efficacy evidence from placebo-controlled randomised trials provides no justification for regulatory or political actions against homoeopathy in health-care systems.’9
Bhattacharyya et al., 2024. Individualized Homeopathic Medicines in the Treatment of Knee Osteoarthritis: Double-Blind, Randomized, Placebo-Controlled Feasibility Trial. Homeopathy. Aug;113(3):158-166. PMID: 37748512
Koley M, Saha S, Ghosh S, 2015. A double-blind randomized placebo-controlled feasibility study evaluating individualized homeopathy in managing pain of knee osteoarthritis. J Evid Based Complementary Altern Med. Jul;20(3):186-91. PMID: 25636410
Saha et al., 2014. Hering's Law Assessment Tool revisited: introducing a modified novel version-Patients' Response Assessment Tool after Homeopathic Treatment (PRATHoT) in chronic cases. J Evid Based Complementary Altern Med. Oct;19(4):260-6. PMID: 25053753
van Haselen R, 2021. Development of a Prognostic Factor Prediction Model in Patients with Musculoskeletal Pain Treated with Homeopathy: An Individual Patient Data Meta-Analysis of Three Randomized Clinical Trials. Complement Med Res. 28(1):46-55 DOI:10.1159/000508716
Moons et al., 2015. Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration. Ann Intern Med. Jan6. PMID: 25560730
Chabanov D, Tsintzas D, Vithoulkas G. 2018. Levels of Health Theory With the Example of a Case of Juvenile Rheumatoid Arthritis. Journal of Evidenced Based Integrative Medicine. Jan-Dec23. DOI:10.1177/2515690X18777995
Tsintzas et al., 2020. Individualized Treatment of Bone Marrow Edema of the Knee With the Aid of Classical Homeopathy: A Report of 2 Cases. Clinical Medicine Insights: Case Reports. PMID: 32110129
Howick et al., 2022. Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis. J Clin Epidemiol. Aug;148:160-169. PMID: 35447356
Hamre et al., 2023. Efficacy of homoeopathic treatment: Systematic review of meta-analyses of randomised placebo-controlled homoeopathy trials for any indication. Systematic Rev. Oct 7;12(1):191. PMID: 37805577