Homeopathy & Pain

physicians prescribe opioids at double the rates of physical therapy

Millions of adults in the United States use complementary health approaches to manage painful conditions such as arthritis, and back pain,¹ chronic musculoskeletal pain is a frequent reason for a medical visit, with US physicians found to be prescribing opioids at double the rates of physical therapy in 2017.²

Use of complementary therapies in paediatric populations increases worldwide, especially for pain and chronic conditions, as demonstrated in European³ and US ⁴ ⁵ epidemiological surveys.  Homeopathy, one of the most often used complementary therapies,⁶ was used by 47 % of Italian paediatric headache respondents.⁷ In 2012 an estimated 123,000 4-17 year old’s in the US were treated with homeopathy most often in back or neck pain, head or chest cold, other musculoskeletal conditions, anxiety or stress, and attention deficit hyperactivity disorder.⁸

Chronic Pain and Homeopathy in Double-blind, Randomized, Placebo-Controlled Clinical Trials:

Cervical spondylitis - an encouraging but nonsignificant direction of effect favoured individualized homeopathy over placebo in the treatment of Cervical spondylosis in pain, stiffness and weakness.⁹

Lumbar monosegmental spinal sequestrectomy - patients who took potentiated Hypericum in addition to usual pain management showed lower consumption of analgesics.¹⁰

Plantar fasciitis - preliminary findings of an underpowered RCT found individualized homeopathy acted over placebo in plantar fasciitis.¹¹

Dysmenorrhea - homeopathy acted favourably in the treatment of primary dysmenorrhea.¹²

Endometriosis - homeopathy was found to be significantly more effective than placebo for reducing endometriosis-associated pelvic pain.¹³ (Double-blind, Randomized, Placebo-Controlled Clinical Study)

Chronic low back pain - a homeopathic drug combination acted to improve the treatment of chronic low back pain.¹⁴

Chronic low back pain due to Osteoarthritis - a study too small to be conclusive, suggested a homeopathic drug combination, together with physiotherapy, can significantly improve symptoms.¹⁵ (A Randomized, Controlled Pilot Study)

Possibly the most robust homeopathy trial to date is Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo¹⁶

This 2004 double-blind, randomized, parallel-group, placebo-controlled trial of homeopathy followed fifty three physician-confirmed fibromyalgia participants who completed the treatment protocol of a randomized individually chosen homeopathic remedy or an indistinguishable placebo. Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression.

Authors of a 2018 chronic chikungunya arthritis study note homeopathy as an alternative to traditional pharmacological treatment¹⁷ citing a 2013 study¹⁸ where 90% of the twenty chronic phase cases achieved full recovery after an average of 32.5 days and did not return to traditional treatment.

Arnica, indicated when a part of the body is bruised, with a sore feeling produced by an injury, but also from other causes also such as the overexertion of an organ, or a strain, or an acute disease¹⁹ has been widely used in pain management and postoperative settings.²⁰ No other homeopathic medicine has been subject to more controlled clinical trials.²¹

A 2022 meta analysis found that homeopathic Arnica produced small effect size across a series of 18 placebo-controlled trials (just shy of significance) and is equal to conventional non-steroidal anti-inflammatory drugs in the treatment of postoperative pain, swelling, and functional limitations.²²

Within actual, real world homeopathic clinical settings, two individualized case studies using Arnica in the treatment of bone marrow edema (BME) of the knee joint have been published.²³

 Case one had an excellent clinical and radiological outcome. Receiving only homeopathic treatment, (Arnica 200CH selected after repertorization of the case) with almost no weight-bearing protection, the patient was pain-free in 4 months’ time from a grade 2 to 3 rupture of the posterior horn of the medial meniscus diagnosed, alongside extensive BME of the anterior aspect of the medial femoral condyle, via Magnetic resonance imaging (MRI, the gold-standard for the diagnosis of BME.) An MRI scan after 5 months showed that the BME of the femoral condyle had almost disappeared.

Case two proposed surgical treatment at the first examination, since the BME of the femoral condyle was extensive and already osteonecrosis of the condyle was present. The patient decided to choose only homeopathic treatment (Arnica 200CH, Arnica 30CH selected after repertorization of the case) with only minimal weight-bearing protection. A second MRI scan showed deteriorating femoral condyle lesions, but, interestingly, the tibial condyle lesions, obvious on the first scan, had almost disappeared. Osteonecrosis of the femoral condyle, being permanent organ damage, represents a very difficult physical obstacle, almost impossible to be treated by classical homeopathy. The authors do not regard this case as a Homeopathic failure - the tibial condyle was saved as was the actual joint, since the involvement of necrosis of the lateral tibial condyle as well would mean that the patient would most probably need a total knee arthroplasty.

(Case 2) MRI scan of the second patient on first consultation (top). Three months after treatment (bottom). Individualized Treatment of Bone Marrow Edema of the Knee With the Aid of Classical Homeopathy: A Report of 2 Cases(23)

Traumeel^® a registered homeopathically manufactured combination formula of twelve botanical and two mineral substances has demonstrated anti-inflammatory, anti-edematous, anti-exudative properties - the exact mechanism of action of which is still to be fully understood.²⁴

Traumeel has been found to be as effective as conventional medicines in the management of mild to moderate injuries, safe to use, and judged by physicians to be better tolerated than conventional medicines in the treatment of acute injuries and trauma.²⁵ Traumeel is reported to be a good alternative approach to dexamethasone for controlling pain, edema and trismus after third molar removal,²⁶ and an appealing and well-tolerated alternative to NSAIDs for symptomatic treatment of epicondylitis.²⁷

Sarah Penrose BSc(hons)Hom. is an Australasian homeopath and can be contacted at goodhealthforgreatlife.com

1. Nahin RL, Stussman BJ, Herman PM. Out-Of-Pocket Expenditures on Complementary Health Approaches Associated With Painful Health Conditions in a Nationally Representative Adult Sample. J Pain. 2015 Nov;16(11):1147-62. Available from https://pubmed.ncbi.nlm.nih.gov/26320946/

2. Feldman DE, Carlesso LC, Nahin RL. Management of Patients with a Musculoskeletal Pain Condition that is Likely Chronic: Results from a National Cross Sectional Survey. J Pain. 2020 Jul-Aug;21(7-8):869-880. Available from https://www.jpain.org/article/S1526-5900(19)30876-4/fulltext

3. Lambert TD, Morrison KE, Edwards J, Clarke CE. The use of complementary and alternative medicine by patients attending a UK headache clinic. Complement Ther Med. 2010 Jun-Aug;18(3-4):128-34. Available from https://pubmed.ncbi.nlm.nih.gov/20688258/

4. Davis MP, Darden PM. Use of complementary and alternative medicine by children in the United States. Arch Pediatr Adolesc Med. 2003 Apr;157(4):393-6. Available from https://pubmed.ncbi.nlm.nih.gov/12695237/

5. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008 Dec 10;(12):1-23. Available from https://pubmed.ncbi.nlm.nih.gov/19361005/

6. Beri A Jr, Pisulkar SG, Bansod AV, Dahihandekar C. Alternative Prosthodontic Therapies: A Multifaceted Approach. Cureus. 2022 Sep 20;14(9):e29363. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584032/

7. Dalla Libera D, Colombo B, Pavan G, Comi G. Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg. Neurol Sci. 2014 May;35 Suppl 1:145-8. Available from https://pubmed.ncbi.nlm.nih.gov/24867852/

8. Black LI, Clarke TC, Barnes PM, Stussman BJ, Nahin RL. Use of complementary health approaches among children aged 4-17 years in the United States: National Health Interview Survey, 2007-2012. Natl Health Stat Report. 2015 Feb 10;(78):1-19. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562218/

9. Tomar et al., Efficacy of Individualized Homeopathic Medicines in the Treatment of Cervical Spondylosis: A Double-Blind, Randomized, Placebo-Controlled Trial. Complement Med Res. 2023;30(1):26-36. English. Available from https://pubmed.ncbi.nlm.nih.gov/36244334/

10. Raak et al., Hypericum perforatum to Improve Postoperative Pain Outcome After Monosegmental Spinal Sequestrectomy (HYPOS): Results of a Randomized, Double-Blind, Placebo-Controlled Trial. J Integr Complement Med. 2022 May;28(5):407-417. Available from https://pubmed.ncbi.nlm.nih.gov/35171041/

11. Shahid et al., Efficacy of Individualized Homeopathic Medicines in Plantar Fasciitis: Double-blind, Randomized, Placebo-Controlled Clinical Trial. Homeopathy. 2022 Feb;111(1):22-30. Available from https://pubmed.ncbi.nlm.nih.gov/34492725/

12. Ghosh et al., 2021. Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial. J Complement Integr Med. Jun 3. Available from: https://pubmed.ncbi.nlm.nih.gov/34085495/

13. Teixeira MZ, Podgaec S, Baracat EC. Potentized estrogen in homeopathic treatment of endometriosis-associated pelvic pain: A 24-week, randomized, double-blind, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:48-55. Available from https://pubmed.ncbi.nlm.nih.gov/28187404/

14. Beer et al., Wirksamkeit und Sicherheit eines homöopathischen Komplexpräparates bei chronischen Rückschmerzen. Doppelblinde, randomisierte, placebokontrollierte, klinische Studie [Effectiveness and safety of a homeopathic drug combination in the treatment of chronic low back pain. A double-blind, randomized, placebo-controlled clinical trial]. MMW Fortschr Med. 2012 Jun 28;154 Suppl 2:48-57. German. Available from https://pubmed.ncbi.nlm.nih.gov/23424755/

15. Morris M, Pellow J, Solomon EM, Tsele-Tebakang T. Physiotherapy and a Homeopathic Complex for Chronic Low-back Pain Due to Osteoarthritis: A Randomized, Controlled Pilot Study. Altern Ther Health Med. 2016 Jan-Feb;22(1):48-56. PMID: 26773321. Available from https://pubmed.ncbi.nlm.nih.gov/26773321/

16. Bell et al., 2004. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology (Oxford). May;43(5):577-82. Available from https://academic.oup.com/rheumatology/article/43/5/577/1788410

17. Sales et al., Treatment of chikungunya chronic arthritis: A systematic review. Rev Assoc Med Bras (1992). 2018 Jan;64(1):63-70. Available from https://www.scielo.br/j/ramb/a/kcbnXjJRXNfNhLyctnTPr7B/?lang=en

18. Wadhwani GG. Homeopathic drug therapy. Homeopathy in Chikungunya Fever and Post-Chikungunya Chronic Arthritis: an observational study. Homeopathy. 2013 Jul;102(3):193-8. Available from https://www.thieme-connect.com/products/ejournals/abstract/10.1016/j.homp.2013.02.001

19. Vithoulkas, G. 1995. Materia Medica Viva: Volume 3. Alonissos, Greece, International Academy of Classical Homeopathy.

20. Iannitti et al., 2016. Effectiveness and Safety of Arnica montana in Post-Surgical Setting, Pain and Inflammation. American Journal of Therapeutics.  January/February 2016 23: 1. Available from: https://pubmed.ncbi.nlm.nih.gov/25171757/

21. Ernst & Pittler, 1998. Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials. Archives of Surgery [online]. Nov; 133 (11): 1187-90. Available from: https://pubmed.ncbi.nlm.nih.gov/9820349/

22. Gaertner et al., 2021. Is Homeopathic Arnica Effective for Postoperative Recovery? A Meta-analysis of Placebo-Controlled and Active Comparator Trials. Front Surg. Dec 17;8:680930. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718509/

23. 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 [online]. January 2020. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016301/

24. Vanden Bossche L, Vanderstraeten G. A multi-center, double-blind, randomized, placebo-controlled trial protocol to assess Traumeel injection vs dexamethasone injection in rotator cuff syndrome: the TRAumeel in ROtator cuff syndrome (TRARO) study protocol. BMC Musculoskelet Disord. 2015 Feb 4;16(1):8. Available from https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0471-z

25. Schneider C, Schneider B, Hanisch J, van Haselen R. The role of a homoeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med. 2008 Feb;16(1):22-7. Available from https://pubmed.ncbi.nlm.nih.gov/18346625/

26. Souza GM, Fernandes IA, Pinheiro MLP, Falci SGM. Comparative Effectiveness of the Homeopathic Preparation Traumeel S in Third Molar Extraction Surgery: A Preliminary Triple-Blind Clinical Trial. Homeopathy. 2021 Nov;110(4):229-235. Available from https://pubmed.ncbi.nlm.nih.gov/33765688/

27. Heinz Birnesser, Menachem Oberbaum, Peter Klein, Michael Weiser. The homeopathic preparation Traumeel S compared with NSAIDS for symptomatic treatment of epicondylitis. Journal of Musculoskeletal ResearchVol. 08, No. 02n03, pp. 119-128 2004 Available from https://www.worldscientific.com/doi/abs/10.1142/S0218957704001284