Arthritic conditions occur commonly and can be progressively disabling for some people. It is thought that unpleasant side effects associated with conventional treatments for arthritis lead to wide use of complementary and alternative medicine. The objective of this review was to assess the evidence for plant and herbal therapies in the treatment of osteoarthritis. Avocado soybean unsaponifiables (ASU) were shown to have promising results in two studies and further studies would be desirable to verify efficacy. Single studies of other interventions, a willow bark preparation (Reumalex), topical capsaicin and tipi tea, were inconclusive.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 2, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Little CV, Parsons T, Logan S. Herbal therapy for treating osteoarthritis. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002947. DOI: 10.1002/14651858.CD002947.

This version first published online: January 22. 2001

Abstract

Background

The increasing popularity of complementary and alternative medicine appears to be particularly evident amongst people with chronic diseases. In the treatment of osteoarthritis, one therapy that has been identified as having potential benefit is plant and herbal medicine (phytotherapy).

Objectives

To determine the effectiveness of herbal therapies in treating osteoarthritis.

Search strategy

Databases for mainstream and complementary medicine were searched using terms to include all forms of arthritis combined with herbal medicine. We searched the following electronic databases: Cochrane Musculoskeletal Group register, Cochrane Complementary Medicine Field register, Cochrane Controlled Trials Register (CCTR), MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Dissertation Abstracts and BIDS ISI. We also searched the reference lists from retrieved trials.

Selection criteria

All randomized trials of herbal interventions in osteoarthritis, compared to placebo. Studies were included according to an a priori protocol and agreement was reached between two reviewers who independently read each selected paper for content and assessment of quality. Papers of any language were included.

Data collection and analysis

Data were extracted independently by the same two reviewers.

Main results

Five studies (four different herbal interventions) met the review criteria. Two studies were suitable for data pooling. It was not possible to draw firm conclusions from the single studies but the two combined studies of avocado/soybean unsaponifiables showed beneficial effects on functional index, pain, intake of non-steroidal anti-inflammatory drugs (NSAIDs) and global evaluation. No serious side effects were reported.

Authors' conclusions

The evidence for avocado-soybean unsaponifiables in the treatment of osteoarthritis is convincing but evidence for the other herbal interventions is insufficient to either recommend or discourage their use.

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