Arthritis is one area in which there are several studies which have shown that homeopathic medicines are efficacious. Because homeopathic medicines need to be individually prescribed to the unique pattern of symptoms that sick people experience, controlled studies must be sensitive to this therapeutic requirement in order to adequately and accurate test this medical system.
One study published in the British Journal of Clinical Pharmacology (1980, 9, pp. 453-459) showed that 82% of patients with rheumatoid arthritis experienced some degree of relief after being prescribed an individually chosen homeopathic medicine. Only 21% of patients given a placebo received a similar degree of relief.
This study used two homeopathic physicians, both of whom interviewed patients (46 in total) and prescribed individualized medicines for each. These prescriptions were given to a pharmacist who then blindly gave half their homeopathic medicine and gave the other half a placebo.
The British Medical Journal (1989, 299, pp. 365-6) published a double-blind, placebo-controlled, cross-over study on the treatment of fibromyalgia. Although cross-over studies are normally difficult when using homeopathic medicines due to the need for strict individualization of remedies, this unique study included a pre-qualification interview which allowed into the trial only those patients with fibromyalgia that fit the need for a specific remedy, Rhus toxicodendron (poison ivy).
The researchers admitted 42% of those they interviewed with fibromyalgia into the study. Then, half of the subject began taking Rhus toxicodendron 6c, while the other half took a placebo. Halfway through the trial the treatment was switched: the group who were unknowingly taking the placebo began taking the active treatment, and the group who were unknowingly taking the active treatment began taking the placebo.
The study showed that patients did better in all variables being tested (the number of tender spots, 10 cm visual analogue scales of pain and sleep, and overall assessment) when they took the active treatment rather than placebo. The number of tender spots was reduced by about a quarter (p<0.005).>
Not all studies have shown the efficacy of homeopathic medicines in the treatment of arthritis conditions, though the following study had a major flaw in it which seriously threw into doubt its value. This study, published in The Lancet (January 15, 1983, pp. 97-98), was a controlled trial on the homeopathic treatment of osteoarthritis. The researchers compared the use of a single homeopathic medicine (Rhus toxicodendron) with fenoprofen (a standard anti-inflammatory analgesic) and a placebo.
In order for patients to be admitted to the study, they had to be diagnosed with osteoarthritis, and they had to have two key symptoms of Rhus toxicodendron (pain in the affected joints which was made worse by immobility and exacerbated on movement or by initial weight bearing and pain in the affected joints had to be aggravated by cold and damp and ameliorated by warmth).
Although these inclusionary features were important, they were inadequate. There are numerous other symptoms which suggest the appropriate prescription of Rhus toxicodendron. A perhaps even more significant problem in the study design is the fact that Rhus toxicodendron is often prescribed to patients with rheumatoid arthritis who have its unique symptoms, but it is rarely prescribed for patients with osteoarthritis.
The study predictably showed that the homeopathic medicine acted no better than the placebo, though numerous letters to the editor followed its publication (February 26, 1983).
By Dana Ullman, MPH
