What Massage Creams Do Physios Use?
A number of my clients will ask me, what cream am I using on them in my clinic and should they buy any specific creams to apply to their sprain, strain or injury? A common “active ingredient” in many creams used to help treat sprains and strains is arnica. The logical question here is does arnica work? Frequently arnica is one of the ingredients in the creams I use at work but this is more through association than anything else, as a physio the creams I select to use are typically based on several factors including the creams consistency, will it stain my patients clothes and does it have either no or very low odor. These factors I rate most relevant for my needs in the clinic, more so the active ingredients contained. This is a pretty underwhelming answer for most patients asking the question, looking for me to say I use this particular cream because it is amazing at healing and contains this or that…
Personally, I do not advise my patients to purchase arnica creams and if I ever suffer a sprain or a strain myself I don’t apply or take arnica to aid the healing process. Arnica however has a fantastic reputation and many practitioners and members of the public talk about how great it is for treating muscle pain, sprains and strains as well as bruising. Because of this I thought perhaps I should look into it a little more, just in case my patients (and I) are missing out by me not pushing it in my clinic. This is when I came across an article by Paul Ingraham written in 2012 titled “Does Arnica Cream Work For Pain” This article by Mr Ingraham was a detailed review of popular homeopathic herbal creams designed to be used on the very sorts of complaints I see in my physio practices every day and addresses the question does arnica work?
Does Arnica Work? There Is Plenty Of Anecdotal Evidence
Mr Ingraham comments that arnica is popular, and that “A great many people firmly believe that it works. But a lot of people thought drinking mercury was a great cure … and it was killing them… So it’s hard to trust what people believe.” He then states that every person and situation of healing is different and therefore it is impossible to accurately predict how fast healing would have occurred without treatment, “…so patients can’t know that their recovery was accelerated. Faster than what? A guess? A pessimistic one? What about an optimistic one? Surprisingly quick recoveries happen, cream or no. They can easily create an illusion of success.”
As a result someone using arnica cream may have what they believe to be a faster than expected recovery and as a result attribute this speedy recovery to using arnica thus it is easy to see how reputation can be established. Further more Mr Ingraham comments “Since the experiences of patients who recover well without taking arnica and those who receive no benefit from arnica are less likely to be reported, the myth becomes reinforced.” There is a bias to attribute the outcome to the events or methods that were taken in an attempt to enhance the outcome in an attempt to justify the effort, use. Therefore if someone goes to the effort physically and financially clearly they wish this effort to be justified so are more likely to attribute any positive outcome to such efforts.
Arnica Is A Very Popular Homeopathic Herb
Arnica is a popular homeopathic herb, Homeopaths treat with extremely diluted substances believing that “diluted ingredients are medicinally effective because the solution “remembers” something about the active ingredient… They also believe that this effect gets more potent as the original ingredient is further diluted — a situation of less is more”
So in reference to homeopathic arnica creams although the active ingredient in the cream may be the herb Arnica if the cream you are using is a homeopathic cream then the cream itself may potentially contain very little Arnica at all. Hence it is important if you are buying an arnica cream that you are aware what you are buying. If you are buying a homeopathic arnica cream it will most likely have very little arnica in it and will be a homeopathic cream operating on the homeopathic law of infinitesimals. Meaning there is stuff all arnica in it but the cream remembers that there once was some arnica in it and this makes the cream effective…
How Much Arnica Is In Homeopathic Arnica Cream?
Mr Ingraham goes on to explain the actual amounts of arnica in a popular homeopathic cream “Even in a whole tube, that’s only 0.75mg — not even one thousandth of a gram! It is difficult to overstate how little arnica we’re talking about here. The same amount of the most potent toxins known to man are not considered dangerous… Finally, it is well worth noting that because the dose is applied externally, most of it will never make it through the skin. The actual dose delivered to the tissues is probably much lower still.” So it could be suggested that a true homeopathic arnica cream probably isn’t an arnica cream at all.
How Much Arnica Is In A Pure Undiluted Arnica Cream?
Mr Ingraham looks at a popular undiluted full strength arnica creams, and comparing this to a homeopathic arnica cream this cream has a “whopping 65,000 times as much arnica as you’ll get from the same size dose of homeopathically diluted arnica.” he then makes a reasonable comment that due to there being 65,000 times the difference in arnica present between the arnica content of a homeopathic arnica cream verses the pure undiluted arnica cream “It is an oddity that people might buy arnica in either concentrations expecting basically the same result!”
If you are buying a homeopathic arnica cream then you are doing so because you believe in the power of homeopathy, however if you are buying a pure undiluted arnica cream (a non homeopathic arnica cream) you are buying a herbal cream not a homeopathic cream because you believe in the power of the herb arnica and I guess the question then is “does arnica work” and does arnica actually do what so many believe and claim it does?
What Is Arnica?
To answer this question it is probably best to first look at what Arnica is. Mr Ingraham writes “Arnica montana… It’s “Montana” because it grows in the mountains — mountain arnica… This flower has some anti-inflammatory effects, but it’s not clear that they are strong enough to justify bottling the stuff. The research is incomplete … but partly because it doesn’t show enough potential.” that is showing enough potential to actually bother researching it further.
“There is almost no question that the undiluted flower has some anti-inflammatory effects. The problem is that it’s unlikely that the effects are strong enough to justify putting it in a bottle. There is no clear, strong, confirmed effect on inflammation … according to the limited research done so far.”
“It takes many years and lots of science to determine which compounds are significant, how significant they are, and how safe, and for what uses, and in what dosages… Arnica has not been subjected to such scrutiny for the simple reason that no study of arnica has ever revealed more than a few minor chemical effects.” Mr Ingraham then goes on to suggest that if some useful compound in Arnica Montana actually existed then researchers would have be onto it years ago.
Arnica is a genus of perennial, herbaceous plants in the sunflower family and like many plants it has anti-inflammatory properties but again as mentioned above it is questionable as to if it actually has strong enough effects to warrant use and if so in what form and dose is it most effective are other unanswered questions.
Does Arnica Work: The Power Of Placebo
So with regard to the question does arnica work? Well lets just say I’m not about to change my approach to practicing to make room for more arnica in my physio treatments sessions just yet. However placebo can be a powerful weapon in arnica’s crusade meaning if there is a little bit hiding away in my current physio treatment creams it may just help my patients to let them know it contains some arnica and all sorts of other unproven goodies to “help” the healing process. Providing that no one reads Paul Ingraham article first that is.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance on Does Arnica Work? should consult his or her general practitioner or otherwise appropriately skilled practitioner.