Background: The increasing popularity of complementary and alternative medicine appears to be particularly evident amongst people with chronic disease. In the treatment of osteoarthritis, one therapy that has been identified as having potential benefit, is 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: MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Cochrane Controlled Trials Register (CCTR), Cochrane Musculoskeletal specialized register, Dissertation Abstracts, BIDS ISI and the Cochrane Complementary Medicine Fields Specialized Register. 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 the a priori protocol and agreement between two reviewers who independently read each selected paper for content and for 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 two studies of avocado/soybean unsaponifiables showed beneficial effects on functional index, pain, intake of NSAIDs and global evaluation. No serious side effects were reported.
Reviewer's 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.