Here we look at studies that involved the use of both Homeopathic Arnica Montana (AM) dilution creams and the ingestion of AM as a dilution. For acute injuries where there is clearly the tearing of bodily tissue resulting in the release of the associated biochemical reaction, the studies shown positive results when using Homeopathic AM. Whereas studies that have concentrated on the use of AM for DOMS (delay onset of muscles soreness) in other words muscles that have been 'worked hard' are not positive. Since the development of more sensitive technology we are now able to see the effect of Homeopathy on molecules and DNA allowing us to also look at some new evidence regarding the effect of AM at this deeper level.

Keywords: homeopathy, arnica montana; high-dilution, DOMS, nanomedicine, high-dilution pharmacology, homeopathy and gene expression profiles, molecules and homeopathy, DNA and homeopathy, inflammatory possessed, ligament contusions and lacerations, traumatic injury, sports injury, sports post-trauma ankle sprains, anti-inflammatory, ICAM-1, M2/M1 macrophages, knee surgery, nano-pharmacology, sprains, strains, inflammation, contusions and lacerations

Anyone who has had the opportunity to really look at the research around Homeopathic AM (Arnica Montana) in the area of sport related injuries will quickly see that there is a lot of conflicting information, bias/rhetoric for and against. There is positive practical experience from our athletes in the field which is then easily brought into question by looking at the negative results reported by reviews of research in our various sports journals. There is a combination of negative and positive attitudes coming from the reviewers as well! There is a lot of ambiguous causal texture to see through, yet injury therapists just want clear information that can be applied practically.

My bias comes from practical experience, I am a student homeopath, and injury therapist qualified through Active Health Group in 2004 and a injury massage therapist qualified in 1996. I have been using homeopathy for chronic and acute injuries that are sports and accident related. I am not going to coldly report to you only findings that someone else has discovered, you will read here a combination of research that others have done and my personal experience. My real bias is toward the comfort of my patients and finding the quickest route possible to their recovery. I regularly require the help of AM as a tool for speeding up the recovery process and lowering the pain levels experienced by my patients.

It is easy to get confused about the difference between Homeopathic AM and Herbal AM as quite often news paper reports and magazine articles do not differentiate between the two. The herbal materials, known for their excellent wound healing properties since ancient times, used in tinctures, oils and creams are made from extracts of the roots and the flowers of the Arnica Montana plant that can be harvested from European, Brazilian and Canadian Alpine regions. A study carried out on 128 herbs shows that wild AM (Arnica sp.) is only used externally (or as a homeopathic drug) and not in open wounds, and its leaves or flowers are rubbed on to bruises or the crushed leaves are bandaged on the wound³ These parts of the plant have antiseptic, antibiotic, wound healing, immunomodulatory, haemostatic properties, activates the mechanisms of tissue restoration and healing, stimulates circulation and promotes hematoma resorption.⁴ There are a number of creams, oils and gels on the market today that contain AM in its crude form from companies like Arnicare (Boiron), Weleda and Bioforce.

Compared to this the use of AM as a Homoeopathic high dilution is quite recent. Hahnemann began studying the benefits of Homeopathic AM and using it as a dilution early in the 1800's. He discovered a huge range of applications during his research that aided and cured many deeper physical, mental and emotional ailments. Today Homeopathic AM is widely used as a topical application in creams and oils for pains and strains. As well as this, in my clinic and many others, Homeopathic AM is often used for patients that are suffering from acute and long term inflammation and pain often caused by accidents at work, sport and from falling.

In the last two years exciting research with homeopathic dilutions in the new scientific area of nano-pharmacology and the study of gene array responses have been seeing and reporting the measurable effectiveness of homeopathy, see one such study below in Table 1 using AM. It is possible that we could rapidly see the issues for homeopathy changing from trying to prove that homeopathy works to simply looking at what exactly the biochemical reaction to the remedies are Research papers being published are showing that advancements in technology are making it possible for us to measure/read gene expression profiles when coming into contact with homeopathic dilutions and they have been seeing the effect of homeopathy on Molecules and DNA. High-dilution pharmacology is emerging as a pioneering subject in the domain of nanomedicine and is providing greater plausibility to the puzzling claims of homeopathy.⁷ It seems that the future of homeopathic research could get very interesting.

The two following tables look at research using Homeopathic AM dilution for two types of exercise-induced physical problems. Table 2 shows results for AM on DOMS (Delayed Onset of Muscle Soreness), all of which found that AM does not help to relieve the symptoms. Table 1 shows positive results for AM used for injuries involving inflammatory possessed that are associated with muscle and ligament contusions and lacerations.

Another problem that I came across here is one of categorisation within research journal search engines. Papers on DOMS comes up under 'traumatic injury' and 'sports injury' searches, which I would argue is not the correct place for them. To my mind stiff muscles after a hard training session are not the same as a regular injury. DOMS research is then cited by, for example, sports injury review writers, who have their work published in our sport journals and perhaps news papers. These reviewers usually don't know anything about homeopathy but are researching it's effectiveness on 'sports injuries'. They find and report with negative results for AM under this category which they accept at face value due to their ignorance of homeopathic principles and in this way the myth that homeopathy does not work is perpetuated.

My experience is very different when using Homeopathic AM. Firstly I would like to confirm that, as with any homeopathic remedy, it should not be given unless there are the gilding symptoms being presented by the individual. All the studies above involved giving the remedy without symptoms, before, during and after the exercise, which I would argue is the same as giving penicillin without due cause. When I have given AM for DOMS in the time period when the extreme stiffness is actually present in the body about two days after the heavy training I have seen good results, especially if it can be taken before a night's sleep.

For acute injuries where there is clearly the tearing of bodily tissues resulting in the release of the associated biochemical reactions, studies have shown positive results when using AM creams and/or AM ingested dilution. If the two are used together the results seems to be more effective. As distinct from the unsuccessful studies these results involved using AM when there are actual guiding symptoms or the relevant chemistry was present. Treatment with AM 200 CH, administered alone or associated with the selected AM creams, Artrin and Ruticelit, was shown to be superior to the nonsteroidal anti-inflammatory drug, through its effect on the sensation of pain and on the size of inflammatory oedema, in the studied grade II ankle sprains 2.⁵

When I have used AM at the point of the injury event and when the relevant associated swelling begins I have seen positive results. What I have learnt is that the skill of matching the severity of the injury to the correct dose makes all the difference, and when the dose is correct the comfort levels and stress levels of the patient reduce dramatically. Over a couple of days with repeated AM doses the swelling reduces very quickly and then a different remedy is often required. It is becoming obvious to homeopathic researchers that there is a problem for homeopathy when researched in the tight constraints of RCTs, the model does not normally transpose, mostly because we need to take symptoms before giving a remedy. Homeopathy differs from conventional medicine in many aspects. Little recognized to date is the unique, multidimensional nature of the response to homeopathic treatment.¹³ We take into consideration in a very detailed way the individual's responses as they arise spontaneously and this guides the course of treatment uniquely. Making it very difficult to perform a controlled study that fits the conventional 'Golden standard' medical criteria for research, we simply cannot remove the individual patient from the decision making process.

When we start comparing the Biochemical releases of the DOMS research type of muscle strain to a laceration or contusion of a muscle or ligament we see a completely different biochemical reaction. Intercellular adhesion molecule (ICAM-1) plays an important role in the inflammatory process and immune response and is associated with not only injuries but many other inflammatory based diseases as well. When ICAM-1 molecule is present, current research in the area of nano-pharmacology is showing us that Homeopathic AM has a measurable effect. In the field when there is an injury with the type of inflammatory response that can be simply confirmed through visual indications like swelling of the injured joint/muscle, indications of internal bleeding and also the fact that the athletes ability to use the injured part becomes very reduced, often suddenly and with accompanying extreme pain I have found AM to be effect.

Unfortunately there are sports journal reviews that conclude that AM doesn't work for sports injuries. But when we look at the research they were citing it was research based on DOMS not on actual sprains and strains. In Table Two you will see research that has shown that AM does show positive results when compared to placebo and or conventional treatments for more serious injuries. This confirms Hahnemann's (2010/1812) statement AM is for injuries that involve severe contusions and lacerations of the fibers. The skill is in choosing the correct dose and this is based on the spontaneous symptoms expressed by the patient at the time.

1. Hahnemann S. Materia Medica Pura. B Jain Publishers, India. 2010.
2. Alan VS. A brief introduction to homeopathy. Hpathy. 2009.
3. Lans C, Turner N, Khan T, et al. Ethnoveterinary medicines used for ruminants in British Columbia, Canada. Journal of Ethnobiology and Ethnomedicine. 2007;3:11.
4. Wolf M, Tamaschke C, Mayer W, et al. [Efficacy of Arnica in varicose vein surgery:results of a randomized, double–blind, placebo–controlled pilot study]. Forsch Komplementarmed Klass Naturheilkd. 2003;10(5):242–247.
5. Jurcău R, Jurcău I. The effectiveness of Arnica Montana treatment, in sports post–trauma ankle sprains. Palestrica of the Third Millennium Civilization & Sport . 2013;14(1):33–39.
6. Wilkens J, Lüdtke R. Arnica 30x after knee surgery. British Homeopathic Journal. 2000;89(s1):S72.
7. Bellavite P, Marzotto M, Olioso D, et al. High–dilution effects revisited. 2. Pharmacodynamic mechanisms. Homeopathy. 2014;103(1):22–43.
8. Plezbert JA, Burke JR. Effects of the homeopathic remedy arnica on attenuating symptoms of exercise–induced muscle soreness. Journal of Chiropractic Medicine. 2005;4(3):152–161.
9. Vickers AJ, Fisher P, Smith C, et al. Homoeopathy for delayed onset muscle soreness: a randomised double blind placebo controlled trial. Br J Sports Med. 1997;31(4):304–307.
10. Gulick DT, Kimura IF, Sitler M, et al. Various treatment techniques on signs and symptoms of delayed onset muscle soreness. J Athl Train. 1996;31(2):145–152.
11. Raschka C, Trostel Y.  [Effect of a homeopathic arnica preparation (D4) on delayed onset muscle soreness. Placebo–controlled crossover study]. MMW Fortschr Med. 2006;148(29–30):35.
12. Brancaccio P, Lippi G, Maffulli N.  Biochemical markers of muscular damage. Clinical Chemistry and Laboratory Medicine. 2010;48(6):757–767.
13. Oberbaum M, Singer SR, Vithoulkas G. The colour of the homeopathic improvement: The multidimensional nature of the response to homeopathic therapy. Homeopathy. 2005;94(3):196–199.