last updated 36 days ago, Jul 29th, 2010

Traumeel is a popular homeopathic remedy for aches and pains. But does it do anything?

Does Traumeel Work?

A detailed review of Traumeel®, a homeopathic remedy (not herbal) widely used for muscular pain, joint pain, sports injuries, bruising, and post-surgical inflammation

by Paul Ingraham, Vancouver, Canada MORE
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Credentials and qualifications

I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.

For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.

Traumeel® is a popular ointment for aches and pains. It is a homeopathic preparation — a significantly diluted medicine. It contains several herbs, but mostly Arnica montana — in fact, people often call it “Arnica cream.” The manufacturer claims that Traumeel’s basic benefit is “anti-inflammatory effects,” and the product enjoys a strong reputation for being “good for” muscular pain, joint pain, bruising, and sports injuries.1

Traumeel is pricey. A 100g tube of it costs about CDN $35 in Vancouver.

In my career, I have often heard colleagues and patients sing the praises of Traumeel — stories of its miraculous healing powers are common. It is regarded as a secret sauce, a “secret” weapon against pain. But does Traumeel actually work? This article gets into the science of this controversial subject. No verdict will be issued, but all the evidence will be laid out for you to do with as you choose.

It’s been 168 years since Oliver Wendell Holmes wrote “Homeopathy and Its Kindred Delusions.”2 It’s sad that those delusions still persist this long after his masterful debunking. The homeopathy Energizer Bunny is still marching along, banging its drum and trying to drown out the voices of reason. It is still necessary to keep explaining why homeopathic theory is incompatible with known science and to point out that remedies like Traumeel have been shown not to work, as Paul Ingraham does eloquently in this well-researched article. Unfortunately, belief in homeopathy is not based on reason or evidence, so no amount of rational argument is likely to make it go away.

Dr. Harriet Hall, The SkepDoc, and author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon3

Got stubborn pain?

Before continuing with Traumeel, I want readers to know that most pain is caused by cranky muscle — which cannot be treated with Traumeel.4 Although hardly the only cause of undiagnosed and misdiagnosed pain problems, the humble muscle knot is the most common troublemaker by far — and a problem that easily slips under the medical radar.5

Painful muscle is “sneaky” because it can cause and complicate and mimic other pain problems. So, for instance, nearly any kind of pain problem will be complicated by some muscle pain, or even replaced by it. Many people can go for years assuming that they have untreatable “arthritis” or [insert common misdiganosis here]. And yet at any time they might have be pretty much cured by a 10-minute massage in the right location. This actually happens! Not every case is so easy, but many are. Many knots yield to your bare hands and a little know-how, so learning about muscle pain gives great bang for buck.

In my opinion, the question of Traumeel is overshadowed by the importance of muscle pain. That didn’t stop me from writing the most detailed analysis of Traumeel available anywhere — but if you think this article about Traumeel is detailed, take should see the one about trigger points!

Advanced Tutorial: Save Yourself from Trigger Points & Myofascial Pain Syndrome!

Traumeel, homeopathy and marketing

Many people who use Traumeel aren’t aware that it is a homeopathic product, because it is not marketed that way. However, many others buy Traumeel because it is homeopathic!

Homeopaths treat by prescribing extremely “diluted medicine.” They believe that diluted ingredients are medicinally effective because the solution “remembers” the active ingredient, like an echo. They also believe that this effect gets more potent as the original ingredient is further diluted — less is more, or the “Law of Infinitesimals”6 — even to the point that no molecules of the original substance remain, just their “essence.”

Some products are not homeopathic at all, but use the marketing power of the word to sell products, as with the cold-remedy Zicam. Zicam is labelled as homeopathic, but there’s enough zinc in Zicam to damage your sense of smell.7 Homeopaths might consider Zicam to be a “low potency” preparation, but such a mild dilution is usually considered too concentrated to be truly homeopathic.8

The complete family of homeopathic Traumeel products. The word “homeopathic” does not appear on most of the packaging.

Traumeel’s manufacturer seems to avoid presenting Traumeel as homeopathic. You have to read the fine print.9 10

What’s in Traumeel? Only trace amounts of Arnica

Despite the ambiguity, Traumeel is still a homeopathic remedy, albeit one of “low potency.” If you just want some actual Arnica, you won’t find much in a dose of Traumeel.

The packaging reads “Arnica montana 0.75g” and “3X”, a homeopathic notation meaning “diluted to 10% of its original concentration three times.”11

Although less than many other homeopathic products, 3X is still a lot of dilution: 7.5 micrograms of actual Arnica in a gram dosage of Traumeel. In the whole tube, that’s .75mg — not quite even a milligram (thousandth of a gram)! This is what a scientist would call a “trace amount.”12 See this note for the math.13

Could trace amounts of Arnica and other ingredients have a biochemical effect?

As they would say on Mythbusters: “It’s plausible … but not likely.”

Dilution really takes the punch out of chemical effects.14 Even if an infinitesimal concentration of a potent herbs has some kind of effect, it’s doubtful that it would be a significant therapeutic effect … and that’s the key to this question.

Have you ever tangled with poison ivy? I have! On the edge of a natural hot spring in the Kootenay region of British Columbia. It was memorable, but not all that bad. If the poison ivy toxin (urushiol) had been diluted 90% — 1X — it would only have been mildly irritating. I could rub urushiol 3X in my eyes with no trouble!

Evidence of absence: Arnica has never been studied carefully because it has never shown any promise

The idea that an herbal remedy can be judged “effective” based only on historical folk usage is deeply wrong. Plants are like little chemistry sets! And all plants have a variety of minor pharmacological effects. Only a small fraction of species contain a compound with a prominent effect, and many of those are toxic. A chemical effect can only considered a medicine when it turns out to have a clinically significant effect on human physiology, with side effects we can live with. Since every plant consists of literally thousands of chemical compounds, it takes a many years and hundreds of scientific studies to determine which compounds are significant, how significant they are, and how safe, and for what uses, and in what dosages. Years and decades after debut, a plant-derived medicine can still turn out to have surprising side effects. Arnica has not even remotely been subjected to such scrutiny for the simple reason that no study of Arnica has ever produced more than the usual array of minor chemical effects. If there was some potent, useful compound in there — if it was anywhere close to as good as other famous plant-derived medicines — then pharmaceutical researchers would have been all over it decades ago.

Indeed, homeopaths argue that dilution makes their treatments safe.

Chemically speaking, a subtle effect is not helpful for a terrible bruise or raging bursitis. But not even full-strength Arnica has any clear effect on inflammation.15 That’s why medicinal anti-inflammatory creams like Voltaren® Gel use diclofenac16 — not arnica.

So if Traumeel works for aches and pains, it’s extremely unlikely that it’s due to a straightforward medicinal effect, like aspirin.

Four key homeopathic controversies

Traumeel is a flagship homeopathic product, studied more than any other homeopathic remedy. If homeopathy doesn’t work, Traumeel doesn’t work. Several key information resources about homeopathy are presented at the end of this article.

There’s one that matters more than all the others, though: The National Center for Complementary and Alternative Medicine. NCCAM’s raison d’etre is to study and validate alternative health care practices such as homeopathy, and they have massive taxpayer funding, and they employ hundreds of real scientists.17 If you can’t cite NCCAM in support of homeopathy, who can you cite? Unfortunately, even after many years of expensive research, NCCAM has literally nothing good to say about the effectiveness homeopathy:

Most analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition.

Homeopathy: An Introduction, National Center for Complementary Medicine (NCCAM.nih.gov)

So what’s the problem? Here are four key controversies:

The inability-to-end-the-argument problem. A truly effective medicine should be able to decisively put an end to argument with clearly impressive benefits, not subtle and debatable effects.18
The zero concentration problem. It’s one thing to believe that low concentrations of active ingredients are medicinal, but more incredible to believe that zero concentrations are (“Law of Infinitesimals”19). Homeopathic dilutions are not just extreme, they’re routinely diluted to the point where none of the original substance remains at all.20
The contaminant problem. Homeopaths believe that water “remembers” the active ingredients, so they can work even after extreme dilution. However, even the most pure water contains thousands of trace contaminants, compounds of every description21 — how are those “forgotten”?22 23
The quality control problem. In 2006, ten out of ten secretly tested UK homeopaths gave lethally unsafe prescriptions for malaria prevention.24 Imagine if ten randomly selected doctors all recommended treating a dangerous infection with water instead of antibiotics.25

Next: two more controversies that are especially relevant to Traumeel.

The consistency problem

The homeopathic “Law of Similars” is that “like cures like.” This idea is one of the two most important “laws” of homeopathy (along with the Law of Infinitesimals).

Guided by the Law of Similars, homeopaths choose ingredients whose normal effects are in some way similar to the problem they want to treat. For instance, an inflammatory condition is treated with an ingredient that would normally cause inflammation at pharmaceutical concentrations.

Traumeel breaks the Law of Similars! Traumeel’s primary ingredient, Arnica, is believed to be an anti-inflammatory herb. Therefore, using Arnica is not “like cures like” but “opposites cure.”26

The one-size-fits-all problems

Traumeel is prescribed for every kind of pain problem, even though many of them don’t have much in common with each other. For instance, consider tendinitis: acute tendinitis and chronic tendinitis are quite different conditions, with different chemistry.27 28 It’s unlikely that any one medicine can be truly effective for both.

Another good example: delayed onset muscle soreness (DOMS), that nasty soreness for a day or two after exercise. It can be savage, and its physiology is quite mysterious.29 Whatever causes it, it’s quite different than any other common pain problem. It’s also widespread and deep in the tissues — not in one convenient spot to rub Traumeel into.

The trouble with the anecdotal evidence

Few products seem to enjoy the loyalty that Traumeel does. A great many people firmly believe that it works. The standard Traumeel story is, “I was amazed by how fast I healed.” But how fast would healing have been without Traumeel?

Patients are poorly informed about how quickly healing normally occurs.30 It is actually impossible to accurately predict healing time from anything — everyone is different — and impossible for patients to accurately declare that their recovery was accelerated. Surprisingly quick recoveries occur routinely, Traumeel or no. This creates an illusion of success:

Some patients recover very quickly from surgery. If those taking Arnica attribute their good recovery to the homeopathic remedy and this apparent association is widely reported, it is easy to see how the reputation can build. 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.

Stevinson et al, “Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery,” Journal of the Royal Society of Medicine, 2003

Traumeel certainly hasn’t saved people in severe chronic pain

If you really want to know how well a pain remedy works, ask someone with severe chronic pain. The stories people tell about chronic pain are almost all about minor injuries and pain problems — the kinds of things that tend to go away on their own sooner or later.

But what if your pain never went away? Severe chronic pain is a common and awful problem. Why hasn’t Traumeel helped these people? Where’s the army of formerly debilitated victims of the most painful inflammatory diseases, liberated from their prison of agony by Traumeel?

It’s not for lack of trying. Severe pain drives patients to all manner of cures, and Traumeel is supposed to be able to help anyone in pain.31 But it doesn’t actually do anything worthy of testimonials for people with serious pain.

The state of Traumeel research

As they'd say in Missouri, the Show-Me State, “If it works, show me.” Better yet, impress me. If Traumeel works, there’s no reason why it shouldn’t be able to ace a fair test, showing obviously superior results than not using it would show.

“No other homeopathic remedy [than Traumeel] has been subject to more controlled clinical trials” (Ernst et al) … but that’s really not saying much. Less than a dozen somewhat noteworthy studies about the efficacy of Traumeel have been undertaken, a couple dozen if you include some really poorly designed ones. Considering the popularity of the product, that’s almost no research at all — much less, say, than what is required for FDA approval of a new drug, and most has been of poor quality.32 33 34

If you make even a token effort to separate the good research from the bad, it’s the small, poorly-designed studies35 that claim to have proven that Traumeel works on the basis of barely-there data, while better and larger studies found that it had no effect.

The only significant review of the scientific research is from 1998.36 It was co-authored by Dr. Edzard Ernst (who used to be a homeopath, so he may understand the issues much better than a physician or scientist who’s never actually been trained in homeopathy). Ernst looked only at studies that compared homeopathic Arnica to a placebo, chose only eight,37 and found even those wanting:

Two studies yielded a statistically significant positive result (ie, Arnica superior to placebo), 2 studies had a numerically positive result (ie, no formal test statistics were applied but an advantage of the Arnica groups was apparent) and 4 studies showed a significantly negative result (ie, Arnica not superior to placebo).

… the more rigorous studies tended to be the ones that yielded negative findings.

On balance, the trial data do not support the notion that Arnica is efficacious.

… the hypothesis claiming that homeopathic Arnica is clinically effective beyond a placebo effect is not based on methodologically sound placebo-controlled trials.

And what about the research since 1998? I know of only one good study, better-designed and a little larger than most, done in 2003. Researchers tested homeopathic Arnica to see if it would reduce swelling and pain after hand surgery for carpal tunnel syndrome. It did not: “The trial data do not support the notion that Arnica is efficacious.”38

Two 2006 studies are noteworthy because their data seems negative to me, but their pro-homeopathy authors found a way to write positive-sounding conclusions.39 40

No one has yet demonstrated clearly that Traumeel works.

Traumeel in ointment form is completely unstudied

I am not aware of a single study that directly tested the kind of Traumeel most people are familiar with — the stuff in a tube.

Most of the research is of other homeopathic Arnica preparations, such as SINECCH™, a pill intended to reduce post-operative bruising, prescribed almost exclusively by plastic surgeons. Certainly the idea of SINECCH is the same as Traumeel — they both involve heavily diluted Arnica — but of course the delivery system is rather different: ingesting something is very different than rubbing it on your skin.

But there is just no research at all about Traumeel-in-a-tube, used for bumps and scrapes and tendons on fire. It’s simply never been done. Not even the manufacturer has troubled themselves to do the research,41 despite their large profits. They can certainly afford to do the research. But they haven't.

How homeopathy can keep you from going out to dinner

The manufacturer of SINECCH™ (Alpine Pharmaceuticals) publishes a “research” page that cites (and exaggerates) the conclusions of one study of SINECCH … a study that is itself a great example of weak science.

Surgeons (not scientists) at a cosmetic surgery clinic wanted to see if SINECCH would reduce post-operative bruising after nose jobs.42 43 Their experiment is tiny and sloppy. Key data is omitted from the conclusion — for instance, patients actually had more pain with homeopathy! Instead, a trivial improvement in the size of bruising is emphasized — a difference so small that it could only be detected by instrumentation,44 and not by patients or doctors, and was statistically significant (barely) on only two of five measurements taken.

And yet this paper has been widely cited as a “thumbs up” study of homeopathy, not only by the manufacturer of SINECCH, but by homeopaths everywhere.

Does that sound like a positive result to you? What good is a reduction in bruising so small that the patient cannot detect it? With an actual worsening of pain? This is the ultimate in ho-hum scientific results — and that’s even if we accept the published conclusions as statistically meaningful.

Which we can’t. The study was just too small.45 Alpine pharmaceuticals describes the results as “highly statistically significant”! But does the word “highly” appear in the paper? Nope — not once. You can check it yourself: here’s the full-text of the paper.

The surgeons reported that patients who received SINECCH “actually did worse than those in the control group at each time point” (and that is an accurate quote). It was not a statistically important difference, but that doesn’t matter: data showing a lack of benefit is still a thumbs down for SINECCH (evidence of absence). If the stuff works, it should cause a statistically significant reduction in pain, not any increase in pain! And who really cares what else goes on if pain isn’t improved? Who would buy SINECCH if they knew that it would only reduce bruising slightly, but have zero effect on pain?

This highly relevant data is blatantly dodged in the paper’s conclusion. The authors do say that there were “no subjective differences,” but they do not explain that those subjective differences include no difference in pain.

Amusingly, the surgeons also collected data on patient readiness for a night on the town — that is, they asked when patients felt that their bruising had faded enough that they were willing to go out to dinner! It sounds a bit silly, but it’s an interesting piece of data to collect: doubtless plastic surgery patients are acutely conscious of their appearance, and their dinner-readiness does seem to be one fair way to measure their recovery, and it might be even more emotionally important to them than pain.

So, how’d they do?

Amazingly, once again, patients on SINECCH did worse — not much worse, not statistically significant, but still definitely not better. Patients on SINECCH took an average 11.2 days before they felt ready for a public appearance. If only they’d gotten the placebo, they would have been out schmoozing by 10.6 days!

Neither the surgeons, nor Alpine Pharmaceutical — nor any homeopath on Earth I am aware of — has emphasized that result. In effect, omitting it is a lie by omission — blatant concealment of what anyone would actually find most interesting about the results. To try to justify the concealment by arguing that the differences weren’t statistically significant is an obvious evasion — what we care about is the absence of a statistically significant benefit to SINECCH.

An honest conclusion to this study, sans jargon, would have read like this:

15 patients treated with SINECCH had about the same pain and bruise colouration as 14 patients treated with a placebo, and took just as long to feel socially comfortable with the appearance of their faces. The size of their bruising was less, but the difference was so small that it was only detectable with instrumentation, and even then it was barely statistically significant on only 2 of the 5 days on which measurements were taken.

That’s the real conclusion. That’s what Alpine Pharmaceutical is citing to support their product. As evidence goes, the best you can say is that … it's unconvincing.

Perhaps a more rigorous and larger study of Traumeel would have different results than SINECCH. Perhaps. It might be interesting to compare the two. Perhaps a topical ointment would be a more effective delivery medium, or at least it would give a stronger placebo effect and let people go out for dinner faster. But as I say, there is just no research at all about Traumeel-in-a-tube. And without research, there's no evidence.

Wouldn’t it be amazing?

It would be amazing if Traumeel worked. And, if it works well enough to matter, it should be easy to prove. So, where is that proof? Where are the results of the simple experiments that could end the argument? Without it, I’m not yet amazed by Traumeel.

Homeopathy information resources

Science-Based Medicine publishes a good collection of critical articles and resources about homeopathy.

Homeowatch is entirely devoted to debunking homeopathy.

The above are some of the most strongly anti-homeopathy sources available, created by physicians and scientists. It is not my impression that they are mindlessly dismissive of homeopathy: they seem to have put a great deal of thought into their criticisms, and the quality of writing is generally excellent. They impress me.

Wikipedia has a thorough article about homeopathy. It’s not neutral — homeopaths probably dislike it. Still, it seems well-written and it’s heavily referenced, and you can’t beat that as a starting point. It provides a lot of well-sourced information.

The National Center for Complementary and Alternative Medicine is a curious case, as described above. The organization has a mandate and huge budget to prove that homeopathy works, but hasn’t been able to do it. Their information page on homeopathy reads with a friendly-to-homeopathy tone, as though it’s a rather good idea … but openly acknowledges that there is still no evidence that it works (previously quoted), even after many years of well-funded attempts to prove it. An interesting and unusual source.

The National Center For Homeopathy disagrees with NCCAM, and claims that “there are literally hundreds of high quality, published basic science, pre-clinical and clinical studies showing that homeopathy works.” They publish a bibliography and a few articles. There are numerous other homeopathy associations with similar websites.

I have had trouble finding good quality sources of information promoting homeopathy. Information presented by homeopaths is often of such poor quality that citing it is often no favour to their cause. Consider the case of a recent YouTube video by homeopath Charlene Werner: she earnestly makes a case for homeopathy on the basis of a string of appalling misunderstandings of physics. If you know nothing about physics, trust me … neither does she. See Dr. David Gorski’s pained analysis.

I invite anyone reading this to contact me and supply examples of better quality resources about homeopathy. I will happily publish a link to any such source.

What’s New in this Article?

Tuesday, April 13, 2010 — Added endorsement from Dr. Harriet Hall.

February 25, 2010 — Editing to make the article shorter, more readable. Move a lot of optional information into footnotes. Added and clarified of a few citations.

January 30, 2010 — Complete re-write and major expansion.

2008 — Original publication of basic article.

Notes

Ernst et al. Arch Surg. 1998. “The Homoeopathic Pharmacy lists as its first indication "trauma" and even recommends it as a first-aid treatment.” Return to text.
Homeopathy and Its Kindred Delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge. Holmes. 1842. This is a nicely done web-reprint of Holmes’ classic 1842 essay on homeopathy — a critical analysis of the subject that has easily stood the test of time, its reasoning validated in countless ways by experimental evidence ever since. Return to text.
Hall. Women Aren’t Supposed to Fly. 2008.

zoom

Return to text.
Traumeel is clearly marketed and used primarily as a treatment for superficial inflammation — and common muscle pain is neither superficial nor inflammatory. As discussed in much more detail below, pain has too many sources for any one kind of treatment to work on all of them. But muscle pain is very common, and basically has nothing to do with Traumeel … regardless of whether Traumeel works as advertised. Return to text.
The existence of muscle knots (technically called trigger points) is not controversial. Although poorly understood, they can be photographed, measured electrically, and their toxic and acidic tissue fluids biopsied. All the references for this are provided in the muscle pain tutorial that this section promotes. Return to text.
The various “laws” of homeopathy are described by nearly every homeopath with an online presence. Here is a typical example. Exact definitions vary significantly, but there are strong common themes. The Law of Infinitesimals is one of several that is routinely mentioned. The hypothesis that less is more is discussed more below. Return to text.
For which it was banned by the FDA in 2009! Warnings on Three Zicam Intranasal Zinc Products. fda.gov. 2009. Return to text.
Homeopathy-help.net explains that “The 6 potency is the lowest strength generally available and works very gently.” (Traumeel is a “3” potency, as described below.) Homeopath Singh Veet states, “Experience has trained homeopathic practitioners that in most circumstances the smaller the dose, the more powerful it is.” Similar statements by other homeopaths are easy to find, so it’s pretty clear that many of them equate potency with strength.
However, other sources contradict this, explaining that “potency” does not actually mean “strength.” What it does mean is hard to be sure of. Some say that low potencies are for localized problems, while high potencies are for system-wide problems. Other sources describe low potencies as being appropriate for “minor” problems, though, which sounds more like the “strength” definition. Homeopath Gina Tyler describes 9 considerations in choosing the potency, including vague and subjective considerations like “the susceptibility of the person” and their constitution, temperament and habits! So, a more dilute preparation is always considered a more potent preparation, but the definition of “potency” seems to be rather flexible. Return to text.
As of February 3, 2010, the only reference to homeopathy on the front page of traumeel.com is a fine print notice that the product has won an award: “Homeopathic product of the Year in Canada.” Return to text.
Why would that be? With so many customers willing to pay for homeopathy, why not trumpet the fact that it’s homeopathic? It could be because Traumeel is already well known to customers who like homeopathy, but the product can also claim a big chunk of the mainstream market by avoiding the controversies that swirl around homeopathy. Like Zicam, Traumeel’s active ingredients are not diluted enough to be considered a typical or “strong” homeopathic remedy, but they are diluted too much to be considered regular medicine. The curious result is an ambiguous product that can be sold in two large market segments that are normally almost mutually exclusive.
Return to text.
“X” is not “times” as in multiplication, but the Roman numeral for 10, indicating orders of magnitude of dilution: every 1X is another 10% dilution. (“C,” the Roman numeral for 100, is also used to denote a 1% dilution.) Homeopathic remedies are prepared by a series of a dilutions and mixings (succussions). The process, called “potentization,” works like this: dilute the active ingredient to 10% of full concentration, mix vigorously (succussion), and repeat. Each cycle is another 1X. Thus the three cycles of a 3X remedy result in an active ingredient 1000 (10³) times less concentrated than the original. Return to text.
A microgram (µg) is a really, really small amount: one millionth of a gram! So how much is 10µg? Let’s put it in perspective: the same amount of lead would not be considered dangerous, even though lead is mind-bogglingly poisonous. In fact, lead is so poisonous that even a single molecule of the stuff is harmful in theory. In practice, however, the measurable effects of lead poisoning don’t start until you’ve got at least 10–100µg/litre of blood, so that would be 50–500µg total in an average adult male … and at that level the effects would be subtle. So 7.5µg of arnica is an incredibly small amount — arnica has very little effect on your biology compared to lead, and even 10–100 times as much lead has a negligible effect. Return to text.

The math!

				grams	micrograms	quantity	comments
.75g diluted arnica	÷	1000	=	0.00075g	750µg	actual arnica per tube	The .75g of arnica on the tube is diluted to “3X,” a.k.a. 1000 times less actual arnica than .75g, so divide .75 by 1000 to get the amount of actual arnica.
.00075g actual arnica	÷	100	=	0.0000075g	7.5µg	actual arnica per dose	Assume that a dose is about 1 gram, there are about 100 doses in a tube, so the amount of arnica in a dose is 1% of the arnica in the tube.

Return to text.

Some extreme substances are certainly potent even when heavily diluted. But most ordinary chemical compounds lacking in dramatic effects at full concentration will be rendered entirely neutral by dilution. Return to text.
It has this reputation as a folk medicine, but many studies of arnica over the years have been done, and no such effect has ever been found. If it did, it would have been adopted by mainstream medicine long ago, and would be widely available. Like most herbs that haven’t been, Arnica’s effects remain unclear. Return to text.
Diclofenac. Wikipedia.com. Return to text.
But many other scientists are deeply irritated by NCCAM. For instance, Dr. David Gorski, a cancer researcher, writes that NCCAM is “a grossly irresponsible use of taxpayer money not to prioritize funding for projects that have hypotheses behind them that have a reasonable chance of being true. Scarce NIH funds should not be for projects that have as their basis hypotheses that are outlandishly implausible from a scientific standpoint.” See The National Center for Complementary and Alternative Medicine (NCCAM): Your tax dollars hard at work. Return to text.
For more detail, see another article on SaveYourself.ca, The “Impress Me” Test: Most controversial therapies are fighting over scraps of scientific evidence. Return to text.
Homeopaths not only believe that zero concentrations work, but that they are potent. Return to text.
For more detail, see another article on SaveYourself.ca, The Power of Avogadro Compels You! James Randi and Alexa Ray Joel try to poison themselves — one of them deliberately and the other accidentally making homeopathy look 10X sillier than it already did. Return to text.
There is no such thing as truly “pure” water any more than there is such a thing as a perfect vacuum. Deep space is generally much more empty than any artificial vacuum, and a perfect vacuum is an ideal state that is impossible in a laboratory or, indeed, anywhere in the universe that we know of. Just like with vacuums, water can never be perfectly pure: there are always some molecular contaminants in water. Although their concentrations are outrageously low, many of them measured in parts per trillion or more, they are still much higher than homeopathic concentrations — and they simply can’t be diluted out, because they are present in all samples. Every time you dilute, you simply swap several million contaminant molecules for several million others. Return to text.
The skeptical comedian Tim Minchin sassily explains this problem, “It somehow forgets all the poo it’s had in it!” See Storm , 9:37. Return to text.
And you can’t just say that the active ingredient was remembered “better” because it was recently in a high concentration. The dilution process doesn’t just replace the ingredient, but the water around it — after many dilutions, not only is there none of the original ingredient left, there’s also none of the original water left, either. Return to text.
Malaria advice ‘risks lives’: Some high street homeopaths claim they can prevent malaria, a Newsnight investigation has found. Jones. 2006. Secret filming revealed homeopaths were claiming their preparations could be used instead of anti-malarial drugs to protect travellers in high risk areas such as sub-saharan Africa. Return to text.
Of course, many doctors are guilty of malpractice and incompetence. No profession is perfect. However, in recent decades, medical error rates have gotten quite low — certainly it would be extremely unlikely for 10 out of 10 physicians to make a lethally incompetent recommendation. Return to text.
I am not aware of any other example of a homeopathic prescription that does not obey the Law of Similars, and I have never been able to find any explanation for why the most popular homeopathic remedy breaks the most important law of homeopathy. Homeopaths are invited to contact me with a proposed explanation — I will publish any explanation provided, in this spot. Return to text.
Although straightforward enough in the acute stage, chronic tendinitis degenerates into something more complex and puzzling. Inflammation ceases to be a dominant feature of the condition. Instead of “tendinitis,” it is better called “tendinosis” — a less specific “disease” or “condition” of the tendon. The pathophysiology of tendinosis is not well understood. Although painful, the tendon is not inflamed. Return to text.
Khan et al. Phys Sportsmed. 2000. From the abstract: “If physicians acknowledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management …” Return to text.
The physiology of DOMS remains a good medical puzzle. One researcher described DOMS research as so deeply frustrating — difficult and poorly funded — that he abandoned it. For more detail, see another article on SaveYourself.ca, You Can’t Beat DOMS! The myth of treatment for nature’s little tax on exercise, delayed onset muscle soreness (DOMS). Return to text.
One of the most common questions that patients ask health professionals is, “How long will this take to heal?” Most patients aren’t the least bit knowledgeable about what constitutes a normal healing time, and sensibly defer to clinicians who have seen hundreds or even thousands of examples — who all know that healing time varies wildly depending on countless known and unknown variables. Healing rates are affected by many variables, and we often recover faster or slower than we expected to for reasons no one can ever know. We also seem to recover faster or slower, depending on which psychological “goggles” we had on at the time. Return to text.
If advocates of Traumeel protest that it’s not intended for a common and serious problem like rheumatoid arthritis, for example … why not? “Inflammation” is the common denominator in all the conditions that Traumeel supposedly treats. And rheumatoid arthritis is a (very nasty) disease of “pure” inflammation. So, Traumeel should show a clear, measurable benefit to victims of rheumatoid arthritis, should it not? And why not? Return to text.
Ernst et al. Arch Surg. 1998. “… burdened with a multitude of methodological limitations. Small sample size and lack of test statistics are frequent and obvious ones.” Return to text.
“…many of these trials have methodological limitations that make the findings unreliable.” Stevinson et al. Journal of the Royal Society of Medicine. 2003. Return to text.
And even from NCCAM (remember, supposedly sort of pro-homeopathy): “… many of the studies have been flawed.” Return to text.
And in journals with a likely bias, (in journals like Homeopathy and Complementary Therapies in Medicine. Return to text.
Ernst et al. Arch Surg. 1998. Return to text.
Here are seven of the eight: Campbell, Savage, Hildebrandt, Pinsent, Kaziro, Tveiten, Gibson. Return to text.
Stevinson et al. Journal of the Royal Society of Medicine. 2003. Return to text.
Brinkhaus et al. Complementary Therapies in Medicine. 2006. In this study, surgeons found a small positive effect in 57 patients, and emphasized that in their conclusions … instead of emphasizing their best data, which showed no benefit in 227 other patients. Averaged out, it would have been a strongly negative study — good evidence of absence. But they spun it as a positive study. See the full bibliographic record for details. Return to text.
In the other, the authors failed to emphasize that patients actually had more pain with homeopathic Arnica, and instead painted the results as positive because of a barely measurable improvement in bruising. This study (Seeley) will be dissected in detail below as a classic example of “positive” homeopathic research. Return to text.
Not that anyone would trust it if they did, but it would be a start, and if the stuff works it should show an obvious benefit. If it did, independent scientists might get interested and do their own tests. Return to text.
Seeley et al. Archives of Facial Plastic Surgery. 2006. Return to text.
SINECCH™ is basically Traumeel in a pill. Although it’s not perfect, SINECCH research is a good-enough substitute for Traumeel research. We’ll call it a reasonably safe assumption that, if SINECCH doesn’t work, Traumeel probably doesn’t either. Return to text.
Using custom computer software, “… the exact density of pixels per square centimeter for that image was calculated. This density was then extrapolated to the study area, which had a known number of pixels, and thus an exact area of ecchymosis was calculated, despite its markedly irregular borders.” Return to text.
In science, such a tiny study is the sound of one hand clapping. This experiment was as small as they come — 14 patients getting SINECCH compared to 15 getting a placebo. These are such small groups that an abnormality in a single patient could skew the stats. Even the most dramatic results in such a study could easily be a fluke, and would have to be confirmed by multiple larger studies. That’s how science works. Return to text.