Monday 10 February 2020

Herbal Comfrey (Symphytum officinale L.), the Remedy for the Treatment of Painful osteoarthritis

By Kyle J. Norton

Osteoarthritis (OA) one of the most common forms of arthritis that affects over 25 25 million people in the United State, is a chronic inflammatory disease of the joints due to wear and tear over time.

The characteristics of osteoarthritis are aching pain, stiffness, or difficulty of moving the joint or joints. The pain usually gets worse in a change of weather, at night and in the advanced diseases, the pain can occur even at rest.

Conventionally, treatment of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, nonpharmacological, and surgical treatments.

The most common risk factors associated with the onset of OA include genetic preposition, being overweight or obese, previous joint injury and repetitive movements or injuries to joints (such as a fracture, surgery or ligament tears).

the most common diseases associated with OA are
* Hypertension
According to the University Health Network Research Institute, the economic burden incurred by RA significantly exceeds that related to OA and HBP(76)(77).

* Cardiovascular disease
According to Erasmus University Medical Centre, there are associations of atherosclerosis with osteoarthritis of the knee and hand joints in women(72)(73)(78).

* Peripheral vascular disease
According to Himchan Hospital, patients with due to osteoarthritis are associated to risk of asymptomatic peripheral vascular disease(80). The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population(79).

* Congestive heart failure
Hypertension, diabetes, and older age have shown to increased risk of Congestive heart failure modestly(81). Etoricoxib, annti-inflammatory painkillers showed statistically significant inhibition at 90 mg in patients with osteoarthritis and rheumatoid arthritis(82).

* Renal function impairment
According to the Southampton University Hospitals NHS Trust, pain pharmacotherapies such as osteoarthritis (OA) or mixed OA and rheumatoid arthritis may increase the risk of adverse events in patients with concurrent cardiovascular (CV) or renal disease(83). Median excretion of pyridinoline and deoxypyridinoline in the OA patients as a whole was raised above values found in a healthy control population(84).

* Diabetes
Several epidemiological and experimental data support the hypothesis that diabetes could be an independent risk factor for osteoarthritis (OA)(76)(85).

Comfrey is a perennial plant in the genus of Symphytum, belonging to the family Boraginaceae, native to Europe. It has been used in herbal and traditional medicine to ease excessive bleeding or on open wounds, relief pain and swollen, treat circulation issues, reduce cholesterol, etc.

On finding a potential compound for the treatment of osteoarthritis, researchers investigated the effect of Kytta-Salbe f (3 x 2 g), a topical including comfrey over a 3 week period with patients suffering from painful osteoarthritis of the knee.
The randomised, double-blind, bi-center, placebo-controlled clinical trial including 220 patients was conducted by the Merck Selbstmedikation GmbH.

In the course of the trial, the visual analog scale (VAS) total score (primary target value) in the verum group dropped by 51.6 mm (54.7%) and in the placebo group by 10.1 mm (10.7%).

The average difference between the groups of 41.5 mm (95% confidence interval=34.8 to 48.2 mm) or 44.0% is significant (p<0.001).

The WOMAC (Western Ontario and McMaster Universities) total score (secondary target value) also improved similar to the VAS total score.

At the end of the trial, a reduction by 60.4 mm (58.0%) was recorded for the verum group and a reduction of 14.7 mm (14.1%) for the placebo group.

The average group difference of 45.7 mm (95% confidence interval=37.1 to 54.3 mm) or 43.9% is significant (p<0.001).

The difference between the treatment groups increased systematically and significantly, in parallel with the duration of the treatment.

Based on the results, researchers said, "the superiority of the treatment with Kytta-Salbe f over that with the placebo is proven, even by means of the multi-factorial multivariate analysis for repetitive measurements. In respect of the explorative secondary target values SF-36 (quality of life), angle measurement (mobility of the knee), CGI (clinical global impression) and global assessment of efficacy by the physician and the patient, a significant superiority (p<0.001 each) of the verum group over the placebo group was also proven".

Taken altogether, Comfrey combined with other herbal medicine may be considered for the treatment of a remedy painful osteoarthritis, pending to the confirmation of the larger sample size and multicenter human study.

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Author Biography
Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published online, including worldwide health, ezine articles, article base, health blogs, self-growth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bioscience, ISSN 0975-6299.

Sources
(1) Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial by Grube B1, Grünwald J, Krug L, Staiger C. (PubMed)
(2) The Research and Studies of Musculo-Skeletal disorders(MSDs) - Osteoarthritis: The Diseases associated with osteoarthritis by Kyle J. Norton


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