Arnica and the Management of Pain in Acute Musculoskeletal Extremity Injuries

NCT ID: NCT05283434

Last Updated: 2022-03-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

324 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-15

Study Completion Date

2023-06-30

Brief Summary

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In the Emergency Department, there is no standard of care for pain medication distribution for children with an acute musculoskeletal injury when there is no fracture present. Currently, ibuprofen is a favorable choice for the treatment, but studies have shown concern for delayed healing activity associated with NSAIDs like Ibuprofen. Homeopathic Arnica Montana is a well-established complimentary medicine and may provide a good alternative for managing acute pain from musculoskeletal injuries, especially in children, given the palatability and rarity of side effects. This study aims to compare usual care vs. usual care plus Arnica 1M\* (oral) or the placebo for management of pain in acute musculoskeletal extremity injuries without fracture by utilizing a double-blind clinical trial design. The primary outcome is to determine if subjects use less ibuprofen when given Arnica 1M.

Detailed Description

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Conditions

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Pain, Muscle Pain, Acute

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Double-Blind Clinical Trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Double-Blind Clinical Trial- Placebo Group

Patients will be assigned to the placebo (e.g., unmedicated sugar pill) or experimental group (e.g., Arnica 1M pellets) via a randomization chart from that only the research pharmacist will have access to. Subjects assigned to the placebo group will take the recommended doses of sugar pellets (i.e., 2 pills to be taken every 4 waking hours over a 24 hours period), and will track their pain scores, swelling measurements, sleep rate, ibuprofen doses, adverse reactions, further ED visits, and the number of days/activities the patient has missed for 3 days following their enrollment in the study.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Sugar pill placebo

Double-Blind Clinical Trial- Experimental Group

Group Type EXPERIMENTAL

Arnica

Intervention Type DRUG

Patients will be assigned to the placebo (e.g., unmedicated sugar pill) or experimental group (e.g., Arnica 1M pellets) via a randomization chart from that only the research pharmacist will have access to. Subjects assigned to the experimental group will take the recommended doses of Arnica 1M coated sugar pellets (i.e., 2 pills to be taken every 4 waking hours over a 24 hours period), and will track their pain scores, swelling measurements, sleep rate, ibuprofen doses, adverse reactions, further ED visits, and the number of days/activities the patient has missed for 3 days following their enrollment in the study.

Interventions

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Arnica

Patients will be assigned to the placebo (e.g., unmedicated sugar pill) or experimental group (e.g., Arnica 1M pellets) via a randomization chart from that only the research pharmacist will have access to. Subjects assigned to the experimental group will take the recommended doses of Arnica 1M coated sugar pellets (i.e., 2 pills to be taken every 4 waking hours over a 24 hours period), and will track their pain scores, swelling measurements, sleep rate, ibuprofen doses, adverse reactions, further ED visits, and the number of days/activities the patient has missed for 3 days following their enrollment in the study.

Intervention Type DRUG

Placebo

Sugar pill placebo

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient presents to the Emergency Department with an acute, soft tissue ankle or forearm injury
* ED Provider orders an X-ray for evaluation of injury
* Patient's initial pain score is of a 4 or higher
* Patient has noticeable swelling at the site of the injury

Exclusion Criteria

* Patient is diagnosed with a fracture
* Patient has an allergy to ibuprofen
* Patient is already on a NSAID, acetaminophen, anticoagulant or oral corticosteroid therapy for chronic pain treatment (a NSAID given in triage or use for the current injury is allowed)
* Use of other concurrent complementary medicine therapy, e.g. massage, acupuncture, physical therapy
* Patient has been treated for this injury in the past
* Patient has a bleeding/bruising disorder
* Patient is pregnant or is lactating
* Patient has a liver or kidney disease, malignancy, infection, immunodeficiency or metabolic syndrome
* Patient is allergic to the Asteraceae family of plants (arnica, ragweed, chrysanthemum, marigold, or daisy are the most common)
* Patient is nonverbal, and thus unable to give a pain score
* Patient does not have a working telephone (required for follow-up call)
* Family requires foreign language interpreter during their ED visit
Minimum Eligible Age

11 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Children's Hospitals and Clinics of Minnesota

OTHER

Sponsor Role lead

Responsible Party

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Manu Madhok

Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Manu Madhok, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Children's Hospitals and Clinics of Minnesota

Locations

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Children's Minnesota

Minneapolis, Minnesota, United States

Site Status RECRUITING

Children's Minnesota

Saint Paul, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Manu Madhok, MD, MPH

Role: CONTACT

612-813-6843

Shea M Lammers, MS

Role: CONTACT

763-478-1547

Facility Contacts

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Manu Madhok, MD, MPH

Role: primary

612-813-6822

Shea M Lammers, MS

Role: backup

763-478-1548

Manu Madhok, MD, MPH

Role: primary

612-813-6822

Shea M Lammers, MS

Role: backup

763-478-1547

References

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Thompson EA, Bishop JL, Northstone K. The use of homeopathic products in childhood: data generated over 8.5 years from the Avon Longitudinal Study of Parents and Children (ALSPAC). J Altern Complement Med. 2010 Jan;16(1):69-79. doi: 10.1089/acm.2009.0007.

Reference Type BACKGROUND
PMID: 20105063 (View on PubMed)

Oberbaum M, Schreiber R, Rosenthal C, Itzchaki M. Homeopathic treatment in emergency medicine: a case series. Homeopathy. 2003 Jan;92(1):44-7. doi: 10.1054/homp.2002.0071.

Reference Type BACKGROUND
PMID: 12587994 (View on PubMed)

Arnica. 2024 Oct 15. Drugs and Lactation Database (LactMed(R)) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Available from http://www.ncbi.nlm.nih.gov/books/NBK501828/

Reference Type BACKGROUND
PMID: 30000888 (View on PubMed)

Mawardi H, Ghazalh S, Shehatah A, Abdelwahid A, Aljohani A, Felemban O, Almazrooa S, Elbadawi L, Shawky H. Systemic Use of Arnica Montana for the Reduction of Postsurgical Sequels following Extraction of Impacted Mandibular 3rd Molars: A Pilot Study. Evid Based Complement Alternat Med. 2020 Dec 12;2020:6725175. doi: 10.1155/2020/6725175. eCollection 2020.

Reference Type BACKGROUND
PMID: 33381206 (View on PubMed)

Iannitti T, Morales-Medina JC, Bellavite P, Rottigni V, Palmieri B. Effectiveness and Safety of Arnica montana in Post-Surgical Setting, Pain and Inflammation. Am J Ther. 2016 Jan-Feb;23(1):e184-97. doi: 10.1097/MJT.0000000000000036.

Reference Type BACKGROUND
PMID: 25171757 (View on PubMed)

Paris A, Gonnet N, Chaussard C, Belon P, Rocourt F, Saragaglia D, Cracowski JL. Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study. Br J Clin Pharmacol. 2008 Feb;65(2):180-7. doi: 10.1111/j.1365-2125.2007.03008.x.

Reference Type BACKGROUND
PMID: 18251757 (View on PubMed)

Karow JH, Abt HP, Frohling M, Ackermann H. Efficacy of Arnica montana D4 for healing of wounds after Hallux valgus surgery compared to diclofenac. J Altern Complement Med. 2008 Jan-Feb;14(1):17-25. doi: 10.1089/acm.2007.0560.

Reference Type BACKGROUND
PMID: 18199022 (View on PubMed)

Robertson A, Suryanarayanan R, Banerjee A. Homeopathic Arnica montana for post-tonsillectomy analgesia: a randomised placebo control trial. Homeopathy. 2007 Jan;96(1):17-21. doi: 10.1016/j.homp.2006.10.005.

Reference Type BACKGROUND
PMID: 17227743 (View on PubMed)

Brinkhaus B, Wilkens JM, Ludtke R, Hunger J, Witt CM, Willich SN. Homeopathic arnica therapy in patients receiving knee surgery: results of three randomised double-blind trials. Complement Ther Med. 2006 Dec;14(4):237-46. doi: 10.1016/j.ctim.2006.04.004. Epub 2006 Oct 13.

Reference Type BACKGROUND
PMID: 17105693 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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1812-139

Identifier Type: -

Identifier Source: org_study_id

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