About Arnica: Does Arnica Gel Really Relieve Pain?

Folk medicine has incorporated arnica for centuries for its purported anti-inflammatory and relaxing characteristics, and it continues to be a popular natural remedy today (1).

Arnica gel comes from the arnica montana plant, also called Wolf’s Bane, which is a semi-toxic flower (2). This ancient plant looks like a daisy flower and is native to the mountainous regions of East Asia, Europe, and the northern United States (2).

Topical arnica solutions, including gels and creams, come from the dried flower-heads of the arnica plant (3). Most topical preparations originate from alcohol extracts of the plant (1).

Arnica tablets are commonly sold under the Traumeel and T-Relief brands (4, 5). Another popular brand is the Arnicare brand manufactured by Boiron, the leader in homeopathic medication production (6).

Arnica montana contains certain chemicals called “sesquiterpene lactones,” which can relieve pain by inhibiting the p65 subunit protein and consequently inducing an anti-inflammatory effect (7).

Arnica gel is most useful in relieving arthritis-related joint pain and inflammation. It’s also been shown to reduce muscle pain following surgery or intense exercise.‍

Arnica Gel and Arthritis

Early research indicates that arnica gel can treat mild to moderate knee osteoarthritis with limited adverse events (8). This kind of arthritis gradually wears down the knee joints, leading to pain, swelling, and stiffness (9). Osteoarthritis usually affects individuals over the age of 50 (9).

Initial studies indicate that arnica gel is as effective in treating hand osteoarthritis pain NSAIDs like ibuprofen gel, but more research is needed to substantiate this (11).

Initial trials indicate that arnica may also be helpful in treating cases of rheumatoid arthritis, an autoimmune disease that causes the body to mistakenly attack the joints (12). In clinical experiments, mice were injected with collagen-induced arthritis, the most common laboratory method for studying rheumatoid arthritis (12). The mice were then treated with arnica montana extract (12). The results were positive and showed a reduction in arthritic symptoms in the limb joints due to the cumulative therapeutic effects of phytochemicals in arnica montana (12).‍

Other Uses for Arnica Gel

When applied after vigorous physical exercise, arnica gel can treat muscle soreness and pain, although in this use case it doesn’t reduce inflammation (13).

Low concentration homeopathic preparations of arnica montana can offer a similar degree of pain relief as oral NSAIDs following injury or surgery, although additional studies are needed to examine this (14).

Topical arnica solutions come in unscented gel, ointment, and cream formulations (15, 16). Arnica is also available in heavily diluted homeopathic doses in liquid and tablet formulations (15).

Arnica gel is non-greasy and doesn’t stick, while arnica cream is more viscous (16). Arnica ointment generally has a petroleum jelly base, giving it a slick texture (16).

The active ingredient in Arnicare Gel, a common arnica gel option, is arnica montana 1X HPUS 7%, a preparation which is officially recognized by the Homeopathic Pharmacopœia of the United States. Its inactive ingredients include carbomer, a thickening agent, as well as purified water and sodium hydroxide (17). It’s paraben-free (17).

Before using a new package of arnica gel, check that the tube seal is intact to ensure non-contamination. Adhere closely to the accompanying instructions for use, as arnica demonstrates toxicity in higher dosages (18). Do not apply to broken skin as this will increase the rate of absorption and toxicity of arnica (18).

Apply arnica gel up to three times a day to the affected area, rubbing the solution thoroughly into the skin (19). Let it dry before replacing any clothing items (19). Avoid touching mucous membranes of your eyes or mouth and wash your hands thoroughly after use (16).

Arnica gel should be used externally (18). Do not ingest. If accidentally ingested, seek medical help from a poison control center (18).

Store at room temperature and keep out of the reach of children (18).

Although initial research suggests that arnica gel can be beneficial in relieving arthritis pain and muscle soreness, there isn’t consensus on the efficacy of arnica gel.

Studies show that homeopathic preparations of arnica gel in doses of less than ten percent carry no benefits for reducing muscle pain, swelling, and bruising beyond the placebo effect (20, 21). FUrther research has also supported this (22).

Homeopathic arnica tablets also don’t outperform placebo treatments in relieving postoperative pain, bruising, or swelling in patients following hand surgery (23, 24).

Higher concentration preparations of arnica gels and creams may help reduce muscle pain and joint inflammation associated with osteoarthritis, but additional research is needed to validate this. Arnica does in fact have similar therapeutic effects as NSAIDs in treating osteoarthritis pain, but patients have reported more adverse effects with arnica gel than with ibuprofen (25).

Arnica gel is generally safe to use if applied according to dosage guidelines, but it does carry potential side effects.

The most common side effect associated with arnica gel is minor skin irritation (26). The sesquiterpene lactones helenalin proteins, acetate, and methacrylate acids are the primary causes of irritation (26). Arnica gel may cause contact dermatitis, an itchy, red, skin rash (18, 26, 27). Stop use if you notice skin discoloration or irritation (27).

Arnica supplements can cause digestive issues and amplify the effects of irritable bowel syndrome, Crohn’s disease, and stomach ulcers (18).

You should never ingest the pure arnica flower as it is toxic (28, 29, 30). Serious side effects can occur if ingested, including adverse gastrointestinal events, anxiety, muscle weakness, and coma (29, 30). The Federal Drug Administration (FDA) considers arnica an unsafe herb (29).

If ingested in high concentrations, overdose may occur (30). Overdose symptoms include severe vomiting and subsequent vision loss in both eyes (29). If not treated immediately, death may result (29, 30).‍

Who Should Not Use Arnica Gel

Individuals with allergies to ragweed, daisies, chrysanthemums, marigolds, and related plants should avoid arnica (18).

Avoid using arnica gel if you’re pregnant or breastfeeding (29). Drinking arnica teas can cause miscarriage (30).

Ask your doctor before using arnica gel or supplements if you have a fast heart rate as it can increase this condition (18).

Arnica can cause additional bleeding before and after surgery. Stop using arnica products at least two weeks before a scheduled surgery (18).

Seek medical advice from your doctor before using arnica gel or supplements if you have high blood pressure and are taking anticoagulants (18, 29, 31). Arnica can amplify the effects of blood thinners like Warfarin and Naproxen, increasing the possibility of bruising or bleeding (31).

If arnica gel isn’t working, or you think it may not be the right choice for you, there are several alternatives you may consider when tackling chronic pain.‍

NSAIDs

NSAIDs exhibit similar or better anti-inflammatory effects and reduced side effect profiles to arnica gel (10, 14, 25, 32). Both treatment options demonstrate pain-relieving properties in cases of hand osteoarthritis, but patients who use NSAIDs like ibuprofen report fewer side effects than those who use arnica gel (25, 32).

Topical NSAIDs, particularly diclofenac gel, are particularly effective for treating joint-related pain caused by arthritis (33, 34).

Oral NSAIDs can reduce pain and swelling, but may increase blood pressure, exacerbate heart conditions, and cause stomach pain (35). In contrast, topical NSAIDs like ibuprofen gel carry fewer risks (36). However, topical NSAIDs can cause irritation at the application site, and in more severe cases, generate high blood pressure, swelling, kidney injury, or gastrointestinal bleeding (37, 38).

The Arthritis Foundation doesn’t promote the use of arnica because of the possible adverse effects that can occur if the arnica is not properly diluted (39).‍

Physical Therapy

Physical therapy is a proven tool for achieving long-lasting relief from chronic muscle and joint pain (40, 41).

Physical therapy is a particularly useful treatment option for individuals suffering from osteoarthritis, rheumatoid arthritis, fibromyalgia, or nerve-related pain (40, 42). Physical therapy is also an important aspect of the rehabilitation process following injury (41, 42). It’s often recommended for treating chronic lower back pain, knee and hand injuries, post-operative pain, and Parkinson’s disease (40, 41, 42, 43).

Your physical therapist will create a personalized exercise plan to target the source of your pain without placing undue stress on the body (40). Exercises may include stretching, toning, stabilizing, and strengthening movements.‍

Home Remedies

There are natural home remedies that can ease muscle pain and swelling.

RICE (rest, ice, compression, elevation) can help relieve muscle pain in the knees and legs if the cause of inflammation is overexertion (44). Limit your physical activity and apply ice to the affected area in 15 to 20-minute increments throughout the day (44). Compress the area using an elastic band and elevate the leg (44).

Alternatively, the application of a heating pad to the area of soreness can ease muscle tension (45).

In cases of hand arthritis, it may be beneficial to wear a wrist splint or hand brace to remove daily stress from the bones and joints (46). Finger splints can prevent deformities in the finger due to rheumatoid arthritis (46).

Arnica montana has a long history as a homeopathic remedy for minor injuries and muscle aches. However, there's mixed evidence concerning the efficacy of this herb.

Medical research indicates that homeopathic preparations of arnica gel don’t exhibit therapeutic effects. More concentrated preparations of arnica may help with joint inflammation caused by arthritis.

The elevated risks associated with large doses of arnica, including toxicity and possible overdose, make it an inferior treatment to traditional pain management drugs and physical therapy.

Avoid using arnica products if you have a ragweed allergy, are pregnant, or breastfeeding. Ask your doctor before using arnica gel if you suffer from high blood pressure and are taking anticoagulants, or have a fast heart rate.