A Homeopathic Ointment Preparation Compared With 1% Diclofenac Gel for Acute Symptomatic Treatment of Tendinopathy

Context

The incidence of tendon injuries and tendinopathy has risen substantially in the past decades.

Objective

To assess the noninferiority of therapy based on the homeopathic preparation Traumeel S ointment (Heel GmbH, Baden-Baden, Germany) compared with treatment based on diclofenac 1% gel in patients with tendinopathies of varying etiology.

Design

Nonrandomized, observational study.

Setting

Ninety-five homeopathy and conventional medical practices in Germany.

Patients

Three hundred fifty-seven patients aged 18 to 93 years with tendinopathy of varying etiology based on excessive tendon load rather than inflammation.

Interventions

Traumeel S ointment or diclofenac 1% gel for a maximum of 28 days.

Main Outcome Measures

Efficacy was measured on a four-degree scale on pain-related variables, on variables related to motility, and on overall treatment outcome. Tolerability was monitored as adverse events. Compliance was assessed by practitioner and patient on a four-degree scale.

Results

The patients groups were comparable at baseline. The changes in summary score of all pain-related variables were −5.3 ± 2.7 (all values means ± SD) in the Traumeel group and −5.0 ± 2.7 in the control group. Changes for all motility-related variables were −4.2 ± 3.8 with Traumeel and −3.7 ± 3.4 with control therapy. The summary scores for all clinical variables were reduced by −9.5 ± 5.7 with Traumeel therapy and by −8.7 ± 5.4 with diclofenac-based treatment. Homeopathic therapy was noninferior to diclofenac therapy on all variables. For motility-related variables, there was a trend toward superiority of Traumeel. Treatments were well tolerated with no treatment-related adverse events.

Conclusions

The results suggest that Traumeel ointment is an effective alternative to nonsteroidal antiinflammatory drugs therapy for the acute symptomatic treatment of patients with tendinopathy.

Key words:  Homeopathy , motility , noninferiority , NSAID , observational study