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Stinging Nettle Cream for Osteoarthritis

Charles Leiter, PharmD; Thomas Bush, MD

Osteoarthritis (OA) is the most common joint disease and one of the oldest documented chronic diseases of humans; archaeologists have found changes typical of osteoarthritis in prehistoric human bones.1(p51) The malady’s antiquity is further evidenced by the plethora of remedies reportedly used by aboriginal peoples for relief from the pain of “rheumatism.” The Native American people known as the Ohlone, formerly inhabiting the central coastal region of California where our research was conducted, utilized at least 12 different herbs for painful joints. Among these Ohlone medicinal plants, we selected stinging nettle, Urtica dioica, for a pilot study, as it has shown beneficial effects in patients with joint pain.4

The American College of Rheumatology5 recommends a stepped approach to control pain of OA, ranging from nonpharmacological measures, through various medications, to surgery when other therapies fail. Alternative therapies exist, some of which are widely used by patients with or without physician recommendation. Glucosamine is the most widely known of these agents. Others include chondroitin, S-adenosylmethionine (SAMe), methylsulfonylmethane (MSM), and a variety of herbal treatments such as devil’s claw (Harpagophytum procumbens), turmeric (Curcuma longa), and ginger (Zingiber offi cinale).6 A previous study demonstrated efficacy of fresh nettle leaf applied directly to aching joints compared to a control application of “dead nettle” plant.4 For our study, we prepared the plant in a topical cream, as this was considered a more practical way to eventually incorporate this treatment in a clinical setting. We conducted a trial of stinging nettle cream prepared by compounding 13.33% (w/w) stinging nettle extract (Liquid Phyto- Caps Nettle Leaf, lot number A1413230000910, Gaia Herbs, Brevard, North Carolina) in Lipobase oil-in-water emulsion (lot number 0802256, Gallipot Pharmaceuticals, St Paul, Minnesota). Twenty-three patients with radiologically confirmed OA were recruited sequentially in a primary care clinic. These subjects applied the cream twice daily for 2 weeks. Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) short form assessments measuring functional status7 were conducted at baseline and at week 2. The Student’s t-test was used to analyze the WOMAC scores, and subjects were also monitored for any untoward effects.

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