Osteoarthritis Clinical Trial
Official title:
The Efficacy of the Homoeopathic Complex and Physiotherapy in the Treatment of Chronic Low Back Pain Due to Osteoarthritis
Osteoarthritis (OA) is a chronic arthropathy characterised by disruption and possible loss
of joint cartilage along with other joint changes. OA symptoms include progressively
developing joint pain provoked or elicited by activity, joint stiffness that lasts for less
than 30 minutes on waking and after activity, and occasional joint swelling. It is a common
specific mechanical cause of chronic low back pain. Conventional treatment for OA includes
physiotherapy treatment and drugs such as paracetamol, non-steroidal anti-Inflammatory drugs
(NSAIDs), intra-articular injection of corticosteroids and surgery, however these may have
possible side effects. Arnica montana, Bryonia alba, Rhus toxicodendron, Causticum, Kalmia
latifolia and Calcarea fluoride are homoeopathic remedies indicated and used in the
treatment of OA, however, there is no evidence of studies conducted on a complex made up of
these remedies.
The aim of the study is to investigate the efficacy of the homoeopathic complex (Arnica
montana 6CH, Bryonia alba 6CH, Causticum 6CH, Kalmia latifolia 6CH, Rhus toxicodendron 6CH
and Calcarea fluoride 6CH) and physiotherapy in the treatment of chronic low back pain due
to osteoarthritis, using the Oswestry Low Back Pain Disability Questionnaire, range of
motion (ROM) measurement using the attraction tape and the visual analogue pain scale (VAS)
.
This study is a six week, double-blinded, placebo-controlled study, involving thirty
participants, males and females, aged 45-75 years receiving physiotherapy treatment for OA
of the lumbar spine at a specific and identified physiotherapist's private practice. A
poster advert , placed in the physiotherapist's private practice, with permission , will be
used to recruit participants. Individuals who respond to the poster advert will be provided
with information pertaining to the study and will be requested to sign a consent form . A
screening examination forming part of the inclusion criteria will be conducted by the
researcher. Participants meeting the inclusion criteria will be randomly allocated to a
treatment or control group; both groups will receive a standard physiotherapy treatment once
every two weeks from the physiotherapist. Treatment will consist of lower back classic
massage, lumbar joint manipulation, the application of a hot pack and each treatment session
will last for 30 minutes. In addition to physiotherapy treatment, participants will be
allocated, either a placebo or the homoeopathic complex, with instruction to take two
tablets, dissolved under the tongue 20 minutes away from meals, twice daily, starting from
day one. This will comprise of 168 tablets, 56 tablets will be issued forth nightly to
assess participant's compliance in taking their medicine.
Four consultations will take place at the physiotherapist's private practise. At the first
consultation after having divided participants into the treatment and control group,
participants will complete the Oswestry Low Back Pain Disability Questionnaire with the
researcher's assistance. The researcher will assess the lumbar spine's ROM using the
attraction tape measurement. Participants will be provided with 1 copy of the VAS pain scale
with spaces to rate their pain every evening for 14 days and 56 tablets. During the second
and third consultation, copies of the VAS pain scale will be collected as well as medication
containers, to assess participant's compliance in taking their medication. A subjective and
physical examination will be conducted, the Oswestry Low Back Pain Disability Questionnaire
will be completed and ROM for the lumbar spine will be measured. Participants will receive
tablets and copies of the VAS pain scale. On the forth consultation the researcher will
conduct the last subjective and physical examination, complete the last Oswestry Low Back
Pain Disability Questionnaire and conduct the last ROM measurement using the attraction tape
measurement. The last copies of the VAS pain scale and medication containers will be
collected.
A subjective and physical examination, Oswestry Low Back Pain Disability Questionnaire, the
retraction tape measurement for ROM and the VAS pain scale will be used to collect data and
analysed statistically using the Wilcoxon signed test or t-test within groups and t-test
(parametric) or Mann-Whitney U (non-parametric) on between groups
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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