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Treating acute back pain with ointment of comfrey root extract

Issue 30 Synovium (Summer 2010)

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Readers may be more familiar with the horticultural merits of Symphytum officinale as a fertiliser than its medicinal use. Comfrey is a perennial plant native to Europe. It has small white, cream, blue or pink flowers, broad hairy leaves (the bits used as a mulch around your tomatoes) and a large black turnip-like root – the part of much interest to herbalists. The old country name for comfrey is knitbone, which nicely illustrates potential therapeutic value.

There is some editorial embarrassment that trials of comfrey root extract ointment (admittedly published in the German literature) demonstrating efficacy in treating the pain of ankle sprain and osteoarthritis of the knee have gone unnoticed. In the British Journal of Sports Medicine a further study from Germany1 now reports excellent therapeutic effects in treating acute back pain. The study was a randomised, double-blind, placebo-controlled trial involving 120 patients with acute back pain. Curiously the study used the terms acute upper and lower back pain without clearly defining what was meant by ‘upper back pain’, although the trapezius, latissimus dorsi, teres major and one or two other muscles were mentioned, indicating thoracic and neck symptoms. This aside the results, as assessed by a number of outcome measures, some familiar – visual analogue scales (VAS), Oswestry Disability Index (ODI) – and some perhaps less so – pressure algometry – were impressive, in particular the pain relief assessed at 1 hour from application of the comfrey ointment. Pain intensity on active standardised movements measured by VAS decreased by 33% with active treatment compared with 12% in the placebo group. At 5 days these figures had increased to 95.2% and 37.8% respectively. After 5 days the ODI scores were reduced by 65.2% in the comfrey group and 27.6% in the placebo group, having been comparable at the outset. Reported adverse effects were mild and similar in both groups.

A quick search of the web for herbal supplies suggested comfrey ointment is widely available and relatively cheap. Unfortunately, preparations come with various other ingredients which may or may not be beneficial and the concentration of comfrey root extract – 35% in the study – was not stated. However, this looks like a really promising development and we await with interest the outcome of further study.

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