Homœopathic Links 2012; 25(1): 50-55
DOI: 10.1055/s-0031-1298204
RESEARCH

© Sonntag Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

A Randomized Controlled Clinical Trial Comparing the Outcomes of Homeopathic-phytotherapeutic and Conventional Therapy of Whiplash in an Emergency Department

Salvatore Piraneo[1] , Jeanette Maier[2] , Giovanni Nervetti[3] , Piergiorgio Duca[4] , Cristina Valli[5] , Anna Milanesi[6] , Francesco Pagano[7] , Daniela Scaglione[8] , Massimo Osio[9] , Caterina Nascimbene[10] Italy
Further Information

Publication History

Publication Date:
14 March 2012 (online)

Summary

From 2006 to June 2007, 51 patients have been triaged for acute whiplash injury and randomized to receive conventional or nonconventional therapy. The conventional therapy group A (n = 27) received diclofenac + tinazidine for 15 days. The complementary therapy group B (n = 24) received Hypericum perforatum as a homeopathic remedy and Ribes nigrum as a phytotherapeutic agent. Ambulatory controls were programmed twenty days after whiplash (post-acute outcome) and every month for one year. Electromyography (EMG) was performed on both groups in all the patients 30 days after whiplash to evaluate the radicular damage. Visual analogue scale (VAS) was used to rate the patient's pain. A score was developed to evaluate the therapeutic control of pain and neurologic symptoms. We also considered the incidence of late whiplash syndrome (LWS) in both groups of patients. Statistical analysis revealed a significant improvement of post-acute outcome in the B-group patients (p = 0.005) and a significant increase of adverse effects in the A-group (p = 0.013), while no differences were observed between the two groups in terms of the EMG evaluation (p = 0.0612), use of additional therapies (p = 0.0542), and incidence of LWS (p = 1.000). We conclude that nonconventional therapies might offer a valid aid in treating whiplash injury, even in the presence of neurologic symptoms. However, the final incidence of LWS is not influenced by the complementary therapy chosen for this study.

References

  • 1 Radanov B P, Sturzenegger M, Di Stefano G. Long-term out come after whiplash injury: 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings.  Medicine. 1995;  74 281-297
  • 2 Mayou R, Bryant B. Outcome of ‘Whiplash neck injury.  Injury. 1996;  27 617-623
  • 3 Berglund A, Alfredsson L, Jensen I, Cassidy J D, Nygren A. The association between exposure to rear-end collision and future health compliants.  J Clin Epidemiol. 2001;  54 851-856
  • 4 Moog M, Quintner J, Hall T, Zusman M. The late whiplash syndrome: a psychophysical study.  Eur J Pain. 2002;  6 283-294
  • 5 Olivergren H, Jerkvall N, Hagstrom Y, Carlsson J. The long-term prognosis of whiplash-associated disorders (WAD).  Eur Spine J. 1999;  8 366-370
  • 6 Alpar E K, Onuoha G, Killampalli V, Waters R. Management of chronic pain in whiplash injury.  J Bone Joint Surg [Br]. 2002;  84 807-811
  • 7 Bostick G P et al. A population-based survey of beliefs about neck pain from whiplash injury, work-related neck pain, and work-related upper extremity pain.  Eur J Pain. 2009;  13 300-304
  • 8 Pettersson K, Toolanen G. High-dose methylprendisolone prevents extensive sick leave after whiplash injury: a prospective, randomized, double-blind study.  Spine. 1998;  23 984-989
  • 9 Wenzel H G, Haug T T, Mykleltun A, Dahl A A. A population study of anxiety and depression among persons who report whiplash traumas.  J Psychosom Res. 2002;  53 831-835
  • 10 Mayou R, Radanov B P. Whiplash neck injury.  J Psychosom Res. 1996;  40 461-474
  • 11 Bogduk N, Yoganandan N. Biomechanics of cervical spine Part 3: minor injuries.  Clin Biomech. 2001;  16 267-275
  • 12 Binder A. Uncomplicated neck pain.  Clin Evid. 2002;  8 1188-1202
  • 13 Woodward M N, Cook J C, Gargan M F, Bannister G C. Chiropractic treatment of chronic ‘whiplash injures.  Injury. 1996;  27 643-645
  • 14 Freund B J, Schwartz M. Treatment of whiplash associated neck pain with botulinum toxin-A: a pilot study.  J Rheumatol. 2000;  27 481-484
  • 15 Fattori B, Borsari C, Vannucci G, Casani A, Cristofani R, Bonuccelli L, Ghilardi P L. Acupuncture treatment for balance disorders following whiplash injury.  Acupunct Electrother Res. 1996;  21 207-217
  • 16 Borchgrevink G E, Kaasa A, McDonagh D, Stiles T C, Haraldseth O, Lereim I. Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident.  Spine. 1998;  23 25-31
  • 17 Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols.  Spine. 2000;  15 1782-1787
  • 18 Spitzer W O et al. Scientific monograph of the Quebec Task Force on whiplash-associated disorders.  Spine. 1995;  20 (Suppl.) 1S-73S
  • 19 Vesteegen G J, van Es F D, Kingma J, Meijler W J, ten Duis H J. Applying the Quebec Task Force criteria as a frame of reference for studies of whiplash injures.  Injury. 2001;  32 185-193
  • 20 Philip B K. Parametric statistics for evaluation of the visual analog scale.  Anesth Analg. 1990;  71 710
  • 21 Stevinson C, Ernst E. Hypericum for depression. An update of the clinical evidence.  Eur Neuropsychopharm. 1999;  9 501-505
  • 22 Hunt E J, Lester C E, Lester E A, Tackett R L. Effect of St. John's wort on free radical production.  Life Sci. 2001;  69 181-190
  • 23 Shule C, Baghai T, Ferrera A, Laakman G. Neuroendocrine effects of Hypericum extract WS 5570 in 12 healthy male volunteers.  Pharmacopsychiatry. 2001;  34 127-133
  • 24 Hosseinzadeh H, Karimi G-R, Rakhshanizadeh M. Anticonvulsant effect of Hypericum perforatum: role of nitric oxide.  J Ethnopharmacology. 2005;  98 207-208
  • 25 Bilia A R, Gallori S, Vincieri F F. St. John's wort and depression. Efficacy, safety and tolerability-an update.  Life Sci. 2002;  70 3077-3096
  • 26 Sindrup S H, Madsen C, Bach F W, Gram L F, Jensen T S. St. John's wort has no effect on pain in polyneuropathy.  Pain. 2001;  91 361-365
  • 27 Schadde A. When rolls talk to each other at the breakfast table … a case of Hypericum.  Homoeopathic Links. 2006;  19 87-89
  • 28 Muller W E. Current St. John's wort research from mode of action to clinical efficacy.  Pharmacol Res. 2003;  47 101-109
  • 29 Garback N, Kinet M, Nusgens B, Desmecht B, Damas J. Proanthocyanidins, from Ribes nigrum leaves, reduce endothelial adhesions molecules ICAM-1 and VCAM-1.  J Inflamm. 2005;  2 9
  • 30 Tant L, Gillard B, Appelboom T. Open-label, randomized, controlled pilot study of the effects of a glucosamine complex on low back pain.  Curr Ther Res. 2005;  66 511-521
  • 31 Vermeulen F. Prisma. The Arcana of Materia Medica Illuminated. Similars and Parallels between Substance and Remedy. Haarlem, The Netherlands: Emryss bv Publishers; 2002
  • 32 Hansson E, Mansson N O, Ringsberg K A, Hakansson A. Dizziness among patients with whiplash-associated disorder: a randomized controlled trial.  J Rehabil Med. 2006;  38 387-390

Authors

1 Emergency Department, L. Sacco Hospital, Degree of School of Homeopathy

2 Professor of General Pathology, Dip. Scienze Cliniche L. Sacco Università di Milano

3 Chief of the Emergency Department, L. Sacco Hospital

4 Professor of Statistical Analysis, Dip. Scienze Cliniche L. Sacco Università di Milano

5 M. D., Department of Surgery, Hospital of Tradate, Varese

6 M. D., Emergency Department, L. Sacco Hospital

7 Biologist, Degree in Phytotherapy

8 M. D., Emergency Department, L. Sacco Hospital

9 M. D., Department of Neurology, L. Sacco Hospital

10 M. D., Department of Neurology, L. Sacco Hospital

Salvatore Piraneo, M.D.

Luigi Sacco Hospital

Via G. B. Grassi 74

20157 Milan

Italy

Email: [email protected]