| Herbal Topicals in Pain Management: A Narrative Review of Recent Clinical Trials and Key Considerations for Future Studies |
| Paper ID : 1302-IGA |
| Authors |
|
Fatemeh Hassani * Student's Scientific Research Center, Tehran University of Medical Science, Tehran, Iran |
| Abstract |
| Background and Aim: Pain affects nearly one in five adults worldwide. While long-term use of NSAIDs and opioids is associated with significant side effects, non-topical routes also result in higher systemic absorption. These challenges have led to growing interest in topical plant-derived preparations. The unclear mechanisms of many such products highlight the need for more research. This narrative review aimed to identify limitations, considerations, and key gaps in previous clinical trials to guide future studies. Materials and Methods: A non-systematic search of 74 keywords was conducted in PubMed, ScienceDirect, and Cochrane. Eligible studies were clinical trials assessing topical herbal preparations on pain, as measured by scales. Exclusion criteria were non-topical administration, unclear outcomes, reviews, and irrelevant topics. From 3,316 records, 1,683 remained after limiting the search to 2017–2025; 140 were clinical trials, of which 56 met inclusion criteria. The review was structured using the JBI checklist for narrative reviews. Results: Of 56 trials, capsaicin (34%) and menthol (10.7%) were the most frequently investigated topical herbal agents, while licorice and arnica were least studied (1.7% each). The most common pain assessment tools were VAS (48%) and NRS (27%). Findings on menthol, capsaicin, and aloe vera were contradictory across some studies. Nanogel formulations significantly enhanced absorption of curcumin and clove eugenol. Negative interactions were reported when menthol was mixed with capsaicin, diclofenac, or methyl salicylate. Major limitations included difficulties in blinding due to distinctive odor or color, absence of herb–drug interaction assessments, and lack of long-term follow-up. Conclusion: While topical herbal agents like capsaicin and menthol show efficacy for pain relief, methodological limitations and inconsistent findings emphasize the need for standardized formulations, robust clinical trials, smart blinding, and long-term safety assessments. |
| Keywords |
| Herb, Phytotherapy, Analgesia, Topical |
| Status: Accepted |
