HOMEOPATHY AND RHEUMATIC DISEASE

Chronic musculoskeletal (MS) syndromes are some of the most common and debilitating diseases in the United States. These syndromes range from conditions such as osteoarthritis (OA) and rheumatoid arthritis (RA) to more vague but common problems such as fibromyalgia, fibrositis, myalgias, and arthralgias. OA alone affects nearly 10% of the population over 60 years of age, resulting in an average of 3.5 physician visits and 3.7 million hospitalizations per year.18, 20 The economic impact of these diseases results in billions of dollars spent on medications, physical therapy, and surgery and millions of lost work days every year.²² For individuals who do not die of more lethal diseases such as cardiovascular disease, stroke, or cancer, arthritis and MS syndromes often become major obstacles to quality life in later years.

Despite a growing interest in uncovering the basic mechanisms of arthritis, medical treatment remains symptomatic, involving nonsteroidal anti-inflammatory drugs, analgesics, and antirheumatic drugs aimed at the modification of selected aspects of its pathophysiology. Current medical treatments do not consistently halt the long-term progression of these diseases, and surgery may still be needed to restore mechanical function in large joints.⁷ Patients with rheumatic syndromes often seek alternative therapies, with homeopathy being one of the most frequent. In a survey comparing the kinds of conditions treated in homeopathic practices compared with primary care practices that did not use homeopathy, arthritis and MS syndromes were more frequently treated in those practices that used homeopathy.¹² Homeopathy is one of the most frequently used complementary therapies worldwide.

Homeopathy was developed by the German physician Samuel Christian Hahnemann (1755–1843) in the latter half of the eighteenth century. Its rise is at least partly attributed to the barbaric practices that were popular in orthodox medicine of the time such as blood-letting and dosing with large amounts of cathartics and heavy metals.⁹ Although the popularity of homeopathy has varied over the last 200 years, its use has increased with the recent interest in complementary and alternative medicine around the world. In the United States, there were almost 5 million visits to homeopathic providers in 1990, ⁶ and the number of patients using homeopathy is estimated to have increased almost fivefold in the last 7 years.⁵

There are two main tenets of homeopathy.10, 17 One is the principle of “similars.” The principle of similars states that patients with a particular pattern of signs and symptoms can be cured if they are given a drug that produces the same pattern of signs and symptoms when given to a healthy individual. The result of this principle is that treatment is individualized in homeopathic medicine. Two or more persons with the same clinical diagnosis may be given different medicines depending on the specific pattern of symptoms of illness in each person.

The second tenet in homeopathy is that remedies retain biological activity if they are diluted and agitated or shaken between serial dilutions. These serially agitated dilutions are said to produce effects even if diluted beyond Avagadro's number and no original molecules of the starting substance remain.³ This tenet has often led scientists to reject homeopathy out of hand, without looking at the evidence for its effects in clinical trials.²³ Most patients and physicians, however, are interested in whether there is clinical evidence for homeopathic treatment for defined conditions and are less concerned about mechanisms. Therefore, the authors decided to evaluate the controlled clinical research on homeopathy using systematic review methods.