Old Technique – New Evidence: Topical agents for musculo-skeletal injuries

Leung-kim Hung, Lung-fung Tse, Hi-shan Cheng, Jing-zhou Chen, Erik Chun-hay Ko, Sammy Wing-sum Siu, Xue-lin Zhou, Chak-hei Fung, Ellie Suet-yee Pang, King-fai Cheng, Chun-kwok Wong, Ping-chung Leung

Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, 5/F, School of Public Building, Prince of Wales Hospital, Shatin, Hong Kong SAR. Tel: (852) 2252 8868; Fax: (852) 2632 5441. E-mail: pingcleung@cuhk.edu.hk


The popular use of topical agents for the treatment of musculo- skeletal injuries has persisted for centuries but not much scientific evaluations have been done. Since medicinal herbs are particularly popular in Asia, we started a systematic exploration on their choices, and their pharmacological activities; whether transcutaneous transport of bioactive components occur and above all, whether quality clinical evidences could be generated. We found that a search on the vast literature pool would reveal the favourable choices of herbal agents. Biological screening of those selected herbs showed that they probably follow three major common pathways to help with healing after injury, viz, anti-inflammation, pro-angiogenesis and cellular proliferation.  Using a simple formula of selected herbs with the ideal bioactivities, evidence based clinical trials could be organized to further prove the efficacy. We have created two such formulae to be put on clinical trial. Our early pilot clinical trials on two minor injuries on the foot and one chronic inflammatory condition have yielded positive data on the value of such topical agents on pain and oedema control, as well as functional maintenance. There was also suggestion of more rapid bone healing. Although limitations exist clear with the small number of study subjects, the positive data and safe application support more studies. Journal of Nature and Science, 1(3):e51, 2015.

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