Osteoarthritis
Adjunct
Nettle leaf is an over-the-counter herbal remedy. The Chrubasik systematic review (Phytomedicine 2007) analysed available nettle studies in joint and muscle pain: small open-label studies and one RCT by Randall (J R Soc Med 2000) using topical leaf stinging on base-of-thumb pain showed moderate VAS pain reduction, but methodology was weak, blinding incomplete and samples small. HMPC in 2010 recognised nettle leaf as adjunctive treatment in mild rheumatic and muscle pain based on traditional use, not RCT evidence. 2022 and 2019 recommend exercise, weight control, paracetamol and topical NSAIDs as first line in osteoarthritis, with short-course oral NSAIDs if needed. Nettle is not in international or Spanish rheumatology guidelines; it is not considered a substitute for NSAIDs, only an option as adjunct therapy in mild pain. If nettle leaf is being considered as an add-on to standard treatment for mild joint pain, discuss with a doctor – when combined with NSAIDs, monitor blood pressure and potassium because nettle has a diuretic effect.
Sources
- EMA HMPC: Community herbal monograph on Urtica dioica L. and Urtica urens L., folium (2010)
- Phytomedicine (Chrubasik et al.): A systematic review on the Rosa canina effect and efficacy profiles, plus a review on stinging nettle preparations in joint pain (2007)
- J R Soc Med (Randall et al.): Randomized controlled trial of nettle sting for treatment of base-of-thumb pain (2000)
- NICE: Osteoarthritis in over 16s: diagnosis and management (NG226) (2022)