Efficacy of topical Linum usitatissimum L. (flaxseed) oil in knee osteoarthritis: A double-blind, randomized, placebo-controlled clinical trial

doi:10.1016/j.ctcp.2018.03.003

Complementary Therapies in Clinical Practice

Volume 31, May 2018, Pages 302-307

https://doi.org/10.1016/j.ctcp.2018.03.003 Get rights and content

Highlights

•
Knee osteoarthritis is the commonest form of arthritis among the elderly.
•
Flaxseed oil is traditionally used for treatment of joints pain in Persian Medicine.
•
Flaxseed oil is effective in pain relief of patients with knee osteoarthritis, especially in improving the severity of symptoms and functional status of patients.

Introduction

Knee osteoarthritis (OA) is the commonest form of arthritis in the elderly individuals [1]. It is progressively disabling disorder that presents with joint pain and functional limitations in most patients [[2], [3], [4]]. OA is a multi-factorial disease resulting from genetics, mechanical pressures, inflammation, and cellular and biochemical processes [5]. Aging, female sex, obesity and heavy physical activity are common risk factors for the knee OA [6]. Studies have shown that by 2020 due to increased life expectancy, sedentary lifestyle and increasing rate of obesity, OA will be the fourth leading cause of disability worldwide [7]. The treatment strategy for osteoarthritis (OA) is focused on pain relief, optimizing joint function, and stopping the process of joint damage [8]. In spite of the current treatment benefits, side effect of medication, costs of treatment modalities, and patients' preferences have caused increasing interest in using complementary and alternative medicine, especially herbal medicine, among the patients [[9], [10], [11], [12], [13], [14]].

In reliable traditional Persian medicine references, such as the Canon of Medicine written by “Avicenna” (980-1037 AD) and Liber Continent written by “Rhazes” (865-925 AD), many herbal remedies have been suggested for treatment of joint diseases [15,16]. Linum usitatissimum L. (linseed) is one of these herbs that had been used traditionally used in treatment of joints diseases [[17], [18], [19]]. According to these references, linseed is a pain-reliever and has anti-fibrosis effects [20,21]. In the current studies, linseed is known as an antioxidant, anti-inflammatory, and analgesic herb being investigated in several studies on different diseases, such as arthritis, carpal tunnel syndrome, cancer and dermatologic disorder [[22], [23], [24], [25], [26], [27]]. Regarding the traditional use of linseed as well as their known beneficial effects in the current studies, we designed a randomized, double-blind, placebo-controlled clinical trial to determine the efficacy of linseed oil on pain and clinical symptoms of the knee OA.

Section snippets

Study design

The study was designed as a randomized, placebo-controlled, double-blind clinical trial by using a parallel design. In this study, we evaluated the effect of linseed oil on knee OA symptoms. No changes occurred as to methods after trial commencement.

Participants

Inclusion criteria for participants enrolled in the trial were men and women aged 40–70 years, with body mass index (BMI) less than 35 that had the knee OA of grade one or more according to Kellgren-Lawrence [28] criteria and had an average pain

Results

From July to December 2016, 85 volunteers were assessed for eligibility. Eighty two patients who met the inclusion criteria and agreed to contribute to the trial were divided into two groups. Forty one patients were assigned to the linseed group and 41 to the placebo group. At the end, 35 patients in the linseed group and 34 patients in the placebo group completed the study. Detailed description of the patients' enrolment, randomization and outcomes are displayed in Fig. 1.

Demographic data and

Discussion

In the present trial, we evaluated the effectiveness of the linseed oil on pain and clinical symptoms of the knee OA through a double-blind randomized placebo-controlled clinical trial. Linseed oil turned out to have significant effects on reducing pain and symptoms of patients with knee OA as compared to the placebo group. Additionally, this study showed the activities of daily living, sport and recreation, and knee-related quality of life in the linseed group significantly improved after the

Conclusion

It seems that linseed oil could be effective in the management of clinical sign of knee osteoarthritis, especially in improving the severity of symptoms and functional status. Additionally, this study showed that the activities of daily living, sport and recreation, and knee-related quality of life in the linseed group significantly improved after the study compared with the placebo group.

Conflicts of interest

The authors declare no competing interests.

Acknowledgments

This study was a part of a PhD thesis by Dr. Nematollah Masoudi which was supported by Shahid Beheshti University of Medical Sciences (Thesis Number: 180). The authors would like to thank Dr. Asgar Ghaderi for his useful cooperation and Dr. Mohammad Hashem Hashempur for the statistical analyses and Dr Nasrin Shokrpour for editing of the manuscript.

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Flaxseed, also known as Linum usitatissimum L., is a valuable grain that can significantly prevent bone deterioration and promote bone health. Flaxseed plays a distinctive role in bone formation and growth. Flaxseed contains lignans, polyunsaturated fatty acids (PUFA), soluble and insoluble fibers, B vitamins, magnesium (Mg) and manganese. The recent nutritional characterization of flaxseed has underscored its importance as a crucial grain in diets aimed at enhancing bone mineral density (BMD) and reducing osteoporosis risk factors. Flaxseed plays a distinctive role in bone formation and growth evident in the elevation of bone production markers, increased BMD, enhanced biomechanical properties, structural changes in the femur, higher total and vertebral bone density and content, increased total bone surface area, raised osteocalcin levels and improved bone thickness. Omega-3 (ω-3) PUFAs are favorably connected with BMD and have beneficial effects on the control of bone metabolism. Alpha-linolenic acid (ALA), an essential fatty acid (FA), plays a crucial role in promoting bone health. In recent years certain experimental trials have supported the bone protective efficacy of flaxseed in different forms like oil, flour, extract and powder. These studies have conclusively shown that the inclusion of flaxseed in our diet can significantly prevent bone deterioration and promote bone health.
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Evaluation of Acute and Subacute Toxicity of Coriander Triphala Tablet in Wistar Rats
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View all citing articles on Scopus

View full text

Efficacy of topical Linum usitatissimum L. (flaxseed) oil in knee osteoarthritis: A double-blind, randomized, placebo-controlled clinical trial

Highlights

Introduction

Section snippets

Study design

Participants

Results

Discussion

Conclusion

Conflicts of interest

Acknowledgments

First page preview

Compl. Ther. Clin. Pract.

Osteoarthritis Cartilage

J. Qazvin Univ. Med. Sci.

Compl. Ther. Clin. Pract.

Clin. Nutr.

Int. J. Cardiol.

Osteoarthritis Cartilage

Compl. Ther. Clin. Pract.

J. Ethnopharmacol.

Atherosclerosis

Randomized clinical trial of peganum oil for knee osteoarthritis

J. Evid. base Compl. Alternative Med.

Osteoarthritis: National Clinical Guideline for Care and Management in Adults

The comparison of the effectiveness of conventional therapeutic exercises and pilates on pain and function in patients with knee osteoarthritis

Compl. Ther. Clin. Pract.

Osteoarthritis

Lancet (London, England)

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Ther. Adv. Muscoskel. Dis.

The use of complementary and alternative medicine in patients referring to shiraz Rheumatology clinics in 2013-2014

Thrita

Topical Allium ampeloprasum subsp Iranicum (Leek) extract cream in patients with symptomatic hemorrhoids: a pilot randomized and controlled clinical trial

J. Evid. base Compl. Alternative Med.

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J. Evid. base Compl. Alternative Med.

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JAMA Dermatol.

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