A Pilot Double-Blinded, Randomized, Clinical Trial of Topical Virgin Olive Oil Versus Piroxicam Gel in Osteoarthritis of the Knee

Abstract

O steoarthritis (OA) is the most common type of arthritis, and the knee is the most common site of symptomatic OA. Knee OA is responsible for a higher incidence of disability than any other long-term conditions. Topical therapies present a therapeutic option for OA pain management. Nonsteroidal antiinflammatory drugs (NSAIDs), salicylates, and capsaicin are currently the main topical therapies available. There is a need for safe and effective drugs for patients who do not respond well to conventional medical therapy. Indeed, such patients are turning increasingly to complementary/alternative medicines. One of the traditional methods for management of knee pain in some rural area of Iran is application of topical olive oil, as reported by Avicenna in his 10th-century book Canon of Medicine. Although the composition of olive oil is complex, the major groups of compounds thought to contribute to its observed health benefits include oleic acid, phenolics, and squalene, all of which have been reported to inhibit oxidative stress. Researchers reported beneficial effects of olive oil on rheumatoid arthritis after oral consumption. In 2005, (j)-oleocanthal, the dialdehydic form of (j)-deacetoxy-ligstroside aglycone present in freshly pressed extra virgin olive oil, was shown to have properties of an NSAID. Although topical virgin olive oil is traditionally used in Iran in treating knee pain as an herbal medication, our survey did not find any scientific evaluation of its efficacy. Accordingly, we conducted a pilot prospective, comparative, randomized, doubleblinded trial of topical virgin olive oil therapy versus piroxicam gel in the treatment of knee OA. The report was prepared as recommended by the CONSORT statement and its elaboration on herbal interventions.