was as effective as ibuprofen 1,200 mg/day after a 4-week
treatment of knee osteoarthritis [34]. Of note is that the
effect found in this study was a result of orally administered
curcumin, which is the main biologically active compound of
turmeric, not a crude preparation as used in herbal compress.
It is uncertain whether a topical application of turmeric herb
would deliver clinical beneficial effects on knee osteoarthritis
like oral curcumin extract due to the low solubility of natural
curcumin that affect the absorption of this compound [35].
Zingiber montanum is another potential ingredient in herbal
compress that may play an important part in improving
osteoarthritis symptoms. Results from a study on the combination
of ginger (Zingiber officinale) and plai (Zingiber montanum)
gel showed that this product was comparable to 1%
diclofenac gel in relieving joint pain, improving problematic
symptoms and quality of life in patient with osteoarthritis
knees following a 6-week treatment [36]. This was consistent
with the pooled effect presented in this review demonstrating
that the reduction of pain in osteoarthritis patients treated
with herbal compress was not significantly different from
those receiving oral NSAIDs. However, anti-inflammatory
effect of herbal compress used in the included studies could
not be justified as it requires additional information on the
measurement of anti-inflammatory related molecular/serum
markers. A tendency of herbal compress to exhibit more
pain reduction in patients with osteoarthritis compared with
any other treatments/managements showed in this review
warrant a conduct of further well design studies on a larger
scale to confirm a clinical efficacy of this treatment.
Similar to the effects on osteoarthritis, heat was shown
to be effective in treating patients with muscle pain [37].
However, evidence regarding the effects of main active herbal
components on reducing muscle and labor pain was limited.
Result from a related study on the effect of essential oil
extracted from herbal compress active compound showed no
additional benefit in reducing muscle pain compared with
Thai massage [38]. These may in part explain the reason
why the pool effect of herbal compress on muscle pain
reduction in this review was not significantly different from
hot compress.