CM Topical Lotion
Indications:
• Knee osteoarthritis
• Musculoskeletal pain
• Tendon strain
• Muscle spasm
Composition:
Essential oils of Apium graveolens and Mentha spicata.
Dosage form:
15 ml. drop with dropper
Pharmacology and Mechanism of action:
Osteoarthritis is the most common form of arthritis in the world. A number of predisposing factors of this disease including: age, history of trauma and obesity. Patient's complaint is usually aching and joint rigidity, morning stiffness and decreased range of motion. Treatment depends on the individual specific case. Treatment include conservative care methods (eg. training programs, regular appropriate exercise, use of mechanical support devices, weight control and food supplements), medical methods (e.g. topical and oral pain relievers) and surgery.
Menthol is one of the active ingredients of Mentha spicata and its counter-irritant and topical analgesic effects are well accepted. When applied to the skin, mint oil or menthol stimulates the nerves which perceive cold, while simultaneously depressing those for pain.(1)
According to results of animal studies, menthol produces antinociceptive effects by activation of the endogenous opioid system and/or by local anesthetic actions without any anti-inflammatory effects. In addition Mentha spicata essential oil suppress muscle contraction due to serotonin and substance P release.(2)
According to results of animal studies, Apium graveolens essential oil has anti- inflammatory, anti spasmodic and relaxant effects.(3) Mentha spicata essential oil has anti-inflammatory and anti spasmodic effects.(4)
In a survey of analgesic and anti-inflammatory effects of Mentha spicata and
Apium graveolens essential oils and their mixture, examined by caraginan test in rat and mice, significant local anti-inflammatory effect of these essential oils and their mixture were characterized. Mentha spicata essential oil and Apium graveolens-Mentha spicata essential oils mixture significantly suppress pain in first phase of formalin test which is a neurogenic pain and resulted from direct nerves stimulation. In addition Mentha spicata essential oil, Apium graveolens essential oil and their mixture showed significant effects on second phase of formalin test which is an inflammatory pain.(5)
In a placebo – controlled, randomized, double-blind clinical trial, 102 patients with knee osteoarthritis were treated with either Mentha spicata, Apium graveolens-Mentha spicata (C.M) or placebo lotion 4 times a day topically. Further examination performed 1, 2, 3 and 4 weeks later after first examination and patients' pain intensity during level walking, climbing stairs, descending stairs, sleeping, sitting down and ascending a slope were evaluated and data were analyzed by statistic tests. According to results, 2 and 4 weeks later, the effect of Mentha spicata essential oil and C.M lotion on pain intensity reduction during level walking, showed significant difference to placebo (p<0.01). In addition C.M lotion showed better effect on pain intensity during level walking and sitting down in comparison with Mentha spicata essential oil (although it was not significant). Two weeks later, in C.M lotion’s group pain intensity during sleeping were reduced significantly in comparison with Mentha spicata essential oil and placebo groups (p<0.01).(6)
Administration and Dosage:
Depends on size of painful area, apply lotion 4 times daily.
Contraindications:
• Pregnancy
• Breast-feeding
• Children
• Wound on painful area
Adverse Effects:
If taken as instructed, no serious side effects are known until today. Skin sensitivity reaction such as tingling, pruritus, skin rash and photosensitivity have been rarely reported in susceptible patients.(3)
Standardized:
Based on at least 55mg (-) Carvon and 54 mg (+) limonene per each ml. of product.
Effective ingredients:
Menthol, Menthon, Limonene, Carvon
Interactions
None significant
Precautions:
1- For external use only.
2- Keep out of the reach of children.
3- Avoid to wrapping painful area after C.M lotion usage.