Traditional Uses: Traditionally used for over 2,000 years, earning the name “knitbone” for the external use of leaf poultices to heal wounds, burns, sprains, swelling, bruises, and bone fractures, as well as for joint disorders and inflammation.
Potential Benefits: Topical application of alkaloid-free preparations may help reduce pain and swelling from muscle and joint complaints, ankle sprains, osteoarthritis, and back pain, with studies showing efficacy comparable to diclofenac gel; this is attributed to allantoin, which stimulates cell proliferation and tissue repair.
Warnings: Internal use is strictly contraindicated due to hepatotoxic pyrrolizidine alkaloids (PAs) that can cause severe liver injury and sinusoidal obstruction syndrome; topical use on broken skin is not recommended, and application should be limited to intact skin for short durations (max 10 days) due to potential PA absorption; avoid during pregnancy and breastfeeding.
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