A Systematic Review of Arnica montana in Postoperative Recovery Across Surgical Specialties

Arnica montana is a popular herbal supplement used to minimize bruising, swelling, and discomfort after surgery, but evidence of its efficacy remains inconsistent across surgical specialties. This systematic review, conducted according to PRISMA guidelines, searched PubMed, Embase, Cochrane Library, Trip Database, and ClinicalTrials.gov on June 13, 2025, for studies evaluating perioperative A. montana (oral or topical) in human surgical patients with reported postoperative outcomes. Risk of bias was assessed using Cochrane RoB 2 for randomized trials, and results were synthesized narratively with subgroup analysis by specialty. Of 266 records identified, 27 studies met inclusion criteria, with plastic surgery accounting for the largest proportion (n = 10), followed by orthopaedics (n = 5), breast surgery, cardiothoracic surgery, hand surgery, otolaryngology, vascular surgery, general surgery, obstetrics/gynecology, and urology. Across all specialties, 55.6% (n = 15) of studies reported measurable benefit from A. montana, 33.3% (n = 9) found no significant effect, and 11.1% (n = 3) were ongoing trials without published results. Plastic surgery demonstrated the highest proportion of reported benefit, while evidence in other specialties was mixed. Overall, A. montana shows moderate potential as an adjunct in postoperative recovery, particularly in plastic surgery, but inconsistency across trials highlights the need for standardization of dosing, administration route, and outcome measurement. Further high-quality randomized studies are warranted to clarify its role in surgical recovery protocols.