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TC-04

Topical application of peony and licorice decoction attenuates exercise-

induced muscle pain: A pilot double-blind randomized controlled trial

4
,1,5
3
Daniel Tzu-Li Chen, #,1,2 Chang-Wei, Hsieh, Chia-Han Tsai, Hen-Hong Chang*

1 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
2 Department of Psychiatry and Mind-Body Interface Research Center (MBI-Lab), China
Medical University Hospital, Taichung, Taiwan
3 School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
4 Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical
University, Taichung, Taiwan
5 Graduate Institute of Integrated Medicine, College of Chinese Medicine and Chinese
Medical Research Center, China Medical University, Taichung, Taiwan
* E-mail: tcmchh55@gmail.com

Abstract
Delayed onset muscle soreness (DOMS) is a common post-exercise phenomenon that leads
to transient pain and impaired muscle performance. While Peony and Licorice Decoction (PLD),
a traditional Chinese herbal formula with known anti-inflammatory and muscle-relaxant
properties, has demonstrated efficacy in preclinical and animal models, no clinical studies have
examined its topical application for DOMS. We aim to evaluate the efficacy and safety of
topically applied PLD ointment for pain relief in individuals with exercise-induced DOMS.
This pilot study was designed as a randomized, double-blind, placebo-controlled trial. Thirty
healthy young male participants underwent a high-intensity resistance training protocol
targeting the bilateral biceps muscles to induce DOMS. PLD and placebo ointments were
applied topically in a randomized manner to each participant’s arms. Pain intensity was assessed
using the visual analogue scale (VAS) immediately before and five minutes after intervention.
Differences in VAS scores were analyzed using Student’s t-test. Significant pain reduction was
observed in the PLD-treated arms (p < 0.0001), whereas no significant change was noted in the
placebo-treated arms (p = 0.3811). Furthermore, the degree of pain reduction was significantly
greater in the PLD group compared to placebo (p < 0.0001). No adverse events were reported
within three days following treatment. Thus, topical application of PLD may offer a safe and
effective short-term treatment for alleviating DOMS-related pain.

Keywords: Delayed onset muscle soreness; Pain; Peony and Licorice Decoction; TCM; Topical