Essential oils (EOs) are widely used topically in musculoskeletal disorders (MSDs); however, their clinical efficacy is controversial. Our aim was to find evidence that topical EOs are beneficial as an add-on treatment in MSDs. We performed a systematic review and meta-analysis to summarize the evidence on the available data of randomized controlled trials (RCTs). The protocol of this work was registered on PROSPERO. We used Web of Science, EMBASE, PubMed, Central Cochrane Library and Scopus electronic databases for systematic search. Eight RCTs were included in the quantitative analysis. In conclusion, EO therapy had a favorable effect on pain intensity (primary outcome) compared to placebo. The greatest pain-relieving effect of EO therapy was calculated immediately after the intervention (MD of pain intensity = −0.87; p = 0.014). EO therapy had a slightly better analgesic effect than placebo one week after the intervention (MD of pain intensity = −0.58; p = 0.077) and at the four-week follow-up as well (MD of pain intensity = −0.52; p = 0.049). EO therapy had a beneficial effect on stiffness (a secondary outcome) compared to the no intervention group (MD = −0.77; p = 0.061). This systematic review and meta-analysis showed that topical EOs are beneficial as an add-on treatment in reducing pain and stiffness in the investigated MSDs.

Background: Due to their antibacterial activities, essential oils can be potential alternatives to antibiotics in certain cases. West Indian lemongrass (Cymbopogon citratus) essential oil (LEO) is effective against a broad range of bacteria by inhibiting spore formation, and is considered safe. In this study, we demonstrated its therapeutical potential in the treatment of pitted keratolysis (PK), a superficial skin infection affecting the pressure-bearing areas of plantar surfaces. Methods: For in vitro antibacterial efficacy testing, LEO was mixed into different ointment bases, including Hydrogelum methylcellulose FoNo VIII., Ungentum oleosum FoNo VIII. (Ung. oleoso), Unguentum stearini FoNo VIII. (Ung. stearin), and Vaselinum cholesterinatum FoNo VIII. (Vasel. cholest.), at different concentrations of 1, 3, and 5%. These formulations were tested on representatives of three bacterial species associated with PK: Kytococcus sedentarius, Dermatophilus congolensis, and Bacillus thuringiensis. Results: In the in vitro tests, Hydrogelum methylcellulose (HM) gel best supported the antibacterial effects of LEO, reducing the number of living bacteria on agar plates by 4–5 orders of magnitude in a concentration-dependent manner during the 30 min exposure times. This was also confirmed by the Franz diffusion cell drug release test; after 30 min, several active compounds could be detected in the HM samples, in contrast to the other bases. Shelf-life experiments showed that the HM base supported the antibacterial features of 3% LEO for at least 2 years without significant loss of efficacy. Conclusions: Our study highlights that ointments containing essential oils potentially have a place in the treatment of PK. Therefore, antibiotics may potentially be replaced for the treatment of PK, thereby reducing environmental antibiotic pressure, which is one of the driving forces behind the spread of antibiotic resistance.