For this review update, we expanded inclusion criteria so studies that included an active control as well as placebo controls, randomised controlled trials published in any language, and unpublished reports of randomised controlled trials were eligible for inclusion. Changes to methods of quality assessment (replaced by assessment of 'risk of bias') and analysis and presentation of results are consistent with updated Cochrane Collaboration and Cochrane Musculoskeletal Group methods introduced since the original review.

One study included in the original review recruited participants with any form of arthritic disease (Mills 1996). This study was excluded from this update because data for the subgroup of participants with rheumatoid arthritis could not be distinguished from the overall data reported. In the original review, studies of the same herbal therapy that used the same outcome measure were pooled regardless of the length of the intervention period. In this update, these data and comparisons have been subgrouped according to intervention time, rather than pooled. The table of herbal interventions has been extensively revised so that it offers detailed information about the herbal medicines, including full botanical names, the part of the plant used, details of extraction methods, drug:extract ratios and co‐active principles. Three further tables have been added; two cover current understandings of the mechanisms of action of herbal therapies and the other table summarises the clinical implications arising from this review.