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Journal of Integrative Medicine ›› 2014, Vol. 12 ›› Issue (4): 359-366.doi: 10.1016/S2095-4964(14)60025-X

• Research Article • Previous Articles     Next Articles

Effects of cinnamon on perineal pain and healing of episiotomy: A randomized placebo-controlled trial

Azam Mohammadia, Sakineh Mohammad-Alizadeh-Charandabib, Mojgan Mirghafourvandc, Yousef Javadzadehd, Zahra Fardiazare, Fatemeh Effati-Daryania   

  1. Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
    Iranian Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
    Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
    Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
    Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  • Received:2014-02-03 Accepted:2014-03-11 Online:2014-07-10 Published:2014-07-15


Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area. 


The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision. 

Design, Setting, Participants and Interventions

In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d. 

Main Outcome Measures

Perineal pain and wound healing were assessed using visual analogue scale (0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale (0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors. 


Follow-up rate was 100% up to the 8 h time point in both groups, and 86% (62 of 72) in the cinnamon group and 85% (61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at (4±1) h (adjusted difference: -0.6, 95% confidence interval: -1.0 to -0.2) and (8±1) h (-0.9, -1.4 to -0.3) after intervention, and on the 10-11th day after delivery (-1.4, -2.0 to -0.7). Also the cinnamon group showed significantly more improvement than the control group in healing score at (8±1) h (-0.2, -0.4 to -0.04) and the 10-11th day after delivery (-1.6, -2.0 to -1.1). 


Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.

Key words: Cinnamomum zeylanicum, Episiotomy, Postpartum period, Pain, Wound healing, Randomized controlled trial

Figure 1

Flowchart of the study"



Figure 2

Mean score of pain intensity in the cinnamon and placebo groups at different time points"

Figure 3

Mean score of healing status in the cinnamon and placebo groups at different time points3.4 Secondary outcomesThere was no significant difference (P>0.05) between the groups at baseline and the (8±1) h in terms of REEDA components except wound approximation (P=0.02). During 10 d postpartum, in the intervention group vs the placebo group, there was no redness (39% vs 15%), no edema (71% vs 34%), no ecchymosis (95% vs 82%), no discharge (13% vs 23%) and complete closure (65% vs 39%). Wound-healing scores in the cinnamon group was significantly less than those in the placebo group in 4 of 5 components (P<0.01 for redness and edema, P=0.021 for ecchymosis, and P=0.003 for approximation). The difference between groups was not statistically significant (P=0.1). However, in the placebo group two patients had serosanguinous discharge (scored 2) and two others had bloody purulent discharge (scored 3), while no one in the cinnamon group had such discharges. Due to existence of significance difference at baseline between the groups in terms of approximation, we also compared change score of this component on day 10-11 (in relation to the baseline), which was also significantly better in the cinnamon group (P=0.025)."

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