This study compared the efficacy of an herbal ointment to a placebo ointment in relieving the pain and stiffness of osteoarthritis. The herbal preparation contained substances believed by alternative practitioners to be helpful in treating osteoarthritis. This study was a double-blind randomized placebo-controlled clinical trial. Subjects were solicited from patients attending an arthritis clinic in Dallas, Texas. Selection of subjects with osteoarthritis was based on the criteria developed by the American College of Rheumatology. Subjects were randomized to an active (n = 11) or a placebo (n = 8) group. Herbal ointment and control contained small amounts of capsaicin and menthol and were similar when applied. Subjects graded their levels of pain and stiffness for a 1-week no-treatment baseline. Subjects then applied the herbal or sham ointment to the involved joint(s) for 28 consecutive days and recorded their levels of pain and stiffness daily on visual analog scales. Significant differences between the active and placebo groups for pain (P < 0.05) and stiffness (P < 0.05) were found when the baseline phase was compared with the fourth week. An herbal ointment was shown to be effective in relieving the pain and stiffness of osteoarthritis without adverse effects. If future studies confirm effectiveness of this treatment, it may have a role as an adjunct to standard drug therapy.