Herbs for Pain

Many people use herbs to enhance the flavor of food or for aromatic pleasure. But there is far more to these botanicals, which provide chemical substances that can support the body’s functions. The synergistic and curative properties of these substances can help ease pain. Herbalism is the science of using (primarily) plants for healing. The herb — that is, the plant or any part of the plant — offers both nutritional and medicinal value.

Western herbalism

The western part of the globe encompasses the herbal traditions of Europe and the Americas, utilizing both European and Native American herbs in treatment. The practice developed from ancient Greece, which in turn adopted modalities from Egyptian and Eastern civilizations.

As medical director of the Southwest College for Naturopathic Medicine’s Pain Relief Center in Tempe, Arizona, Klee Bethel, MD, uses western herbalism as part of interventional pain management. “We are a collaborative center with attention on mind and body,” he says of the practices implemented at the center. “We recommend herbs as supplements to a good diet. One can do more harm with diet than good with supplements.”

Bethel views osteoarthritis as a response to diet, and when pain relief is needed, suggests anti-inflammatory foods containing a boswellia complex. “This offers pain relief similar to Advil or aspirin and does not cause effects on the liver or kidneys. With herbs, you get the good without the bad.” Bethel also notes the pain-relieving effects of cayenne pepper extract, which exerts direct action on the nervous system.

Naturopathic physician and registered herbalist Katrina Stage, also with the Southwest College for Naturopathic Medicine’s Pain Relief Center, worked with a healer in Central America using herbal combinations including ginger and wild yam to improve uterine health. “We worked with women [experiencing anything] from post-birth pain and discomfort to prolapsed organs and difficult menopause,” Stage says. She also recommends including marigold and rose to provide tone to the uterus along with an anti-inflammatory diet. As with Bethel, Stage treats the whole person in her practice.

Stage recalls the marked improvement her 76-year-old patient experienced with herbs. “She came to me for placement of a pessary for a prolapsed uterus. With severe rheumatoid arthritis, she couldn’t do it herself.” Herbal treatment began with turmeric along with an anti-inflammatory diet plus bitter herbs, which stimulate the liver’s bile production, thus improving digestion and fat absorption. “Bioavailability of turmeric is increased by combining it with black pepper or taking it with full-fat milk as an Ayurvedic drink called golden milk,” Stage says. “The patient’s pain has decreased, she takes more time away from her walker and [reports] her quality of life has improved.”

Stage also reflects on a patient in her late 40s living with the challenges of chronic fatigue syndrome, plantar fasciitis, and fibromyalgia. The patient dealt with chronic aches, depression, and sleep disturbance. She decreased inflammation through treatment with white willow, turmeric, and ginger plus an anti-inflammatory diet. “My patient also took betony as an assistant herb for a calming effect, plus passion flower and chamomile for sleep.” She also experienced relief from plantar fasciitis by applying castor oil topically and wearing socks at night. “This also helped her neuropathy.”

Ayurvedic medicine

Meghana Thanki, a naturopathic physician specializing in Ayurvedic medicine in Scottsdale, Arizona, sees sustained results from including herbal treatment with her patients at Second Nature Clinic. In Sanskrit, Ayurveda means “the knowledge of life.” This science of conscious living — originating in India about 5,000 years ago — addresses mind, body, and spirit simultaneously.

“I leave the conventional diagnosis at the doorstep,” Thanki says, citing her focus of diagnosing the imbalance according to Ayurveda. Three doshas, or fundamental bio-elements of the body, called vata, pitta, and kapha, influence a person’s physical, mental, and emotional condition. “Then we can understand if ama [undigested toxins] has come together with the vata, has vata come together with the bone tissue [and/or] has vata come together with the muscle tissue,” Thanki says. “When people talk about rheumatoid arthritis and joints creating inflammation or pain, we really have to boil it down to the causative factors that have led to this, and which dosha has been affected.” This assessment helps determine recommended herbs, diet, and lifestyle changes.

“If there is ama mixed with doshas, then we have to fix the ama situation first,” Thanki says. This undigested material manifests as congestion, or a sticky, muddy substance in the body indicated by a white coating on the tongue. Specific herbs are then recommended to either ignite agni, the Ayurvedic element that transforms food to energy, or to digest the amount of ama in the body. The powder of dried ginger root and herbs including guduchi, dashamoola (10 roots) and/or ajwaiin seeds are often suggested.

“As long as we understand the root of all of this starts with our digestion,” Thanki says, then conditions in other parts of the body can be addressed. “Any time there is pain in the body, the vata dosha is out of balance.” Thanki stresses the importance of understanding which dosha is out of balance, why it is so — and how to avoid the causative factors.

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Anti-inflammatory foods

Tomatoes
Olive oil
Green leafy vegetables (spinach, kale, collard greens)
Nuts (almonds, walnuts)
Fatty fish (salmon, mackerel, tuna, sardines)
Fruits (strawberries, blueberries, oranges)

Source: Harvard Health Publications
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Thanki recommends a basic tri-doshic Ayurvedic diet of warming easy-to-digest foods and not eating “according to the clock, but to when we are hungry.” She suggests soup, lentils, rice — anything that is prepared that day and not left over.

An Ayurvedic assessment includes examination of the patient’s tongue, pulse, abdominal area, bone, and other tissues. “We put three fingers on the pulse to understand the doshas as well as if there’s a muddiness or slowness, lack of energy, or accumulation of ama. On the tongue, we look at the scallops, glossiness, and its tip.” Thanki adds herbs to a patient’s routine and will only suggest gradually deleting supplements.

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Herbal medicine formats

Capsule | contains powdered herb
Decoction | boiling plant/herb for extraction
Tea | beverage made from infusion of herb decoction
Tincture | concentrated liquid form of herb
Poultice | moist herbs applied externally
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Ayurvedic medicine includes topical treatment with castor oil (extracted from the castor bean), which dates back to Egypt 1550 B.C. Absorption of this oil increases circulation, eliminates toxins from the body, and heals tissues and organs under the skin. Thanki recommends castor oil in the evening to treat rheumatoid arthritis and fibromyalgia. “It pulls vata in a downward direction and helps lubricate the tissues,” she says. After starting treatment with digestive herbs, castor oil helps ease the pattern of pain caused by ama vata, or swelling of the body’s joints that moves around.

Thanki worked with a 76-year-old patient who experienced pain in her knee and low back plus tingling in her ankles and legs. The patient was told to avoid leftovers, yogurt in the evening, and tomatoes. Thanki recommended dry ginger plus a castor oil decoction for 15 days as well as the herbs Laghumanjistadi kwath and Kaishore guggulu for swelling and pain. The patient has reported a marked reduction in knee pain, improved sleep, and greater mobility. External herbal oils such as Mahanarayan Taila, which yields nerve, muscle, and ligament-strengthening effects plus pain and inflammation reduction, help in similar circumstances.

Traditional Chinese medicine

Licensed acupuncturist Sami Rank notes that there are many patterns considered in diagnosis within traditional Chinese medicine. “We assess where is the imbalance — and how strong is the imbalance.” Rank, an herbal medicine instructor, serves as supervisor for the Phoenix Institute of Herbal Medicine and Acupuncture’s Student Clinic.

In this form of medicine, which originated more than 3,000 years ago, the assessment also considers the patient’s lifestyle. “When the Yin-Yang [body’s opposing forces] is out of balance, the body opens to pathogens,” Rank says.

Rank notes the pathological elements in traditional Chinese medicine considered before developing a treatment plan that includes acupuncture and herbal therapy. A heaviness throughout the body indicates dampness, which can manifest as achy muscles. “Phlegm in the body can stem from congealed dampness and lead to bony nodules or cysts,” Rank says. Swelling and warmth in the joints indicate heat, and a cold state usually represents pain in one location of the body. Within this modality of medicine, “if a patient applies ice to localized pain, it can create stasis over time in one area, meaning the blood is held in one spot,” Rank says. “It’s a pathogen creating ‘fixed pain.’”

“Each individual diet is different,” Rank says of recommended food guidelines to accompany herbal treatment. Dairy, wheat, and sugary foods usually contribute to a damp internal environment, and too much alcohol can aggravate inflammation. “Ice cream or ice in drinks contributes to pain from a cold state,” Rank says.

Herbal medicine schedules are carefully crafted on an individual basis. Combinations including the herb corydalis offer synergistic action, serving as a blood mover to disperse pain. A patient who is yin-deficient should not take acrid, or drying, herbs.

“Different types of the herb angelica have different functions,” Rank says, noting that the duo huo species is often used in formulas specifically for arthritic joint pain from a wind and damp pathogenic state. Chinese medicine also considers animals as herbs, for example, she tui (snakeskin) and quan xie (scorpion). “Ancient Chinese herbalists found that snakes, vines, and insects can energetically travel through our channels and open up stasis to eliminate pain.” Rank says.

“With fibromyalgia, we look at energy that is stuck, or trapped,” Rank says. Many times a formula crafted around the herb bupleurum can enter the trapped space for release, resulting in pain relief.

Rank treated a male in his mid-50s with spastic paraplegia who had undergone over 30 surgeries. “He was suicidal and experienced pain all over his body.” A formula of 12 herbs including peony and licorice helped considerably to reduce his pain and spasms. “This helped move the blood and chi [vital life force] throughout his body.”

A male in his early 70s with osteoarthritis in his lower back and legs had constant pain and cramping along with breathing difficulty. “He was skin and bones, and yang-deficient,” Rank says. Within two weeks of starting an herbal combination including duo huo and cordyceps (from a caterpillar fungus in the Himalayas) to improve his breathing and yang condition, the patient’s pain significantly decreased.

While often considered food, herbs are also useful as medicine. “Let food be your medicine and medicine be your food” is the well-known quote by Hippocrates, revealing the dual function of food in healing has been observed for centuries.

Want to learn more about alternative therapies for chronic pain? Read “Acupuncture for Pain,” “How Biofeedback Can Help Relieve Pain,” and “Five Pain-Fighting Supplements.”

Carol Levin is a freelance writer based in Prescott, Arizona.

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