I recently had the pleasure of visiting the home of a gracious woman who deals in antiques. As I admired the many fine pieces displayed there, I came to realize that I, too, am something of a period piece — a baby boomer who’s fundamentally sound but sporting the odd, creaky hinge or two.
Fortunately, the herbal apothecary holds promise. Its medicines are good alternatives to nonsteroidal anti-inflammatory drugs for chronic, mild to moderate aches and can reduce the need for prescription drugs.
More than 100 plants are known to have pain-relieving properties, but some are really outstanding. Reporting on herbal painkillers for arthritis, a review of clinical trials in the Clinical Journal of Pain says devil’s claw (Harpagophytum procumbens), capsaicin from hot chiles (Capsicum spp.), gamma-linolenic acid (GLA) from seed oils, and certain blended herbal extracts are especially good. Other studies indicate broader pain-relieving benefits from these as well as two traditional favorites, white willow (Salix spp.) and peppermint (Mentha ¥piperita).
Herbal Rx: Devil’s Claw and Capsaicin
Devil’s claw is a South African herb with medicinally active roots. This herb eases muscular tension or pain in the back, shoulders and neck. A popular treatment for osteoarthritic pain, it may ease rheumatoid arthritic pain as well. The herb’s active ingredients are harpagide and harpagoside, both iridoid glycosides with analgesic (pain-relieving) and anti-inflammatory actions. Devil’s claw extract has been shown to reduce osteoarthritic hip or knee pain by 25 percent and improve mobility within a few weeks. Rheumatoid arthritic pain may also be reduced and mobility enhanced within about two months. Devil’s claw extract is considered safe at the typical dosage of 750 mg (containing 3 percent iridoid glycosides) taken three times daily. It is also available as tincture (use 1 teaspoon up to three times daily) and tea. It should not be taken with blood-thinning medications and may not be safe during pregnancy or for young children, nursing mothers and individuals with liver or kidney disease, or digestive system ulcers.
Capsaicin puts the heat in hot peppers. It manipulates the body’s pain status by hindering pain perception, triggering the release of pain-relieving endorphins and providing analgesic action. Commercial capsaicin-containing creams such as Zostrix, Heet and Capzasin-P are used topically for arthritic and nerve pain. Creams containing .025 percent capsaicin can significantly reduce osteoarthritic pain when applied to joints four times daily. A higher concentration of .075 percent works best for peripheral nerve pain — such as that from diabetic nerve damage, HIV and pain following cancer surgery. When using topical capsaicin products, be sure to avoid touching your eyes and other sensitive areas.
Capsaicin also may be taken internally to help with chronic digestive discomfort, or dyspepsia: A daily dose of 0.5 to 1 grams cayenne, divided and taken before meals, reduces pain, bloating and nausea over a few weeks. If you like to munch hot peppers, rest assured that they do not aggravate stomach ulcers as is commonly believed, and they may actually protect your stomach from prescription-drug damage.
Healthy Oils Help Relieve Aches and Pains
Gamma-linolenic acid is one of the good fats. It may help the body produce the kinds of prostaglandins and leukotrienes (hormone-like substances that influence the immune system and many other processes) that can reduce inflammation. It curbs rheumatoid arthritic pain, relieving morning stiffness and joint tenderness. Some evidence indicates that GLA also may help migraine headaches and mild diabetic nerve damage. Borage (Borago officinalis) and black currant (Ribes nigrum) seed oils are the richest sources of GLA, containing up to 25 percent and 20 percent, respectively, while evening primrose (Oenothera biennis), a traditional source, delivers 7 percent to 10 percent. The recommended daily dose for rheumatoid arthritis is 1 to 3 grams GLA supplement, and for mild diabetic neuropathy 400 to 600 mg daily. GLA is not an overnight fix and may take up to six months for significant relief. Also, long-term use may lead to inflammation, blood clots or decreased immune system functioning. A safe route to introduce a little GLA into your diet is by eating a handful of black currants regularly or spreading the preserves onto your morning toast — you may as well enjoy your medicine!
Time-tested Herbal Helpers
White willow bark is one of the oldest home analgesics, dating back to 500 b.c. in China. Modern research confirms old-time wisdom, showing it helps back, osteoarthritic and nerve pains. Willow bark contains apigenin, salicin and salicylic acid, which provide anti-inflammatory, analgesic and anti-neuralgic actions. At the end of a four-week study of 210 individuals suffering from back pain, reported in the American Journal of Medicine in 2000, 39 percent who had received 240 mg of salicin daily were essentially pain free, compared to 6 percent of those given a placebo.
Individuals with osteoarthritis of the knee or hip also are helped. Willow bark can be purchased as standardized extracts and teas. If you have access to white willow and wish to make your own, collect bark from a twig (never the main trunk). Use about 2 teaspoons of bark to a cup of water, boil, simmer for 10 minutes and cool slightly. Because salicin concentration is low and widely variable in willow bark, you may need several cups to obtain the equivalent of two standard aspirin tablets. A word of caution: Willow should not be given to children, due to the risk of Reye’s syndrome, nor used by individuals with aspirin allergies, bleeding disorders or liver or kidney disease. Willow may interact adversely with blood-thinning medications and other anti-inflammatory drugs. Also, willow tends not to irritate the stomach in the short term, but long-term use may be problematic.
Peppermint is a famous antispasmodic for digestive cramps, while its essential oil is used as a local topical anesthetic in commercial ointments (Solarcaine and Ben-Gay, for example). Germany’s Commission E authorizes use of oral peppermint oil for treating colicky pain in the digestive tract of adults. However, peppermint oil shouldn’t be used for colic in newborn babies, as it can cause jaundice.
Several double-blind studies of individuals with irritable bowel syndrome demonstrate peppermint can significantly relieve painful abdominal cramps, bloating and flatulence. In the largest study, reported in the Journal of Gastroenterology, researchers administered either enteric-coated peppermint oil or a placebo to 110 individuals three to four times daily, 15 to 30 minutes before meals, for four weeks. The study found peppermint significantly reduced abdominal discomfort.
Take a 0.2- to 0.4-ml enteric-coated peppermint capsule three times daily. (Enteric coating prevents stomach upset.) For mild stomach discomfort, try a tea from fresh or dried peppermint leaves. The menthol in peppermint relaxes the muscles. Its antispasmodic and analgesic effects also can help relieve headaches, possibly including migraines, when applied to the forehead or temples — dilute about 3 drops of essential oil in 1 tablespoon of vegetable oil.
Herbal Blends and Other Old Friends
We’re also hearing more about commercial herbal mixtures for pain relief. Two apparently promising ones are avocado/soybean unsaponifiables and Phytodolor, both from Europe. Avocado/soybean unsaponifiables are a complex mix of sterols, pigments and other substances found in the oils, and initial trials suggest that a daily dose of 300 mg soothes hip and knee osteoarthritic pain by anti-inflammatory actions. Phytodolor, with a 40-year history in Germany, is a liquid extract of European aspen (Populus tremula), European ash (Fraxinus excelsior) and European goldenrod (Solidago virgaurea). The extract helps muscle and joint conditions, including osteoarthritis; it contains salicin and other chemicals with anti-inflammatory and possibly antioxidant properties.
Don’t discount the psychological dimensions of pain in everyday aches. For instance, most headaches have psychogenic causes, such as anxiety, depression and stress, rather than vascular causes (dilated or distended blood vessels in the brain). Psychogenic headaches tend to be diffuse, often feeling more like pressure than pain, and often are accompanied by muscular tension. Vascular headaches, including migraines, respond more readily to painkillers, whereas emotionally induced ones might benefit more from herbs with calming or sedative properties, such as lavender (Lavandula angustifolia), chamomile (Matricaria recutita) or valerian (Valeriana officinalis).
It shouldn’t be surprising that pain is multidimensional, and our tools for combating it need to be also. When you’re suffering from creakiness or other discomfort, consider the possible causes — disease, physical strain, nutrient deficiency, chemical sensitivities, allergies or emotional stress. Then you can access the herbal apothecary effectively and appropriately, to fully restore your well-being.
Gina Mohammed, Ph.D., is a plant physiologist living in Sault Ste. Marie, Ontario, Canada. She is author of Catnip and Kerosene Grass: What Plants Teach Us About Life (www.CandlenutBooks.com).
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