Pain is a chronic and unrelenting problem in society today. Well over 50 million Americans, or 20% of the population, suffer from some form of chronic pain according to the Centers for Disease Control. The problem is escalating with the onset of the opioid crises and fewer pharmaceutical options available. People are turning towards using more natural methods to help control the aggravating, persistent episodes of chronic pain they experience on a day to day basis.
If you are seeking a natural root to help your patients explore beyond your treatment sessions, these are the most commonly hailed options. While these are not all of these are officially approved in conventional medicine — or even by the FDA, they are gaining traction in research and popular among herbalists, naturopaths, and osteopaths. As with any medical advice, patients should speak to a physician about any concerns before taking part in a new regimen.
Types of Pain
To adequately treat pain, it is helpful for the clinician to know which type of pain they are dealing with. Generally, we speak of two to three types of major pain classifications:
- Nociceptive: Represents the normal injuries we receive to tissues, organs, joints, tendons or bones. Nociceptive pain can be further divided into somatic and visceral pain with somatic pain refers to pain that occurs closer to the surface of the skin or musculoskeletal system and visceral referring to the internal organs.
- Neuropathic: Pain caused by a lesion(s) in the nervous system. Examples include diabetic neuropathy of the foot, eye or post-stroke pain. The pain is generally felt as numbness, tingling, electric shock or even phantom limb pain.
- Inflammatory: Inflammatory pain is often lumped in with nociceptive pain, thus the variance in the number of types of pain. Pain results from activation of the nociceptive pathways by a variety of chemicals released at the site of inflammation. When inflammation occurs, substances from white blood cells are released into the bloodstream or damaged tissues to protect your body from foreign substances. Leaking chemicals may flood into the tissues resulting in swelling. This protective process may adversely stimulate nerves and cause pain. Examples include appendicitis, irritable bowel syndrome, rheumatoid arthritis, and osteoarthritis. Infections and wounds would not be able to heal without an inflammatory response, so inflammation is not all bad. The discomfort, however, can be exhausting.
Methods of Natural Pain Medication Delivery
The method of delivery often determines the dose and potential side effects. Three primary routes of delivery exist:
- Oral Oral intake includes the use of teas, supplements, syrups, tinctures, sublingual pills and is affected by absorption in the gastrointestinal tract.
- Topical Topical use can involve the application of pain-relieving creams, ointments, salves, sticks and/or essential oils.
- Inhalation Aromatherapy Effect is achieved through inhalation which stimulates the olfactory system, which, in turn, affects the limbic system of the brain and the secretion of neurotransmitters such as serotonin, the endorphins, and noradrenaline. Use distilled water with pure essential oils and follow dilution instructions on labels. For on-going aroma, use a diffuser. One with an automatic shut-off is particularly safe and effective.
Natural Pain Relievers
- Capsaicin: A substance found in chili peppers and is used most frequently in neuropathic pain, particularly the pain of the diabetic foot and in arthritis. It’s thought to stimulate the release of substance P, a chemical that helps transmit pain signals from sensory nerve fibers to the brain. After several applications of capsaicin, local stores of substance P (and possibly other chemical pain messengers) become depleted, and the nerve fibers in that area transmit fewer pain signals.
- Feverfew: In test tube studies chemicals in feverfew such as parthenolide and tanetin helped stop the formation of prostaglandin causing migraines. “ For migraine headaches: Take 100–300 mg, up to 4 times daily, standardized to contain 0.2–0.4% parthenolides. Feverfew may be used to prevent or to stop a migraine headache. Feverfew supplements may also be CO2 extracted. For these, take 6.25 mg, 3 times daily, for up to 16 weeks.”
An increased heart rate, mouth ulcerations and dermatitis were noted side-effects of use of feverfew. It may also have blood thinning properties so consult your physician before taking it if you are on aspirin, coumadin or other blood thinning medication.
- Arnica Oil: This wonderful anti-inflammatory oil works by boosting circulation, stimulating the healing process and reducing inflammatory mediators. Arnica can be toxic when taken orally and although it is taken for mouth sores and swollen veins, etc., its most advantageous use is topical pain relief. Patients should NOT take it internally without direct supervision from a knowledgeable clinician.
The active chemicals in Arnica is believed to act as an antibiotic, anti-inflammatory and pain reducer. Arnica is applied to the skin for pain and swelling associated with bruises, aches, and sprains. It is also applied to the skin for insect bites, arthritis, and muscle and cartilage pain.
- Boswellia: According to some studies, Boswellia is as effective as some non-steroidal anti-inflammatory medications such as diclofenac sodium. The exact dosage for maximum effectiveness is not known. A recent study showed an increase in pain tolerance and good tolerability in study subjects using 125 mg in the Boswellia group. The Arthritis Foundation, in contrast, has suggested 300-400 mg three times per day of a standardized product that contains 60% boswellic acids. Side effects may include nausea, diarrhea or skin rashes.
- Epsom Salts: This simple magnesium mineral reduces muscle soreness and cramps and promotes relaxation and sleep. Too much use may cause a liquid stool and bloating.
- White Willow: This herb has been called nature’s aspirin and is used for its anti-inflammatory effects in the reduction of mild pain. Sold as a tea, supplement or ointment its use is quite versatile in relieving a multitude of aches and pains. Studies have used 240 mg of Salicin (active ingredient) in the treatment of rheumatoid arthritis, headaches and other aches and pains. The only side-effects noted have been tarry stools, nausea and some fatigue.
- Camphor and Menthol: Used topically, it is an excellent minor muscle or joint pain reliever and soother of dry, aching skin. Dosing depends on the percentage weight of each compound in the bottle, so read labels. Dosing is also different in children. Menthol has a cooling effect to the skin and camphor has a warming effect. Camphor or menthol should never be taken by mouth. When camphor and menthol are combined with cannabidiol (CBD), jojoba oil, and other natural emollients; it creates an overall soothing effect to the skin and body.
Ask a doctor before using if you are pregnant or breastfeeding. Make sure to wash your hands well after applying ointments containing these products so as not to contaminate your eyes or oral mucosa
- Lavender oil: Research has found this essential oil to be beneficial in the reduction of headaches, stress, inflammation, sleep disorders and breathing problems. Lavender oil may be inhaled or applied topically using a carrier oil. A 2013 study showed that children who inhaled lavender after a tonsillectomy were able to consume less acetaminophen for pain. Studies have also shown it to reduce severity of migraine headaches and to be as effective as the prescription pain killer tramadol.
- Products containing Cannabidiol (CBD): Topical products containing CBD are legal and frequently combined with other pain-relieving ingredients for maximum effectiveness, however be careful about claims. As of yet, it is not officially FDA approved to treat pain or other serious conditions due to the lack of clinical evidence. That said, CBD is a legal non-psychoactive chemical extracted from the hemp plant Cannabis sativa L., a non-psychoactive component that is receiving ample attention in current medical research.
Using a form or combination of forms of natural pain treatments may help your patients decrease their reliance on prescription pain pills.