Why Essential Oils and Analgesics Combine Synergistically to Alleviate Musculoskeletal Pain

Essential oils

As the opioid epidemic rears its head and people have begun to fear pills; natural treatments are making headway in pain management. But how do they work?

In the medical profession, the mainstay of pain relief revolves around pharmaceutical agents. Corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDS), and opioids are prescribed in an attempt to ease physical distress. Sadly, these come with a range of side effects and potentially deadly consequences.

  • Corticosteroids are linked to gastrointestinal bleeding, increased rates of infection, weakened bones, and weight gain.
  • NSAIDs may increase the risk of heart attack, liver failure, stomach ulcers and bleeding, stroke and death.
  • Opioids are well known for their addictive properties, but they can also cause constipation, dizziness, nausea, and vomiting, and increase the pain they were meant to calm in the first place.

Thus, pharmacists, biologists, medical doctors, and other scientific professionals have developed options that provide much-needed pain relief without a long list of unwanted consequences. Thus, they have returned to nature’s lab to harvest safe ingredients for pain management.

Natural Topical Analgesics that Counter the Pain

While the Food and Drug Administration (FDA) does not generally review natural remedies, they have approved a handful of naturally-derived active pharmaceutical ingredients for over-the-counter (OTC) analgesic drugs, including counterirritants. For those not familiar with counterirritants, the FDA provides a helpful answer in its approval of counterirritants. You can explain that a counterirritant is:

an externally applied substance that causes irritation or mild inflammation of the skin for the purpose of relieving pain in muscles or joints by reducing inflammation in deeper adjacent structures.

In other words,counterirritants counteract pain and itching.

This can include noceptive pain caused by injuries or arthritis, neuropathic pain caused by conditions like diabetes and herpes zoster (shingles) or pruritus associated with bites, stings, minor skin conditions like eczema, and sunburn.

Natural compounds that fall into this category for pain relief include menthol, camphor, capsicum, and turpentine oil. Menthol and camphor are the most popular counterirritants due to their ability to combine well together for enhanced pain relief and their ability to be used on large areas of the body, making them ideal for pain-relieving massage oils, creams, and ointments. However, capsicum and turpentine oil are also useful for isolated pain. additionally, all of these counterirritants have been suggested as excellent penetration enhancers for topical medications to enter the skin, which we’ll discuss in the following section.

Here’s what you can tell your patients about these natural counterirritants.

  • Menthol is the main ingredient of Mentha piperita L (or peppermint) and has been traditionally prescribed for pain relief. It has been shown to relieve and reduce sensitivity to pain, likely through both central and peripheral nervous system actions. In addition, it acts as a penetration enhancer for topical medications.
  • Camphor is obtained from the bark of 50-year old cinnamomum camphora evergreen trees (camphor trees) through steam distillation. This waxy substance is well-loved for its pain-relieving effects as well as its ability to treat congestion as a vapor rub— among its other antibacterial and antifungal benefits. Research shows this natural compound is able to desensitize sensory nerves and activate thermosensitive receptors leading to the relief of physical discomfort. Additionally, it acts as a penetration enhancer for topical medications. It’s important to remind your patients not to use it on broken skin since it can be toxic if it enters the bloodstream in high concentrations.
  • Capsicum is another popular counterirritant derived from hot chili peppers. When applied to the skin, the heat sensation depresses the cutaneous sensory receptors to temporarily relieve pain. It is particularly used to treat neuralgia associated with herpes zoster (shingles), however, it is also used for musculoskeletal pain. Likewise, it acts as a penetration enhancer for topical medications. While capsicum is generally as safe and effective (GRASE), some people are sensitive to the compound. Do not cover the treated skin with a bandage or other type of dressing, which can lock in the heat and cause an uncomfortable burning sensation or redness. If redness or an uncomfortable burning sensation occurs, advise your patients to wash off the product with cool, soapy water.
  • Turpentine oil is another approved counterirritant obtained from the gum of the pinus palustris (pine tree). It is quite similar to camphor, thus many products that list camphor as an active ingredient are actually making synthetic camphor from turpentine oil, likely due to it’s wider availability. Pine trees grow extremely fast and grow virtually everywhere in the United States — and are dispersed throughout China, South-East Asia, Russia, Europe, and parts of the Middle East. It has been used to treat toothaches (external application to the jaw), chest congestion, and musculoskeletal pain much like its sister essential oil. It also acts as a penetration enhancer for topical medications. Like camphor, turpentine oil is only advised for topical application since it can be toxic if high concentrations enter the bloodstream. Thus, you should advise your patients not to use products that list turpentine oil or camphor on broken skin or inside the mouth.

In short, natural counterirritants can be used alone or combined to provide OTC topical pain relief without harmful chemicals. That said, as with any medication, they should be used appropriately according to the intended use of the product. Moreover, those with sensitivity should use small amounts in a small area of the body first.

CBD CLINIC™ has developed a 5-level system that starts with low doses of natural counterirritants (and lidocaine for level 1 ointment) in order to help practitioners customize their treatment for their patients, based on sensitivities and levels of pain.

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Why We Blend Numerous Natural Ingredients With Already Powerful Analgesics

While natural pain-relieving compounds have important actions on their own, as the saying goes, their sum is greater than their parts. By blending a variety of essential oils and extracts with powerful natural analgesics, a synergistic effect can be achieved to maximize their benefits.

Synergistic effects of essential oils

The study Synergy Effects of Herb Extracts: Pharmacokinetics and Pharmacodynamic Basis found that herbal ingredients can combine to confer wonderful synergistic effects. They do this through various mechanisms, including:

  1. The ability of different compounds to modulate an effect via various pathways
  2. Improving the bioavailability of active ingredients
  3. Reducing side effects and boosting therapeutic outcomes

Essential oils as penetration enhancers

The delivery of therapeutic compounds directly through the skin enables local effects, systemic distribution, and ease of use. Topical delivery also avoids first-pass metabolism, where the liver and gut greatly reduce the level of an active ingredient before it enters the systemic circulation.

However, our skin, by design, is a difficult layer to penetrate. This challenge can be overcome by natural penetration enhancers. The following is a list of essential oils that are thought to enhance drug delivery through the skin. Many of these oils are used in OTC products and prescription medications due to their abilities to penetrate the skin, however some of them also act as natural topical analgesics or offer aromatherapy benefits for relaxation or pain. We have starred the ones we use in our formulations.

Essential oil penetration enhancers include:

  • Clove oil*
  • Angelica oil
  • Chuanxiong oil
  • Eucalyptus oil*
  • Peppermint oil*
  • Cyperus oil
  • Cinnamon oil
  • Turpentine oil
  • Cardamon oil
  • Mint oil*
  • Rose oil
  • Tea tree oil*
  • Tulsi oil
  • Fennel oil
  • Niaouli oil
  • Black cumin oil
  • Lemon grass oil
  • Rosemary oil
  • Black cardamon oil

The added benefits of natural emollients

Natural emollients lubricate, moisturize, and protect the skin. Moreover, some natural emollients pull a double duty as penetration enhancers and/or stabilizers such as jojoba seed oil and aloe vera.

Common natural emollients include:

  • Cottonseed oil: Cottonseed oil, derived from the cotton plant, is rich in lipids, which may reduce the skin’s reaction to irritants.
  • CBD hemp oil: From the Cannabis sativa L. plant, this incredible oil acts as a non-psychoactive, non-addictive, and THC-free natural emollient. It works to balance the endocannabinoid system in the skin.

While CBD boasts a host of other benefits, the FDA and other scientific bodies are still conducting empirical research on its benefits for pain. The National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes on Health (NIH) just awarded approximately $3 million to 9 research teams who will investigate minor cannabinoids and terpenes for their analgesic properties.

  • Jojoba seed oil: From the Simmondsia Chinensis plant, this popular oil enhances the absorption of topical therapeutic compounds and stabilizes other oils, including hemp oil.
  • Shea butter: This incredible fat comes from the nut of the African shea tree and has been used in cosmetic preparations for centuries. In addition to its use as an emollient, the article Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils notes it confers anti-inflammatory and antioxidant properties.
  • Aloe vera: This attractive succulent is a popular house plant and a favorite folk remedy for soothing sunburns and cuts and scrapes. Many of us grew up with our mother’s cutting a branch off of the plant and handing it to us when we injured ourselves. But not all of us appreciated the spikes on the side, sticky texture, or strong smell when it is first cut. But the mucus-like liquid inside the plan is perfect for cosmetics. Topically, it has been touted as a natural humectant, penetration enhancer, antioxidant, antibacterial agent, skin protectant, and antiaging remedy. And that’s not counting its internal benefits.

The natural science behind CBDCLINIC ™ products: The Synergy of Pain-Relieving Essential Oils With Active Pharmaceutical Ingredients

Scientifically designed natural products that harness the power of synergy and penetration enhancers are able to deliver pain relief without the substantial risks that accompany pharmaceutical agents. Our unique blends are formulated for pain relief. Our inactive essential oils work in synergy with the active ingredients, menthol and camphor, to enhance their benefits. They include…

  • Clove oil: The aromatic oil contains (eugenol), a compound that has been shown to have analgesic effects. Hence, it is a popular ingredient in toothache remedies and muscle and joint cream. Moreover, it’s spicy aroma makes it an excellent aromatherapy to invigorate the senses.
  • Eucalyptus oil: This cool, minty plant has been hailed for its anti-inflammatory and analgesic effects. Studies have shown that eucalyptus can relieve pain and decrease blood pressure when inhaled. Thus, it is an excellent topical and aromatherapy ingredient to include in natural pain relief ointments, creams, and oils.
  • Peppermint oil:  This oil has been touted for its ability to reduce pain, calm muscle spasms, and decrease inflammation. In fact, menthol, the active ingredient approved by the FDA to reduce pain, is extracted from this plant in order to isolate the analgesic compound and make it available in higher concentrations.)
  • Tea tree oil: This camphor-like pungent oil has been shown to have anti-inflammatory and analgesic properties — among many other uses.
  •  Arnica Montana extract: Research has shown that this ingredient can reduce pain and swelling, but not all studies agree. Further research is needed to understand its full benefits, but it has gained vast popularity as a natural remedy for bruising.
  • Palmarosa oil: This rose-smelling oil boasts anti-inflammatory properties that can help relieve swollen joints and muscles.

* These herbal benefits have not undergone in-depth research or been approved by the FDA.

CBDCLINIC’s 5-level system for incremental levels of pain

At CBDCLINIC, we’ve combined scientific integrity and ingenuity with a pioneering, trailblazing spirit to develop a range of gold standard formulations that treat pain at its source. Each of our five product levels comprises specifically blended products, targeted at the appropriate level of pain and sensitivity.

Our unique combinations of evidence-based essential oils and analgesics ensure we can provide safe, natural, powerful relief from aches and pains, whether they are mild, moderate or severe. Our care and attention to detail enable us to deliver on our promise of pain relief and help you to choose the right product, the first time.

Ask us how your clinical practice can benefit from pain relief products blended with CBD.

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Disclaimer: This information is for educational purposes only. It has not been approved by the FDA to diagnose, treat, prevent, cure, or mitigate any diseases or conditions. We use CBD in our products for cosmetic purposes only.