Many of the clients who come into my Princeville clinic are experiencing musculoskeletal (m/s) pain. Postural therapy looks at pain as a valuable tool: a signal from the body that it will no longer accommodate the muscular imbalances and compensations that up to now have kept us relatively functional. This system of exercise therapy has an exceptional track record of identifying and treating the root causes of m/s pain, and for many clients the postural exercise menus alone are sufficient. The body begins to heal itself: joint range of motion returns, and the pain dissipates.
Some clients who come in are already using painkillers and anti-inflammatories and feel the need to continue while doing their postural therapy regimen. Often these clients will ask for recommendations on “natural” alternatives to what they may be taking.
Before I go on, I want to make clear that I am not a physician, and offer no advice on prescription or non-prescription medications. Any decision on beginning or stopping any medications should be done in consultation with your doctor. *
Having said that, any medical professional will tell you that while painkillers like ibuprofen, acetaminophen, prescription narcotics etc.. can often offer needed short tem relief, in the long run they are really only palliatives and seldom get to the root cause of chronic pain. And as has been reported recently in the press, many of these medications carry serious side effects, especially when used longer term. Adverse effects due to non-steroidal anti-inflammatory drugs (NSAIDs), are estimated to be responsible for over 100, 000 hospitalizations and 36,000 deaths per year in the U.S. In 2011, the FDA asked physicians to stop prescribing high-dose acetaminophen products, because of the potential for severe liver damage. Little talked about, also, is the fact that long-term use of NSAIDs may cause cartilage destruction.
Botanical based medical systems such as Ayurveda and Traditional Chinese Medicine (TCM) have a long history of use of certain herbs for pain relief. Application of the herbal medicines is based on the constitution of the patient matched to the energetics of the particular plant. . American “Eclectic” physicians developed very specific “black letter” symptoms for which their pain formulas were to be used. The herbs used by these systems for the most part are milder and not as quick acting as their pharmaceutical counterparts, but on the flipside these herbal analgesic/anti-inflammatory/anti-spasmodics have few adverse effects with a history of safe use that dates back in some instances thousands of years.
The following are herbs that I often recommend to clients visiting my clinic. Although I’ve limited the list to herbs that can be used as simples (alone), most work best in a formula combined with other herbs and compounded by a qualified herbalist for a client’s specific needs.
Ashwagandha (Withania somnifera) Native Indian plant, root has long history of use as regenerative tonic and helpful for chronic inflammatory diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). Dosage: Two 500mg up to 4x per day, Tincture, 2-4 mils 3x per day Drug/Herb interactions: Avoid if taking thyroid medication, can potentiate barbiturates and benzodiazepines.
Boswellia (Boswellia serrate) Highly anti-inflammatory Ayurvedic plant whose modern uses include tendonitis, bursitis, and repetitive motion injuries. Dosage: 300-400mg standardized extract capsules, 2 capsules 2-3x per day. Tincture: 1.2-2.5 mils 3x per day. Drug/herb interactions: none known
Cats Claw (Uncaria tomentosa) Native Peruvian plant, traditionally used for arthritis, asthma and gastritis, documented modern use for painful, swollen joints, especially the knees. Dosage: 500-600mg capsules 6 to 9 per day. Tincture: 1-2mils up to 5 x per day. Drug/herb interactions: May potentiate hypertensives; avoid concurrent use with blood thinners. Contraindicated for use with immune-suppressive therapies and woman attempting to get pregnant.
Turmeric (Curcuma longa) Used for centuries by Ayurvedic and Chines medicines, this systemic anti-inflammatory is useful for osteo and rheumatoid arthritis and has shown to help limit muscle injury after trauma. A study in 2004 showed that a combination of turmeric, ginger and ashwagandha was particularly effective for osteoarthritis of the knees. Dosage: Up to 4 grams per day of powdered rhizome, standardized extract (95% curcumin) 350 mg 2x per day. Tincture: 2-4 mils 2-4x per day. Drug/herb interactions: Avoid large doses with anticoagulants and NSAIDs
Ginger (Zingiber offinale) Relieves pain and swelling associated with OA and RA. Topically in “hot pack,” significant relief for muscle strain and soreness. Dosage: capsule: up to 8-500mg per day. Tincture 1-2 mils 3x per day.* Herb/drug interactions: may decrease bioavailability of cyclosporine (used with organ transplants). May enhance bleeding with anti-coagulants.
Meadowsweet (Filipendula ulmeria) European in origin, this herb is noted for it analgesic activity, especially helpful for bursitis and muscle pain. The old name for meadowsweet is the predecessor for the word aspirin. Although high in salicylic acid, does not cause gastric irritation and is actually used for acid indigestion. Dosage: Dried herb: 2-4 grams per day. Tincture: 2-4 mils 3x per day. Herb/drug interactions: Avoid if sensitive to salicylate. Possible interactions with anticoagulants.
The therapeutic actions of these herbs can be described in similar terms to conventional medications, i.e. analgesic, anti-inflammatory, antispasmodic, anti-pyretic, sedative etc., but unlike most pain medications their actions affect multiple organ and body systems. So, for instance, ginger is highly anti-inflammatory, it is also a circulatory stimulant, a carminative and digestive aid, helpful for early stage flus and colds, as well an integral ingredient in many herbal formulas aiding in assimilation. Ashwagandha is iron rich (powdered form), is a calming adaptogen (useful for stress) and is helpful for insomnia and also impotence associated with anxiety and exhaustion. Turmeric is used extensively by herbalists for liver congestion and studies have shown it promotes endogenous production of glutathione, a major liver antioxidant. Recent research has also shown turmeric has the ability to inhibit the multiple pathways by which cancer is promoted, sustains itself, and spreads. Holistic herbal practitioners believe nothing in the body happens in isolation, and when viewed this way musculoskeletal pain, besides bringing discomfort, might also be a message that an imbalance exists in other body and organ systems.
The six herbs profiled here are but a small fraction of those with a history of use for pain. Professional herbalists use their knowledge of the actions and energetics of specific herbs and match them to specific signs and symptoms as well as the constitutions of their individual clients. This is always my first choice for anyone looking to use these healing substances: self-prescribing can be frustrating and expensive. However a number of companies make high quality herbal formulas, with helpful suggestions on how to use them. A few are listed below:
Herbalist and Alchemist www.herbalist-alchemist.com
Health Concerns: www.healthconcerns.com
Pure Encapsulations: www.purecaps.com
note: Only practitioners can order from these sites.
References used as background:
1. Winston, David., “The Use of Complementary Therapies for Treating Chronic Back and Neck Pain.” 2004 rev. 2010.
2. Gaedart, Andrew., “Neck and Shoulder Pain,” Health Concerns Seminar, April 11, 2012
3. Herbal Therapy Supplements, Kuhn, Winston. 2nd Ed. 2008 Wolters Kluwer, Philadelphia, PA
5. “FDA Asks Physicians to Stop Prescribing …” Journal of the American Medical Association (JAMA) February 12, 2014, v. 311 No. 6
6. “Differential direct effects of cyclo-oxygenase-1/2 inhibition on proteoglycan turnover of human osteoarthritic cartilage: an in vitro study.” http://www.arthritis-research.com/content/8/1/r2
Helpful websites and books on safe use of herbs:
American Herbalist Guild: www.americanherbalistguild.com
American Botanical Council: www.herbalgram.org
Modern Herbal Medicine Horne, S., Easley T., The School of Modern Herbal Medicine, St. George, Utah. 2014
Adaptogens in Medical Herbalism Donald Yance, Healing Arts Press. Rochester, Vermont 2013
* What is presented here is for informational purposes only, and is not an attempt to diagnose disease, or recommend medical treatment. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.