Are there natural options for chronic pain relief?

Many sufferers of chronic pain may not be aware of the risks of long-term use of medications or realise that there is an alternative. Photo / Getty Images

Often, we don't give much thought to our body until something starts to go wrong. It's part of the Kiwi culture to just "keep on trucking". But those niggles or twinges can quickly turn into something more sinister if we ignore the warning signs and fail to implement the self-care we need to get us back on track.

Chronic pain is the sort of pain that doesn't go away with a couple of days of rest. This sort of pain can be distressing and debilitating. It impacts drastically on emotional and physical wellbeing. One in six New Zealanders suffer from a chronic pain condition, such as chronic back or neck pain and chronic degenerative pain associated with rheumatic conditions.

This is reflected by the fact that paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics (e.g. codeine) are among the most prescribed medicines in New Zealand. Beyond short-term symptomatic relief, these medications do not address the degenerative disease process associated with chronic pain. Furthermore, they can take a hefty toll on the liver, kidneys and digestive system, which limits their suitability for long-term use.

Many sufferers of chronic pain may not be aware of the risks of long-term use of these medications or realise that there is an alternative.

Traditional plant medicine has been used as mainstream medicine for centuries to relieve pain and inflammation. In fact, many of the original pharmaceutical pain medicines are derived from plants, such as morphine and codeine from Papaver somniferum (opium poppy) and aspirin from Filipendula ulmaria (meadowsweet), and later Salix spp. (willow).

Plant medicine is unique in that many of the botanicals that relieve pain and inflammation also help to strengthen and build integrity in the affected tissues, as well as eliminate irritating waste products from the body. In short, they help to get to the underlying cause as well as address symptoms. This is because each plant contains a complex range of phytochemicals, or active constituents, that act in a holistic way on the body. Some of these phytochemicals also help to buffer against side effects, which is why traditional plant medicine, such as medicinal teas and fresh plant tinctures, typically have an exceptional safety profile.

For best results and to support healing from inside out, I recommend plant medicine be used both internally and externally as a wider management strategy for chronic pain.

Excellent evidence exists for Arnica (Arnica montana), used traditionally in a variety of pain conditions for its analgesic and anti-inflammatory properties. Modern scientific evidence now supports traditional use. In a 2008 randomised double-blind placebo controlled study topical application of Arnica was found to be as effective as ibuprofen gel in reducing pain and improving mobility in osteoarthritis of the hand, with Arnica showing better tolerance. Furthermore, Arnica helps to stimulate circulation, which can help to deliver much-needed nutrients to the inflamed area and assist healing.

Willow bark (Salix spp) is a well-known natural source of the aspirin-like phytochemical salicin, but it also contains beneficial flavonoids and polyphenols that contribute to its therapeutic action. It has been used since the 1st century for its analgesic, anti-inflammatory and anti-rheumatic properties to reduce pain and inflammation both topically and internally.

Comfrey (Symphytum officinale) is another well-researched remedy that promotes the healing of joints and damage to the musculoskeletal system, particularly damage to the connective tissue. This can be helpful for arthritic pain or injuries where degeneration of cartilage plays a role. Comfrey also stimulates the growth of new tissue and reduces scarring. Clinical trials support its use in osteoarthritis and lower back pain which often can become chronic.

Heat is also a powerful pain reliever as pain and heat travels up the same receptors to the brain – however the brain can only register either the pain or the heat. Heat also helps to increase circulation and nutrients in the affected area. Cayenne (Capsicum annuum) is a plant with a heating action that has been shown to be particularly useful in deep seated problems like disc damage, frozen shoulder, chronic back pain or overuse syndromes. Applying a heat pack or hot water bottle directly on the area is another possible approach.

In rheumatic conditions such as gout and arthritis, medicinal plants with a gentle diuretic action, such as Birch leaves (Betula pendula), Dandelion (Taraxacum officinale) and Nettle (Urtica dioica), are particularly beneficial for internal use to increase the elimination of urates from the body via the kidneys. Their mineral content makes them alkalising, which helps to balance out the excess acidity characteristic of these conditions.

Anti-inflammatory foods can also be incorporated into the diet on a regular basis, such as ginger and turmeric for their anti-inflammatory phytochemicals, and foods rich in omega-3 fatty acids, such as oily fish, nuts and seeds.

If your condition worsens or does not improve, consult you leading healthcare professional.

• Sandra Clair is a health scientist and registered medical herbalist.