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Herbal Therapies for Pain

Herbal and Natural Pain Remedies

--by Roger S. Cicala,M.D.

Several nutritional supplements and herbal remedies are claimed to help with pain and other uncomfortable. Most of these can be found in your local grocery store of pharmacy. You can also buy them in health food store, although the price there is often higher. The following is not a complete list of every herbal remedy that may benefit painful condition, just the more commonly recommended ones.
It is important to remember that herbal medicines are still medicines. They can have side effects and may have adverse interactions with other medications you may be taking. Here some commonly and herbal medicines and their possible effects and interactions.

Echinacca may cause liver toxicity if taken in high doses or for more than eight weeks. It should not be taken with other drugs that can cause liver toxicity, such as methotrexate (chemotherapy) and ketoconazole(an antifungal medicine).
Evening primrose oil may lower the seizure threshold and should be avoided by persons with seizure disorders.
Feverfew should not be taken with nonsteroidal anti-inflammatory drugs as they may interfere with each other's absorption and actions.
Feverfew, garlic, ginkgo, ginger, and ginseng may increase bleeding time. All should be avoided by anyone who may have low platelet counts after chemotherapy.
Ginseng may cause headache, tremors, and anxiety in patients treated with phenelzine sulfate. It should not be used by persons taking estrogens or corticosteroids because of possible additive effects. It should not be taken by diabetics because it can increase blood sugar and may interfere with digoxin blood levels.
Hawthorn may interfere with digoxin blood levels.
Kava should not be taken at the same time as tranquilizers because of increased sedation.
Kelp may interfere with thyroid replacement therapies.
Licorice can offset the pharmacological effect of some diuretics and interfere with digoxin blood levels.
St. John's wort probably should not be taken by persons taking selective serotonin reuptake inhibitors (SSRIs).
Uzara root may interfere with digoxin blood levels.
Valerian should not be used with tranquilizers or alcohol because excessive sedation may occur.

Mental and Emotional Remedies

  • Ginlgo
  • Ginkgo, or Ginkgo biloba, refers to an extract from the leaves of he ginkgo tree, the oldest surviving species of tree on earth. For years, herbalists have claimed that ginkgo can treat many conditions associated with aging, including memory loss. Ginkgo is also claimed to help the failure and difficulty concentrating that some cancer patients experience. It may also have antidepressant effects.
    Medical studies have shown that the active ingredient in ginkgo, platelet activation factor (PAF), helps restore blood flow through the brains of people with cerebral vascular disease. Several European studies have shown improved memory, thinking, and reasoning ability as measured by standardized tests in persons taking ginkgo. More recently, a yearlong study published in the Journey of he American Medical Association also found that patients receiving ginkgo had improved mental function.
    it should be noted that even in the most optimistic study, the effect of ginkgo was small. It is important to remember that herbal medicines like ginkgo are still medicines -- they have side effects. Ginkgo can interfere with blood clotting and may cause allergic reactions, and some people report headaches or nausea when taking it.
  • Melatonin
  • Melatonin is a natural hormone secreted by the pineal gland in the brain. Its major known effect is in regulating the circadian or sleep-wake cycle, and it is widely used as an over-the-counter treatment for insomnia. The sleep-wake cycle of the body not only affects sleep, but also regulates several other functions including the daily changes in body temperature and blood levels of some hormones.
    There is some scientific evidence that taking melatonin at bedtime helps restore a more normal sleep-wake cycle in patients who do not sleep well at night, but are drowsy during the day. Most studies report that about one-third to one-half of such people improve after taking melatonin. A few people find it actually makes their sleep patterns worse, however.
    Melatonin is sold over-the-counter in the United States, but it is regulated as a medication and requires a prescription in Europe. Almost nothing is known about interactions between melatonin and other drugs and diseases, but because melatonin is a potent natural hormone, it may cause problems, particularly in persons who have hormone-secreting tumors. Although a trial of melatonin is probably worthwhile for persons with severely disturbed sleep, it should be stopped at the first sign of worsening symptoms.
  • St.John's Wort (Hypericum)
  • St.John's Wort has been recommended for the treatment of depression, and several scientific studies suggest it is effective. St.John's wort has an excellent safety record and appears to cause few side effects or adverse reactions. Photosensitivity (sensitivity to sunlight) occurs in a few people taking St.John's wort. In those cases, the photosensitivity is usually mild. However, people undergoing radiation therapy should probably avoid St.John's wort until their treatment is complete. St.John's wort may interfere with the absorption of iron, so it should not be taken by people who need iron supplements.
  • Valerian (Valerianae officinalis)
  • Valerian is an herb that some people claim relieves restlessness and aids sleep. It also is said to reduce anxiety and nervous conditions, improve concentration, and perhaps reduce pain. Valerian is available in capsules, ills, juice, teas, liquid concentrate, and as the fresh herb. The active ingredients, called valepotriates, are removed to some extent in processing, so some people claim the fresh herb is more effective than the other forms.
    Because valepotriates can have toxic effects in high concentrations, valerian should not be taken to excess. It can also increase the effect of sedative medications and the sedative effect of opiods (pain medications). For this reason, it is a good idea to begin taking valerian at a low dose and increase the dose gradually. The usual dose is two to three grams of herb or extract (about two tablespoons of juice) taken once or twice a day.
    A few people experience odd feelings of being separaed from their surroundings when taking valerian. More common side effects include headache, nausea, and intestinal cramps. Occasionally, the herb has an effect opposite to the one expected, causing restlessness, excitability, and insomnia, similar to drinking too much coffee.

Remedies for Joint Problems and Bone Pain

  • Cartilage and Chondroitin Sulfate
  • Shark cartilage products are widely used in the United States for the prevention and treatment of cancer. They are also used for other painful conditions including arthritis, psoriasis, and muscular pain. About fifty thousand Americans use cartilage supplements regularly, and more than forty brand names of shark cartilage products are sold in the United States. The major components of shark cartilage are proteins and calcium salts, Chondroitin sulfate, one of the proteins found in cartilage, is sometimes sold separately.
    Cartilage compounds are marketed as dietary supplements, so they do not require Food and Drug Administration evaluation or approval. Also, there are no specific quality control requirements for cartilage or other dietary supplements. This lack of regulation meanss there is no guarrantee that any claims made about these products are accurate. There are not even any quarantees that the package contents actually are cartilage, or that the products is pure and safe to use.
    Several European studies have demonstrated that chondroitin sulfate, an ingredient found in cartilage, improves joint mobility and reduces pain in arthritis sufferers. There is some evidence that either cartilage or chondroitin may also help patients who have significant joint pain from other causes, including the joint pain that sometimes develops after radiation or chemotherapy. However, chondroitin must be taken for at least several weeks to show any beneficial effect.
    Most of the attention given to cartilage, however, involves its use as a cancer-treating supplement, not as a pain supplement. Since the 1970s, the use of shark cartilage as a cancer treatment and preventive has been heavily marketed because of the belief that cartilaginous fish (sharks, skates, and rays) do not get cancer. However, this is not true, several studies by marine biologists have found that many cartilaginous fish captured over the years do have cancers such as melanomas and softtissue sarcomas. Severl large clinical studies looked for any effect that shark cartilage might have on treating or preventing cancer. So far, every study has concluded that shark cartilage has no beneficial effect for preventing or treating cancer.
  • Glucosamine Sulfate
  • Glucosamine sulfate is the major component in chondroitin. That is, chondroitin sulfate is made up of many repeating units of glucosamine sulfate linked together. By chemically breaking these links, free glucosamine sulfate is obtained. The major advatage to doing so is the glucosamine sulfate is a much smaller molecule than chondroitin and therefore is better absorbed into the body. Only about 15 percent of an oral dose of chodroitin is absorbed into body (the rest just passes through the intestines), whereas more than 9 percent of oral glucosamine is absorbed.
    Advocates also claim that the glucosamine molecule will pass into the joints better than the chondroitin molecule. Not surprisingly, the health food companies that make glucosamine claim that it is far superior to chondroitin for relieving joint pain. Like chondroitin, however, it must be taken for several weeks to show any benefit. In the standard dose of 500mg taken three times daily, glucosamine appears to be quite sage. It may interfere with the absorption of other medications taken at the same time, however, so it should be taken within an hour of other medications.
  • White Willow Bark
  • White willow bark has been used by Native North Americans as a pain reliever for more than a thousand years. There is strong evidence that it is helpful for the pain of headaches, backaches, and arthritis, and that it helps lower fevers. The reason it is effective is quite simple. One of the major ingredients of white willow barm is salicin, which is the precursor to the active ingredient in aspirin. Like aspirin, however, willow bark may cause stomach problems if taken regularly.
  • Arnica
  • Arnica is derived from several speicies of the daisylike flower arnica, which grows in the high mountains of w y dilute oral doses of arnica, as well as arnica ointments, and claim that it is effective for muscle pains, stiffness, swelling, and local tenderness. One scientific study, done in Great Britain in 1991, did find that arnica relieved stiffness in patients with muscle pain.
    Arnica ointment has been reported to cause skin irritation in some persons. It can also be toxic if apllied over broken skin.
  • Antioxidants
  • Antioxidants are chemicals that neutralized free redicals -- molecules with unpaired electrons that can damage various tissues within the body. The body constantly produces free radicals during normal metabplism. The amount of free radicals increases after exposure to radiation, burns, cigarette smoke, certain drugs, alcohol, and during infection. Because antioxidants can neutralize the free radicals, they may have several beneficial effects, including reducing the pain caused by inflammation.
    Since the pain associated with cancer often involves inflammation, antioxidants may help reduce cancer pain. The effect is probably slight, but all antioxdants are extremely safe if taken in reasonable doses. The antioxidants currently available are vitamins C and E, beta-carotene, selenium, bioflavonoids, bioflavanols, and manganese. There are many brands of antioxidant pills available that combine most of these antioxidants in a single capsule.
  • Vitamin E
  • Vitamin E prevent free radical damage and has several beneficial effects. Some good scientific studies indicate it may also help reduce muscle soreness after exercise. Other studies, although less scientific, hint that it may help reduce muscle soreness from many different causes, presumable by reducing muscle inflammation. For this reason, it is sometimes recommended for those people who have significant muscle pain after chemotherapy or radiation treatment.
  • Pycnogenol
  • Pycnogenol, at the time of this writing, is a "hot topic" on the herbal medicine circuit and in health food stores. It is a bioflavonoid derived from the bark of certain French pine trees and from grape seeds. A lot of scientific evidence has found that pycnogenol is very good at neutralizing free radicals. In fact, it is twenty to forty times more potent as an antioxidant than either vitamin E or Vitamin C.
    Pycnogenol marketers claim the substance works for almost everything, including pain, arthritis, heart disease, emphysema, high blood pressure, cancer, and anything else you care to name. Because it is claimed to stimulate the immune system, it is often taken as a supplement by cancer patients. There is fairly good scientific evidence that it does help reduce the pain associated with certain types of cancer.
    The usual dose is 100 to 200mg taken three times a day. Because pycnogenol stays in the body or some time, some people recommend taking 200mg doses for the first week to "saturate" the body, and then reducing the dose to 100mg. Adverse side effects are rare, but nausea and stomach irritation is sometimes reported. A few people have developed an ellergic skin rash after taking it for several days.

Nausea and Vomitting Supplements

  • Ginger
  • Ginger has been recommended for many years as a treatment for intestinal spasms and cramps. There is also some good evidence that it reduces nausea and vomitting. Scientifically, it has benn studies and found effective for nausea associated with pregnancy, motion sickness, and certain diseases. It has not been specifically studied for nasea associated with chemotherapy, but anecdotal reports state that it is sometimes helpful. Ginger root powder is available in capsules. The usual dose is one 250mg capsule four times a day. Fresh ginger root can also be made into tea, which some claim to be more effective. There are some claims that ginger is also effective as an anti-inflammatory supplement, but no studies support this, however.
  • Green Tea
  • Green tea has been advocated as a treatment for nausea and intestinal cramps in patients undergoing chemotherapy. It clearly seems to settle the stomach of some patients during chemotherapy. It has also been advocated as an antioxidant. Green tea is the least processed and freshest of tea, and it does have significant antioxidant activity, which more processed teas do not have. some of the antioxidant activity comes from the large amounts of vitamin C it contains, but it also contains other antioxidant chemicals. Unfortuately, some health food advocates recommend about te cups of green tea a day for antioxidant activity. Since green tea contains about half the amount of caffeine that coffee does, this will result in a significant caffeine dose. Caffeine can worsen insomnia, pain, and anxiety, so green tea may not be a good choice as an antioxidant for cancer patients.