The use of Chinese and Native American herbs for pain dates back thousands of years. The ancient Egyptians also documented extensive use of herbs in medicine on papyrus papers found in tombs and temples.

Despite this long history of herbal use, physicians in general do not use herbal medicine due to lack of FDA approval and insufficient data concerning efficacy and safety. Even so-called “safe natural” supplements have active ingredients with drug effects that can be hazardous. Also, package contamination, misleading information or misidentification can result in life-threatening side effects.

The FDA found some to contain prescription drugs, steroids, controlled substances and harmful levels of lead, mercury, arsenic or even rodent excreta. Some packages contained completely different herbs. The FDA estimates that 70 percent of dietary supplement companies are not following basic quality control standards.

About half of all Americans use dietary supplements with about $32 billion per year spent on herbal products. An annual growth of more than 30 percent is expected and will likely continue to do so with or without the blessing of clinical practitioners. Physicians may not be able to recommend using these supplements; however, we must become more familiar with their potential benefits, side effects and drug interactions so we can educate our patients for safe and proper use. Side effects are usually mild. However, serious respiratory depression, seizures, comas, as well as heart, liver and kidney damage can occur.

To effectively treat pain, most physicians prescribe a combination of drugs that work via different mechanisms. This approach usually boosts the analgesic effect of the “cocktail” and reduces side effects. Herbalists apply a similar rule since most of these herbs share many of the mechanics of action of the traditional drugs that we use on a daily basis.

Here is a summary of herbal medicines used for pain that have some support in western literature:

Topical Capsaicin (active ingredient in chili peppers) decreases back pain, post mastectomy pain syndrome, painful diabetic neuropathy, post-herpetic neuralgia, osteoarthritis, and rheumatoid arthritis. Other counter-irritants include Arnica, Menthol, Eucalyptus, Thymol and clove oil.

Cod-liver oil relieves neuropathic (nerve), inflammatory and musculoskeletal pain. Epsom Salt (magnesium) reduces swelling, muscle aches and pain resulting from bruised or irritated tissuesn as well as neuropathic pain. Magnesium amplifies the analgesic effect of morphine and local anesthetic, Novocaine.

Gamma-Linolenic Acid helps rheumatoid arthritis and painful, diabetic neuropathy.

Ginger is used for treating thermal burns and arthritis. Oil of ginger is used topically as an analgesic.

Ginkgo, black currant, stinging nettle, White Willow, Boswellia, Turmeric, Devil’s Claw and Common Figwort are anti-inflammatory analgesics that work similar to Motrin and Aleve. Black Cohosh and Meadowsweet contain salicylic — the same active ingredient in Aspirin. In fact, Aspirin was named after Meadowsweet. Licorice possesses steroid-like anti-inflammatory properties.

California Poppy and Corydalis have an analgesic, sedative and hypnotic effect. California Poppy works similar to morphine. One study showed that Corydalis has a potency equivalent to 40 percent of morphine.

Feverfew is used to prevent migraines, which works on serotonin in a similar fashion to some traditional headache drugs. Skullcap is a muscle relaxer, anxiolytic and a sedative that works via inhibiting serotonin.

Some important steps to take if you are currently taking herbal/dietary supplements or considering usage are as follows: verify that the product has GMP (Good Manufacturing Processes) to assure that what is written on the label is what’s in the bottle. Also look for “USP Verified” on the label — this proves the supplement has been inspected and approved under the United States Pharmacopeial Convention. Last, check the FDA website periodically for updates on supplements that are under regulatory review or that have been reported to cause adverse effects.

This article can be a helpful resource, but it is never a substitute for professional medical advice. You should always speak with your doctor before you start, stop or change any of your medication/herbal treatment.

Dr. Salah Eldohiri specializes in pain management at CRMC Pain Management Treatment Clinic at 2 Jennifer Court, Carlisle.

Eldohiri is one of a few Carlisle Regional Medical Center physicians contributing to the Health Talk column that appears in The Sentinel on Sundays.

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