The Everything Guide to Herbal Remedies: An easy-to-use reference for natural health care

CHAPTER 8

Treating Aches and Pains

Herbal remedies are perfect for treating the aches and pains that all people experience at one time or another. Unlike the drugs prescribed by conventional medicine, which typically attack a specific bodily function—inflammation, for example—with a synthetic and single-purpose drug, the medicinal constituents of herbs typically work synergistically, meaning they generally don’t have the side effects of pharmaceuticals.

The Anatomy of an Injury

Injuries to the body can take many forms: a contusion or sprain, inflammation from arthritis or tendinitis, a sore back or an aching head brought on by stress. All have one thing in common: irriation or damage to the body’s tissues.

Say you’re running toward home plate, savoring your imminent triumph (and composing your victory speech in your head) when—wham!—you hit the dirt.

Maybe you pulled a muscle? Or twisted an ankle? Either way, you’ve done some damage. If the fall was sudden enough, you’ve probably torn some muscle (or tendon or ligament) fibers, triggering an almost immediate response in your body. Nerves send a pain message to your brain, which in turn tells you to stop what you were doing lest things get any worse. Blood is quickly sent to the injury site, carrying the body’s defensive foot soldiers (white blood cells) and stabilizing the area until help arrives. It’s the inflammatory response in action.

The term inflammation applies to more than one condition. Local inflammation is associated with an injury or infection in one part of the body. Systemic inflammation is often tied to multisystem, long-term diseases like lupus. These conditions, known as autoimmune disorders, are the result of the body’s immune system mistaking its own cells for foreign invaders.

Now, say you’re sitting in your favorite chair, watching the evening news, when you feel an ache in your knee. It’s been there for awhile, so long that you hardly notice it anymore. That ache is also the result of inflammation, which in this case is occurring as a result of an old injury. There’s no emergency here, no microbial intruders to destroy, but your body is reacting to this trauma in the same way it would to any other: with inflammation.

Although it’s the source of countless health problems, inflammation can be a good thing. In inflammation, the body sends blood to the site of some kind of trauma to protect itself from infection or further injury. Signs of inflammation include pain, redness, warmth, and swelling (edema). If the inflammation is happening in a joint or muscle, you’ll also experience stiffness and some loss of function.

All of this is good, of course, unless that inflammatory process gets stuck in the “on” position. This can be caused by a few things: Maybe you’re perpetuating the damage by continuing to do the things that cause the injury in the first place, or you’re developing a chronic condition, like arthritis or bursitis, in which the inflammation is doing nothing but creating more inflammation. Ongoing inflammation can cause any number of problems, but in the case of everyday aches and pains it usually means swelling and discomfort that never go away. It can also mean damage to the tissues in the area, including cartilage and bone.

Herbal Helpers

Herbs generally contain hundreds of ingredients, called phytochemicals, many of which have proven pharmacological benefits in treating general aches and pains.

Phytochemicals are usually referred to as secondary constituents because they’re secondary to the plant’s survival. (Primary constituents are involved in the plant’s essential metabolic processes.) But it’s these nonessentials that are the key to a plant’s medicinal value, and scientists generally attribute a plant’s bioactivity (its effect on another living organism) to its secondary chemistry.

Chemical Actions

Phytochemicals are most often produced by a plant as a form of self-preservation. Some act like the chemical equivalent of spines on a cactus, defending the plant from the animals, insects, and microbes that otherwise might eat it (or give it a deadly disease). Others protect the plant against environmental stresses like extreme temperatures or drought.

Luckily, phytochemicals can help people, too. Over the millennia, we’ve discovered plants whose phytochemicals work as antimicrobial agents, astringents, anti-inflammatories, and anesthetics, all of which can help people deal with aches and pains.

Advantages of Herbs Over Drugs

Although they often contain powerful ingredients, herbs are generally considered a gentler form of healing than the pharmaceuticals and procedures of conventional medicine. That’s because the side effects of most herbal remedies are rare—and much less troubling than their conventional medicine counterparts.

Several new studies have shown that many popular conventional pain medicines can have scary side effects. For example, combining acetaminophen (Tylenol) with large amounts of caffeine could cause liver damage. And migraine sufferers who take the drug topiramate (Topamax) are at a greater risk for kidney stones.

Conventional treatment for most aches and pains typically involves over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Aleve), and ibuprofen (Motrin or Advil), and the pain reliever acetaminophen (Tylenol). Some people also use prescription NSAIDs such as celecoxib (Celebrex) to manage chronic pain. But NSAIDs can have serious effects, including stomach bleeding and increased risk of a heart attack. High doses of acetaminophen can lead to liver toxicity.

In cases that involve chronic inflammation in or around a joint (such as bursitis or tendinitis) and don’t respond to these drugs, a doctor might prescribe a more powerful anti-inflammatory, such as a corticosteroid (steroidal drug), which can be injected directly into the joint or surrounding area. But while corticosteroids can relieve pain, they can also cause serious side effects, including headaches, elevated blood pressure, muscle weakness, impaired wound healing, ulcers, and psychiatric disturbances. Moreover, steroid drugs can actually damage cartilage and weaken tendons and muscles. This can be especially problematic if the injection was made into a weight-bearing joint, such as the ankle or knee.

Chronic Inflammation

Arthritis, bursitis, and tendinitis are three conditions that share a common culprit: inflammation. When they settle into your joints or other tissues, these conditions can run the gamut from annoying to crippling.

Bursitis

Bursitis is inflammation of the bursae, which are small, fluid-filled sacs that keep the bones, tendons, and muscles around your joints cushioned and thus keep the joints moving smoothly. Bursae are also located between bones and other structures (like muscles and skin) that move against the bone. If a bursa becomes inflamed, generally because of overuse or repetitive strain, that movement becomes painful.

Arthritis

Arthritis is the number one cause of disability in the United States. Although arthritis is quite common in seniors—roughly half of everyone over sixty-five has been diagnosed with it—it’s not strictly an old-person’s disease. Almost two-thirds of the 46 million Americans with diagnosed arthritis are younger than sixty-five.

Arthritis encompasses more than 100 different conditions, but osteoarthritis is the most common, typically striking people who put excessive strain on their joints, have had a joint injury (or joint malformation), are overweight, or have a family history of the disease.

Technically speaking, osteoarthritis isn’t caused by inflammation; it comes from physical wear and tear. However, because osteoarthritis includes joint pain, swelling, and loss of function—all symptoms of inflammation—it’s is generally lumped in with the rest.

Tendinitis

Tendinitis (or tendonitis) is an inflammation in the tendon, which is the fibrous, cord-like material that joins muscle to bone. It’s caused by repetitive strain or injury—think tennis elbow and swimmer’s shoulder—but it’s not reserved for athletes: Painting or shoveling also can trigger it, as can using incorrect posture or neglecting to stretch before activity.

Tendinitis produces pain just outside the affected joint. Adults over forty are more susceptible, because tendons become less flexible and more injury-prone as you age.

Treatment Options

The “itis” conditions are typically treated with OTC or prescription medicines such as NSAIDs. But there are several herbs that can treat pain, stiffness, and inflammation without the side effects.

• Ashwagandha (Withania somnifera)

Research shows that this Indian herb can deliver significant and sustained pain relief, alleviate stiffness, and restore function to arthritic joints.

• Cat’s claw (Uncaria guianensis, U. tomentosa)

Studies have confirmed that this South American plant—traditionally used as an anti-inflammatory—is useful against osteoarthritis.

• Pineapple (Ananas comosus)

Pineapples contain bromelain, an enzyme that’s used to treat inflammation. Research shows that bromelain, used alone or in combination therapies, can reduce swelling and manage the pain and inflammation of arthritis.

• Rose hip (Rosa canina, R. spp)

Recent research has shown that powdered rose hip, which contains high levels of vitamin C, can decrease pain and stiffness in arthritis.

• Turmeric (Curcuma longa)

Turmeric can block inflammation and prevent arthritis-related bone loss. In one study, turmeric and frankincense (Boswellia serrata) significantly reduced pain in patients with arthritic knees.

Back Pain

Whether it’s an ache in the lower back or a twinge in the neck, back pain is the most widespread orthopedic condition in the United States, affecting about 80 percent of people.

Back pain is really not a condition—it’s a symptom of an underlying problem in the muscles, nerves, and/or bones of the spine. In many cases, it’s a sign of a mechanical problem, such as muscle tension: Maybe you’ve put undue strain on your back by lifting a heavy object improperly, suddenly twisting your back or neck, or maintaining poor posture for a long time while sitting or standing.

Another mechanical problem is a condition known as intervertebral disk degeneration, which is breakdown of the disks located between the bones, or vertebrae, of your spine. Back pain can also be the result of an injury or a condition like scoliosis (a curvature of the spine) or arthritis.

Sciatica is a type of back pain that involves the sciatic nerve, which runs from the lower back into the legs. Symptoms can include shooting pain, numbness, or tingling in the backside and one leg. Sciatica can occur during pregnancy, and it is also more common in people who are overweight and inactive. Wearing high heels or sleeping on a mattress that is too soft can also contribute to sciatica.

Treatment Options

Conventional medicine treats back pain in a few ways, depending on its cause and severity. For most minor cases, you’ll be advised to take NSAIDs and try physical therapy, massage, or controlled exercise. If you’re experiencing serious or chronic back pain (lasting longer than six weeks), be sure to talk with your health care provider.

Several herbs have been used traditionally to treat back pain—and are showing their abilities in modern laboratories as well. For example:

• Cramp bark (Viburnum opulus)

Also known as guelder rose (among other names), this is a key Western herbal remedy for muscle cramps; it is effective against spasmodic back pain (it has analgesic, antispasmodic, and anti-inflammatory properties).

• Devil’s claw (Harpagophytum procumbens)

This is a classic South African remedy for pain and inflammation. Research shows that an oral extract can significantly reduce back pain.

• Ginger (Zingiber officinale)

Ginger, which is an analgesic and anti-inflammatory, is used both topically and internally to treat muscle and joint pain. Modern research shows it works like the NSAIDs to reduce inflammation.

• Lavender (Lavandula angustifolia)

The aromatic essential oil is a traditional remedy used to relax both muscles and mind. It’s been proven effective at reducing stress as well as pain and inflammation.

• Willow (Salix alba)

The bark from this tree contains salicin, a precursor of aspirin. Research has shown it to be an effective analgesic and a powerful weapon against back pain. In one study, willow extracts relieved pain better than the prescription drug rofecoxib (Vioxx).

Muscle Aches, Sprains, and Strains

Anytime you ask a muscle to do something that it’s not used to doing (such as running ten extra miles or lifting extra-heavy weights), the muscle can respond with pain. Muscle pain also can be caused by an acute injury, such as a fall, or chronic (also known as overuse) injuries. It can range from mild (a dull ache or twinge) to intense (significant pain or stiffness).

Sprains and strains are some of the most common sports injuries. A sprain is an injury to the ligaments, which are the fibrous bands that attach muscle to bone. A strain is an injury to a muscle or tendon, which is the structure that attaches a muscle to another muscle. Both sprains and strains occur when the tissue is stretched (or torn) because it’s been pulled past its normal range of motion.

Conventional treatment for sprains and strains uses what the experts call PRICE: protect, rest, ice, compression, and elevation. That means you immediately stop using the affected joint (protect it and give it a rest), apply ice or a cold pack and gentle compression (via an elastic wrap), and elevate the joint, all of which will help reduce the swelling.

If you sprain something, you’ll know it. In some cases, you’ll hear a popping sound as the ligaments are overextended. In all cases, you’ll experience almost immediate swelling and pain. You should see a doctor if these symptoms are severe (if you can’t put any weight at all on the ankle, for example).

If you’ve sustained a strain (what many people call a “pulled muscle”), you’ll feel immediate pain and increasing stiffness (and possible swelling) over the next few hours. The most common cause of strains are sudden, powerful contractions of a muscle group—like when you slip and fall on the ice, lunge to return a tennis shot, or jump to sink a basket.

Herbal Helpers

To fight the pain of most muscle injuries, you can skip the NSAIDs in favor of these herbal remedies:

• Arnica (Arnica montana)

Arnica is a classic remedy for all kinds of aches, including the sports-induced kind. Studies have confirmed its use as a remedy for soft-tissue (i.e., muscle) injuries.

• Cayenne (Capsicum annuum, C. frutescens)

These peppers contain a chemical called capsaicin, which can be applied topically to produce a warming sensation and reduce pain (it’s the key ingredient in many OTC muscle rubs).

• Comfrey (Symphytum officinale)

This herb is used topically to treat all kinds of sports injuries, including injuries to muscles, tendons, and ligaments.

• Eucalyptus (Eucalyptus globulus)

The oil from this Australian plant is used topically as an analgesic and anesthetic.

• Peppermint (Mentha x piperita)

Peppermint contains menthol, a natural anesthetic and painkiller. Menthol also produces a soothing, cooling sensation.

• Pineapple (Ananas comosus)

Pineapple’s active constituent, bromelain, can be taken internally to treat a variety of sports injuries and trauma. Studies have shown that it can reduce inflammation, swelling, and bruising.

• Saint John’s wort (Hypericum perforatum)

This herb produces an oil that’s used topically to treat muscle and joint injuries (it’s got analgesic, antiedemic, and anesthetic constituents). It also works as an anti-inflammatory and antispasmodic.

• Yarrow (Achillea millefolium)

Yarrow relieves pain and swelling and is a classic remedy for swelling, bruising, and muscle soreness.

Headaches

Seven in ten Americans have at least one headache a year, and 45 million people live with chronic headaches. Headaches can go from merely annoying to debilitating, and the term headache encompasses at least twelve major types, including tension headaches, caffeine-withdrawal headaches, hunger headaches, menstrual headaches, hangover headaches, and ice cream headaches (a.k.a. “brain freeze”).

Tension-type Headaches

Also known as ordinary or idiopathic headaches, these involve infrequent, episodic pain that can last from a few minutes to a few days. The pain is usually bilateral (meaning it’s on both sides of your head) and accompanies a sensation of pressure or tightening. This is the most common type of headache, experienced by roughly 78 percent of the population. Most often, tension headaches are treated with NSAIDs or acetaminophen.

Sinus Headaches

As the name implies, these are created from pressure in the sinus cavities, which may be caused by congestion from a cold or allergies or inflammation from an infection (if you’ve got an infection, you’ll probably have a fever as well). Sinus headaches are generally treated with NSAIDs, antihistamines, and decongestants—plus antibiotics in the case of sinus infection.

Cluster Headaches

These are rare and are extremely intense; they tend to “cluster” over a period of weeks or months, only to go away and reappear later. Cluster headaches typically come on a few times a day and last about forty-five minutes. They occur more often in young men and in people who frequently smoke and drink alcohol. Conventional medical treatment for cluster headaches typically includes drugs like sumatriptan (Imitrex), zolmitriptan (Zomig), or rizatriptan (Maxalt), which are used to prevent a headache or stop one that’s already started. Side effects include tightness in the chest and dizziness.

Migraine Headaches

Migraines are intense and pounding and often accompanied by visual disturbances (called auras), sensitivity to light and noise, nausea, and vomiting. Every year, about 30 million people in the United States experience a migraine.

As with cluster headaches, conventional migraine treatments involve acute and preventive measures. In patients with mild to moderate attacks, NSAIDs are generally recommended. More severe cases are given prescription NSAIDs like naproxen (Naprosyn). Preventive and treatment meds include sumatriptan (Imitrex), zolmitriptan (Zomig), or rizatriptan (Maxalt).

Migraine pain causes many sufferers to try almost anything for relief. A recent national survey found that 20 percent of people who suffer from regular migraine headaches routinely take dangerous, potentially addictive medications that contain barbiturates or opioids (and have not been approved by the FDA) in their quest for a cure.

Herbal Headache Relief

Many traditional herbal formulas have shown the ability to handle even the toughest of headaches:

• Butterbur (Petasites hybridus)

Extracts from this shrub have analgesic, anti-inflammatory, and antiseizure actions. In several recent studies, they produced a marked decrease in severity and frequency of migraines.

• Cayenne (Capsicum annuum, C. frutescens)

Applied topically, cayenne preparations have been shown to relieve and even prevent the devastating pain of cluster headaches.

• Feverfew (Tanacetum parthenium)

This is perhaps the best-known herbal headache remedy. It has been shown in several studies to reduce the frequency of migraine attacks— and limit their symptoms when they do occur.

• Lavender (Lavandula angustifolia)

The essential oil of this flowering plant has been used effectively to treat several types of headache pain. The same is true of peppermint oil (Mentha x piperita).

• Willow (Salix alba)

The salicin from the bark of this tree is a potent analgesic. Its headache-fighting properties are well proven in both laboratory and clinical studies.