ORAL BOTANICALS TO EASE PAIN
TRIED AND TRUE

ABRIDGED: BOTTOM LINE DAILY HEALTH NEWS, NOV. 2005

Last week, I spoke about topical botanicals for targeted pain relief that have fewer side effects than pharmaceuticals. (See Daily Health News, September 26, 2005). But what about when pain is more generalized? Assorted oral botanicals, such as meadowsweet, white willow bark, devil's claw, ginger and turmeric, ease pain and discomfort in a gentler, more natural way. For the best options, I spoke with Mark Blumenthal, founder and executive director of the American Botanical Council.
He told me that there are many advantages to using tried-and-true remedies that have been around for thousands of years. The primary advantage is that even in oral form, botanicals constitute a safe, gentle, natural and lower-tech approach to pain management than powerful drugs. Although Blumenthal is by no means antipharmaceutical, he echoes the words of others I've spoken with: We are sometimes too quick to reach for the most powerful drug to cure whatever ails us -- when often, a milder and safer botanical remedy (one that is less apt to cause serious side effects) is all that's needed.

BLUMENTHAL'S BEST

MEADOWSWEET

The first aspirin (acetylsalicylic acid) was synthesized from meadowsweet (Spiraea ulmaria) in the 1800s. If you are concerned about possible side effects, such as gastrointestinal bleeding, Blumenthal notes that meadowsweet (which has mild antispasmodic, anti-inflammatory and sedative properties) is a good alternative. Because it contains natural buffering agents, this herb is easier on the stomach than aspirin. That said, if you are sensitive to aspirin, you still should consult with your health-care provider before taking it. It is recommended for general muscle and joint pain (as in arthritis), menstrual cramps, fever reduction and digestive disorders.

• How it works: An active ingredient in meadowsweet is the aspirin-like chemical salicin. In the liver and intestines, it is converted to salicylic acid, which works like aspirin to lower the body's level of prostaglandins (hormone-like compounds that are associated with inflammation and pain).
   
• How to take it: A typical dose is one teaspoon of the tincture up to three times daily.

WHITE WILLOW BARK -----------------------------------------------------------------------------------------------------------

Known as "the herbal aspirin," white willow bark (Salix alba) is another precursor of aspirin. Blumenthal suggests taking it for general aches and pains, such as backache and menstrual cramps. It has a milder impact on the body than aspirin, and white willow bark is also less likely to cause side effects such as stomach bleeding.

• How it works: Like meadowsweet, white willow bark contains salicin.
   
• How to take it: Blumenthal notes that there is a lot of research to back up the effectiveness of a German willow bark product known as Assalix. Follow dosage instructions on the package.

DEVIL'S CLAW------------------------------------------------------------------------------------------------------------------------

For thousands of years, people living in southern Africa's Kalahari Desert have used devil's claw (Harpagophytum procumbens) to treat pain. More recently, a number of studies have confirmed that this colorfully named botanical can indeed improve low back, knee and hip pain. Blumenthal recommends it for arthritis.

• How it works: Devil's claw contains chemicals known as iridoid glycosides, which are potent anti-inflammatories. One particularly concentrated iridoid -- harpagoside -- has both anti-inflammatory and analgesic (pain-reducing) properties.
   
• How to take it: A typical dose of devil's claw consists of 1,500 mg to 2,500 mg of the standardized powdered herb in capsule or tablet form daily. Consult your health-care provider before taking devil's claw if you have ulcers, heartburn, gallstones, a bleeding disorder or if you are taking blood-thinning drugs.

Note: It is best to take any aspirin substitutes on a full stomach.

GINGER-----------------------------------------------------------------------------------------------------------------------------------

Although ginger (Zingiber officinale) is usually is hailed for its ability to settle upset stomachs and prevent motion sickness, it also may indirectly control chronic pain by reducing inflammation. In a Danish study, this herb was especially effective in reducing knee pain when combined with galangal (a fellow member of the ginger family). Use it for general muscle and joint pain, as in arthritis.

• How it works: Ginger works by lowering the body's level of pain-inducing prostaglandins.
   
• How to take it: A standard dose in pill form is 100 mg three times daily, or up to four cups of ginger tea a day. (Consult your health-care provider before taking this remedy if you have a bleeding disorder, or if you are taking blood-thinning drugs.)

TURMERIC-------------------------------------------------------------------------------------------------------------------------------

This spice adds a distinctive flavor and yellowish hue to curries and other Asian dishes. Curcumin, an active ingredient in turmeric, has long been used as an anti-inflammatory in Ayurvedic medicine in India for problems such as bursitis, tendinitis and carpal tunnel syndrome. In the US, this botanical is most commonly recommended for arthritis, back and neck pain, carpal tunnel syndrome and sports injuries. (It also is used for indigestion.)

• How it works: According to Blumenthal, there is a growing body of data that powerful anti-inflammatory components in turmeric can safely reduce the pain and swelling of arthritis. Other studies suggest a still wider variety of healing benefits, such as lowering cholesterol and preventing cancer.
   
• How to take it: An easy way to incorporate turmeric in your diet is to spice up your meals with it. An average dose of curcumin consists of 400 mg to 600 mg (containing 95% curcumin) in capsule form up to three times daily.

While these are some of Blumenthal's favorites, there are many other options, including boswellia (for arthritis), bromelain for gastric upset and chronically inflamed tissues and evening primrose oil for joint pain as well as assorted tissues that are especially sensitive to pain. No one approach works for everyone, and often it is a matter of mixing and matching a variety of strategies until you hit on the combination that works best for you.

If you have a preexisting condition or are taking other medications, you should always consult your health-care provider before adding any new supplement to your medical regimen.