Chronic pain

Whether it is in the form of aching, tingling, stabbing, shooting, or burning, prolonged and uncontrollable pain can adversely affect one's entire life. In addition to the physical discomfort, constant suffering can lead to anxiety, anger, and depression, which can all intensify the pain.

Pain occurs when a nerve ending senses a source of distress and sends a signal to the brain. The pain can become chronic if this impulse continues. The causes of chronic pain are too numerous to list but include a poorly healing injury, arthritis, a pinched or irritated nerve, or an underlying disorder such as cancer. Unfortunately, in some cases, especially those involving the muscles and bones, the actual cause remains a mystery, making the condition especially difficult to treat.

Supplements and herbs

Under your doctor's supervision, you can use natural pain relievers, singly or together, for the long-term relief of chronic pain. Most can also be taken with conventional painkillers: Generally, supplements are safer than those drugs and may reduce your need for them. The exception is white willow bark, which shouldn't be taken with aspirin; the two are so similar that combining them increases the risk of aspirin-related side effects. (Both act to reduce levels of natural pain-causing compounds called prostaglandins.)

White willow bark can, however, be safely combined with other pain relieving herbs. According to some, bromelain, an anti-inflammatory protein derived from pineapple, may be useful for inflammation-related pain and sports injuries. Other potentially helpful herbs include ginger (which, like white willow bark, acts on prostaglandins), meadowsweet, feverfew, cat's claw, devil's claw, pau d'arco, and turmeric.

Topical preparations can be beneficial too. Cayenne cream may be especially beneficial for arthritic joints, post-shingles pain, or nerve damage from diabetes or surgery (such as mastectomy or amputation); it may be less effective on large areas of the body because of the burning sensation it causes. Alternatively, try mixing a few drops of ginger, lavender, and birch oils with 1/2 ounce of a neutral oil (such as almond oil) and massaging the blend into the painful area. Other options include peppermint oil, wintergreen oil, or eucalyptus oil, which seem to work by quieting the nerve endings that transmit pain signals.

Supplements typically provide pain relief within three to four hours. If pain is accompanied by depression or anxiety, try St. John's wort first, and then kava. These herbs may have some direct pain-relieving properties as well. If pain is interfering with your ability to get a good night's sleep, consider valerian.

What else you can do

• Consider acupuncture. Mind-body techniques-such as biofeedback, hypnosis, relaxation training, and behavioral counseling-may also help.
• Ask your doctor about pain clinics, which offer a range of treatments.

How much to take

White willow bark

1 or 2 pills 3 times a day as needed for pain (follow package directions).
Standardized to contain 15% salicin. May irritate stomach.

Bromelain

500 mg 3 times a day on an empty stomach.
Eliminate after 2 weeks if ineffective.

Cayenne cream

Apply cream thinly to painful areas several times a day.
Standardized to contain 0.025%-0.075% capsaicin.

Ginger

100 mg 3 times a day.
Look for supplements standardized to contain gingerols. Can use essential oil of ginger as part of a massage blend.

Peppermint oil

Add a few drops oil to 1/2 ounce neutral oil.
Apply to painful areas up to 4 times daily.

St. John's wort

300 mg 3 times a day.
Standardized to contain 0.3% hypericin.

Kava

250 mg 3 times a day.
Standardized to contain at least30% kavalactones.

Valerian

400 mg a day standardized to contain 0,8% valerenic acid.
Don't use during pregnancy or when lactating.

For kids

See age-appropriate dosages of herbal remedies

• Brew a pain-relief tea as follows: Simmer 1 tablespoon of white willow bark in 1 quart of water for fifteen minutes. Add 1 tablespoon of valerian root, 1 tablespoon skullcap, 1 tablespoon chamomile, and 1/2 tablespoon licorice root. Simmer for another ten minutes; then strain and cool. Give your child one dose, every hour, for four consecutive hours, to help relieve generalized pain. White willow bark is an anti-inflammatory similar to aspirin; valerian and skullcap have sedative and antispasmodic properties; chamomile is an effective relaxant; licorice is an anti-inflammatory and enhances the action of the other herbs, in addition to sweetening the tea.
  Note: Skullcap should not be given to a child under six years of age. Licorice should not be given to a child with high blood pressure.

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