As we get older, aches and pains can become an increasing part of everyday life. Whether it is a twinge in your knee when you bend, or an ache in your shoulder that just won’t go away, these everyday nuisances make life a little harder. If you experience this, you are not alone; more than 1 in 10 Americans suffer from chronic pain of more than 3 months.

While many of us people reach for a Tylenol or Ibuprofen, both can cause serious problems if taken for too long. While there are alternatives, like acupuncture, massage or yoga, sometimes, we want something on-hand to relieve pain.

Fear not. Many herbal remedies are over-the-counter, or already in your kitchen. Let’s look at some “tried and true” alternatives for our daily aches.

1. CBD Oil

What Is It and How Does it Work?

Cannabinoidol (CBD) oil is an extract from the Cannabis sativa plant. It has been used for millennia and may have helped Queen Victoria soothe her painful menstrual cramps. While CBD and tetrahydrocannabinol (THC) are the major components, CBD has none of the psychoactive properties and can’t get you “high.”

CBD has many properties including being:

1. Anti-oxidant
2. Anti-inflammatory
3. Anxiolytic and
4. Neuroprotective.

CBD, like THC, is part of the endocannabinoid system found throughout the nervous and immune system. Unlike THC, CBD primarily works through others pathways, explaining why the two are so complementary.

Although the exact mechanisms are not known, CBD:

1. indirectly increases endocannabinoid activation
2. affects serotonin, which helps manage our moods, and
3. modulates the PPAR family, an anti-inflammatory pathway that is a target for diabetes management.

Obviously, CBD is quite the multi-tasker in pain control!

What Kind of Pain Does it Treat and Are There Any Other Benefits?

CBD oils manage chronic, inflammatory and neuropathic pain like multiple sclerosis and chronic cancer pain. These kinds of difficult-to-manage pain easily become resistant to potent medications like opiate drugs, so CBD is a great alternative.

Also, CBD is neuroprotective, so in addition to treating neurodegenerative illness like Parkinson’s and Alzheimer’s disease, it may also prevent nerve damage and stop pain from worsening. CBD also helps reduce anxiety and is a good sleep aid, important benefits if you are dealing with chronic pain.

How Should I Use It?

You usually take CBD oils by mouth. One option is Endoca capsules. Currently, the optimal dose for pain isn’t known, as we don’t have enough rigorous studies on humans. One review article suggests a starting dose between 2.5-10 mg. You can increase the dose weekly, until you achieve good pain relief. As with other oils, take the lowest dose possible 3 or 4 times a day.

Tinctures or creams also come mixed with THC. Tinctures that have a high CBD content (as high as 20 to 1) help with neurologic pain and inflammatory conditions. In topical treatments, a 3 to 1 ratio of CBD to THC helps relieve chronic muscle pain or arthritis. They can also help with painful periods and headaches. Topical treatments won’t give you a high. One recent publication even showed that topical cannabis was effective at treating serious wounds that normally require hefty doses of opioid medications.

Where Do I Get It and What Brands Can I Try?

There are numerous online stores for CBD oils. However, it is important to remember that while CBD oil may be made from hemp, they are not always the same. Traditional hemp oil (i.e. for cooking) has almost no therapeutic use as it contains less than 4% CBD. However some hemp oils are made to have more CBD. While CBD from hemp is legal in the US, CBD from other parts of C. Sativa may be illegal in your state

It goes without saying, but unless you live in one of the eight states that have fully legalized cannabis products, ensure that you can purchase it legally.

2. Arnica

What Is It and How Does it Work?

Arnica is one of the most popular herbal remedies for inflammation, wounds and contusions. It comes from the plant Arnica montana. It is so well-regarded and effective that it is often the go-to medication recommended by primary doctors in Germany. Arnica is an anti-inflammatory and blocks several inflammatory pathways.

Helenalin, the main component of Arnica’s works by:

1. Inhibiting the COX pathway (similar to ibuprofen),
2. Blocking NF kappa beta (a pro-pain and pro-inflammatory molecule that may cause autoimmune disease) and
3. Reducing swelling and inflammation associated and lessening recovery time.

What Kind of Pain Does it Treat and Are There Any Other Benefits?

Arnica is generally used for muscle pain, especially after intense exercise. While some studies have mixed results, Arnica is able to manage osteoarthritic pain. In one study, applying Arnica gel three times a day was as effective as taking ibuprofen. Another study showed that homeopathic Arnica tablets reduce bruising and swelling after surgery and speed up recovery.

How Should I Use It?

Arnica can be taken as a homeopathic treatment by mouth or topically. Oral homeopathic treatments are diluted many times over, as high doses of internal arnica are toxic. There are mixed results as the dose is very low. When taken internally, arnica is used short term – like ibuprofen or Tylenol – and has some promise for use after minor surgeries.

Most people use arnica on the skin for local muscle pain. You can apply it several times a day. It comes in a range of strengths, usually from 1-10X. Arnica gel with a strength of 50 gram/100 gram ratio can be used two to three times daily for pain.

Where Do I Get It and What Brands Can I Try?

Two brands of homeopathic Arnica that have been studied are Traumeel and SinEcch. If you try these medicines, read the directions carefully as high doses of Arnica can be toxic. There are many options for topical treatment, from gels to creams and ointments. It is important to pay attention to the potency as well as the type of Arnica (look for A montana over other subspecies of the Arnica plant).

3. Capsaicin

What Is It and How Does It Work?

Capsaicin is the ingredient in chili peppers that make them spicy. It is so hot that the extract must be diluted 16 million times to lose its heat. In the West, chili was first used as a pain reliever in the 1800s. Since then, it has been put in creams and ointment to reduce itching, pain after surgery and even treat psoriasis.

Capsaicin works by targeting the TRPV1 receptor, the most important pain receptors in our body. It does this better than most any other compound. Over time, capsaicin dulls pain fibers, making us less sensitive to pain. Capsaicin is used on the skin, where it is absorbed well and can last up to four hours at a time.

What Kind of Pain Does it Treat and Are There Any Other Benefits?

Capsaicin is a well-known treatment for nerve and neurologic pain. For example, it is approved to treat pain from Shingles and HIV neuropathy. A super-strength capsaicin patch (8%) has also been shown to be useful for post-surgical pain and arthritic conditions, fibromyalgia, migraines and muscle sprains. One study looked at patients with chronic low back pain found that capsaicin cream reduced pain scores by half over 3 weeks. Newer research indicates that the high concentration capsaicin patch may be able to treat chronic pelvic pain conditions and vulvodynia, common conditions that women face much more than men.

How Should I Use It?

Over-the-counter capsaicin creams and patches come in strengths of 0.15% or less. They are used widely to treat migraines, body aches and arthritis. To treat migraines, capsaicin cream can be dabbed into the inside of nostrils. For all other parts of the body, it can be rubbed onto the painful area part of your body that aches up to 4 times a day. You should never use it on cut or broken skin as there is a small risk of burning and pain where it is applied. Try capsaicin on a small part of the body to make sure you do not react to it.

A high concentration Capsaicin 8% patch is also available, but you need a prescription from your doctor. It is approved for shingles nerve pain, but can help other conditions. One application lasts for up to 3 months.

Where Do I Get It and What Brands Can I Try?

There are many brands of capsaicin around. Strengths are usually between 0.05% to 0.15%. A brand that has been studied often is the German brand Finalgon CPD Warmecreme, which is 0.05% strength. However it is best to experiment to see which strength of capsaicin cream gives you the best effects with the least side effects. Remember, that higher doses can cause more skin irritation.

4. Ginger/Turmeric

What Is iI and How Does It Work?

Both ginger and turmeric are rhizomes or root stalks that have been used the world over for cooking and medicinal purposes. Turmeric is from the root of the Curcuma Longa plant while ginger is from the plant Zingiber officinale. Both are part of the ginger (Ziangiberaceae) family.

Curcumin is the main ingredient in turmeric and is known for its anti-inflammatory properties as it reduces pain, inflammation and stiffness. Like arnica, curcumin reduces inflammation by affecting NF-K beta.

Ginger has hundreds of phytochemicals such as gingerols, shogoal, caffeic acid, curcumin and even capsaicin. It works in several ways to reduce inflammation and pain.

Together, ginger and curcumin are:

1. Anti-inflammatory
2. Anti-oxidant and
3. Improve wound healing

One study showed that a paste made of 3% ginger and 10% curcumin improved wound healing in rats. Their skin had more blood vessels and collagen, which are vital for making new skin.

What Kind of Pain Does It Treat and Are There Any Other Benefits?

In clinical studies, turmeric’s anti-inflammatory action improves rheumatoid arthritis, post-operative inflammation, Crohn’s disease, ulcerative colitis, irritable bowel syndrome, and others. One meta-analysis suggested that 1000 mg a day of curcumin was beneficial in treating osteoarthritis.

In a study of over 200 people, a highly purified ginger extract twice a day had a statistically significant effect in reducing symptoms of OA of the knee. Ginger reduced pain with standing, after walking and decreased their need for rescue medication. Most people tolerate ginger well, but some had mild GI symptoms.

Another meta-analysis study showed that about 750-2000 mg ginger powder for the first 3-4 days of the menstrual cycle reduced dysmenorrhea. Another study found that ginger is just as effective as triptan, the most common migraine treatment.

Ginger is also a well-known remedy for nausea and motion sickness. Curcumin may reduce cholesterol and prevent diabetes when taken regularly.

How Do I use it?

The most obvious way is to get cooking!  Adding ginger and turmeric to your foods is a great way to increase your intake. It is easy to make ginger/turmeric teas when you have pain or menstrual cramps. Some people also enjoy making a turmeric paste to put on the skin or even a Golden paste to add to dishes or to drink.

If you choose supplemental form, about 1000 mg/day of curcumin helps reduce arthritis pain. The recommended dose of ginger is about 255 mg twice a day. You can take a combined turmeric and ginger supplement.

A quick note: Turmeric and ginger are blood thinners at high doses. If you take certain blood thinners like Coumadin, a supplement of turmeric or ginger may increase the effect. Always touch base with your doctor before taking high dose supplements.

Where Do I Get It and What Brands Can I Try?

If you choose supplements, look for those with the most scientific research support. For ginger, this is EV.EXT 77 that can be taken twice a day. For curcumin, this is Meriva, which you should take three times a day.

What herbal supplement will you try?

Nature has a million and one ways to give us what we need. Next time you feel a familiar ache, think outside the box and try one of these herbal remedies to soothe your pain away!

References.

1. Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum. 2001 Nov;44(11):2531-8.
2. Baranidharan G, Das S, Bhaskar A. A review of the high-concentration capsaicin patch and experience in its use in the management of neuropathic pain. Ther Adv Neurol Disord. 2013 Sep; 6(5): 287–297.
3. Bhagavathula N, Warner R, DaSilva M et al. A combination of curcumin and ginger extract improves abrasion wound healing in corticosteroid damaged hairless rat skin.. Wound Repair Regen. 2009 May–Jun; 17(3): 360.
4. Blake A, Wan B, Malek L et al. A selective review of medical cannabis in cancer pain management. Ann Palliat Med. 2017 Dec;6(Suppl 2):S215-S222.
5. Chaiet S and Marcus B. Perioperative arnica montana for reduction of ecchymosis in rhinoplasty surgery. Ann Plast Surg. 2016 May; 76(5):477-82.
6. Daily J, Yang M, Park S et al. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016 Aug 1; 19(8): 717–729.
7. Daily J, Zhang X, Kim D et al. Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials Pain 2015 Dec; 16(12): 2243–2255.
8. Fernández-Ruiz J, Sagredo O, Pazos MR, et al. Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid? Br J Clin Pharmacol. 2013 Feb;75(2):323-33.
9. Karow JH, Abt HP, Frohling M, et al. Efficacy of Arnica montana D4 for healing of wounds after Hallux valgus surgery compared to diclofenac. J Altern Complement Med. 2008;14:17–25.
10. Levesque A, Riant T, Labat JJ et al. Use of High-Concentration Capsaicin Patch for the Treatment of Pelvic Pain: Observational Study of 60 Inpatients. 2017 Jan-Feb;20(1):E161-E167.
11. Maida V, Corban J.Topical Medical Cannabis: A New Treatment for Wound Pain-Three Cases of Pyoderma Gangrenosum. J Pain Symptom Manage. 2017 Nov;54(5):732-736.
12. Maghbooli M1, Golipour F, Moghimi Esfandabadi A et al. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res. 2014 Mar;28(3):412-5.
13. Mead A.The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law. Epilepsy & Behavior. 2017 May; 70(B): 288-291.
14. Tommaso Iannitti, PhD,1 * Julio Cesar Morales-Medina, PhD,2 Paolo Bellavite et al. Effectiveness and Safety of Arnica montana in Post-Surgical Setting, Pain and Inflammation. Am J Ther. 2016 Jan-Feb;23(1):e184-97
15. Arnica. Retrieved at: https://www.webmd.com/vitamins/ai/ingredientmono-721/arnica.
16. Widrig R, Suter A, Saller R, et al. Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study. Rheumatol Int. 2007;27:585–591
17. Xiong W1, Cui T, Cheng K, et al.  Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012 Jun 4;209(6):1121-34.