Treating Aches and Pains with Natural Remedies
by Roberta Lee, MD (topic expert: health)

More than 10 million sports injuries are treated every year in the U.S. That number may rise dramatically as aging baby boomers decide to start an exercise routine for the first time (or after a long pause), increasing the likelihood of joint pain. Injuries such as stress fractures, shin splints, tendonitis, runner's knee and tennis elbow are some of the most common complaints from active individuals [1].

To reduce the inflammation and pain from our sports injuries, most of us pop a few over-the-counter remedies. Our medicine cabinet shelves are groaning with multiple store-bought painkillers like aspirin, ibuprophen and other over-the-counter non-steroidal anti-inflammatory medicines (NSAIDs). The benefit of such remedies is the quick relief from pain that comes usually in a matter of hours and in some cases days or weeks. But for some, there is a downside - stomach pain - both for over-the-counter and doctor-ordered NSAIDS. Out of 70 million anti-inflammatory prescriptions written, 100,000 individuals will be admitted for NSAID-related medical problems - usually gastric ulcers [2].

What are those individuals who suffer side effects from these painkillers to do? Are there any natural herbals that work, and which ones are best? These are questions my patients often ask.

For minor joint pains, turmeric (Curcuma longa) and ginger (Zingiber officininale) supplements are good choices. Turmeric, one of the five spices found in curry, is a root whose active ingredients have significant anti-inflammatory fighting agents [3]. The compounds responsible for reducing inflammation are curcumoids and turmerones. These compounds work on the body's prostaglandins, leukotrienes, and cyclooxygenase enzymes in the same way that conventional NSAIDs work to reduce pain and swelling. Turmeric is taken orally, 500 mg four times daily [4]. Curcumin, a slightly more purified form of turmeric, is also effective as an anti-inflammatory botanical and its dose is 200 mg to 2 grams per day in divided doses. Ginger works much the same way that turmeric does to exert an anti-inflammatory influence in the body. Its active constituents are gingeraol, gingerdione and shogoal. The standard dose is 250 mg four times a day. These supplements are readily available at any health food store and are not too expensive. They are taken with food. Though side effects are rare, some may experience indigestion.

You might also consider adding these herbs to your diet to promote additional anti-inflammatory influences in your body. One example would be to include the consumption of dishes containing curry regularly in your meals. Candied ginger has anti-inflammatory benefits as well. For general health promotion, there isn't really a specific "dose" or amount to take. Both turmeric and ginger have been studied in small trials evaluating the effectiveness for osteoarthritis or degenerative joint disease. While the botanicals showed promising results, the small sizes of the studies rendered the results inconclusive.

Another more extensively researched botanical, great for reducing pain and inflammation, is devil's claw (Harpagophytum procumbens). This root, native to Africa, has been investigated in several trials testing its ability to reduce pain from the most common form of arthritis, degenerative joint disease or osteoarthritis and non-surgical back pain. In several small trials a modest improvement in pain and lessening of the need for other analgesics was achieved. The usual dose for this supplement is approximately 2 grams/day in divided doses. Devil's Claw is readily available in most health food stores and usually comes in capsule form.

The downside of botanical supplements is that they usually take more time to reduce inflammation and pain. For chronic pain, it can take as much as a month or more to achieve maximum relief. So why even consider a botanical supplement, given the potential for delayed improvement? Is the use of supplements such as these worth it? This is really a question that only you and your healthcare provider can really answer. Every person's health history is unique. In a situation where one may have to take non-steroidal anti-inflammatory medication for long periods of time, months to years for example, the consideration of intermittent or continued use of botanicals may make sense.

To get quick relief, you might want to start with a conventional NSAID and transition to a botanical preparation. As with any supplement or medication each individual should make sure to consult with his or her healthcare practitioner and inform them of the use of these supplements, as medications can interact with botanical supplements. Additionally, allergic reactions can occur with any ingested botanical supplement as it can with medication.

Sources:

1. Beers M, Fletcher A, Jones T et al. The Merck Manual of Medical Information, second edition. 2003. Merck Research Laboratories, Whitehouse Station, NJ.
2. www.jr2ox.ac.uk/bandolier/booth/painpag/nsae/nsae.html in Bandolier: Evidence based thinking about healthcare. "NSAIDs and adverse effects" accessed July 5, 2007
3. www.naturaldatabase.com Ginger accessed 6/20/07
4. www.naturaldatabase.com Turmeric accessed 6/20/07.