Herbal Remedies and Pain

Herbal remedies are medications made directly from the leaves, stems, roots and/or seeds of plants. They are also known as natural, complimentary, alternative, homeopathic and holistic medications or preparations.

Herbal remedies have been used for thousands of years by all major cultures of the world. In fact the World Health Organization (WHO) reports that herbal remedies are the primary medicines for approximately 80% of the world’s population today. It is estimated that 50% of adults in the U.S. have used an herbal product at least once and 25% use them on a regular basis.

Herbal remedies were the primary source of medications prescribed by physicians in the U.S. until the early 1900’s. With the rise of technology, many herbal remedies were synthesized into the medications we use today. Approximately 75% of modern medicines come from plant derivatives. Some examples include:

  • Poppy plant – Morphine
  • Belladonna – Atropine
  • Foxglove – Digoxin
  • Willow Bark – Aspirin
  • Yew Tree – Taxol

Since the 1960’s, Americans have become more interested in pursuing less conventional and more “natural” treatments for their medical problems. It is estimated that Americans spent $5 billion a year on herbal remedies.

Although these herbal remedies are considered “natural”, they are not without their complications and adverse side effects.

Herbal remedies are considered dietary supplements by law. They are not considered drugs because they cannot obtain patent rights. Therefore, the Food and Drug Administration (FDA) does not legally require herbal medications to undergo scientific testing before they are available to the public. The FDA may remove an herbal medication once it is on the market if it proves it is not safe.

As a result, there is a lack of regulation of herbal remedies leading to the following problems:

  • Lack of warning labels about adverse effects and problems which may occur when used with other drugs
  • Concentrations and strengths of herbal preparations can be inconsistent or not even exist
  • Toxic substances may be added, either intentionally or by accident, such as pesticides, heavy metals (such as lead or mercury) and prescription drugs

It is estimated that 20% of people who use prescription drugs also use herbal remedies. And 70% do not tell their doctors they are taking these herbal preparations. Due to the lack of regulation, and because there may be effects if they are taken with other drugs, when a physician does not know what herbal preparations a patients takes, the risk for problems is increased.

The remainder of this article will focus primarily on herbal remedies used for pain control and their potential complications.

Herbal Remedies Used for Pain

There are numerous herbal remedies sold in the U.S. for pain control. Of the top ten herbal remedies sold in the U.S., five are marketed directly for pain relief.

  • St. John’s Wort (Hypericum perforatum)

Use: Depression, Anxiety, headache, muscle and nerve pain
Adverse effects: Insomnia, anxiety, fatigue, headache
Serious problems may occur when used with these drugs: Antidepressants, triptans, opiods, HIV drugs, digoxin, warfarin, oral contraceptives, chemotherapy, albuterol

  • Echinacea (Echinacea purpura)

Use: Respiratory infection, urinary infection, wound healing, migraines
Adverse effects: Allergic reaction, nausea, stomach pain, diarrhea, dizziness
Serious problems may occur when used with these drugs: Acetaminophen, immunosuppressive therapy

  • Feverfew (Tanacetum parthenium)

Use: Migraine
Adverse effects: Headache, ulcers, GI upset
Serious problems may occur when used with these drugs: Anticoagulants

  • Ginger (Zingiber Officinale)

Use: Nausea, GI upset, thermal burns, topical analgesic
Adverse effects: Increase bleeding risk
Serious problems may occur when used with these drugs: Diabetic drugs, heart drugs, reflux and stomach ulcer drugs

  • Ginseng ( Panax quinquefolius)

Use: Memory, depression, headache, fatigue
Adverse effects: Anxiety, insomnia, headache
Serious problems may occur when used with these drugs: NSAIDS, antipsychotic drugs, hormones, MAOIs, immunosuppressants, opiods, alcohol

Other herbal remedies used for pain also include belladonna, capsaicin, camphor, chamomile, cloves, devil’s claw, cayenne, dong quai, white willow and yohimbe.

It is encouraging to note that more scientific studies are being performed to look at the effectiveness and safety of herbal remedies. For example, a recent study in Canada showed that devil’s claw, white willow bark, and cayenne plasters may be as effective as prescribed drugs for acute episodes of back pain. Also, ephedra (Ma huang) was taken off the market in 2004 by the FDA. Ephedra was used for weight loss and athletic performance and was responsible for serious cardiovascular side effects as well as reports of death and permanent disability.

Talk to your doctor

Herbal remedies can be effective and safe alternatives or adjunctive therapies to conventional medicine. However, great care must be taken to obtain these remedies from reliable sources. This will increase the likelihood that they are pure and the dosing is accurate. It is of vital importance to always review ALL of your medications (including prescribed drugs and herbal remedies) with all your healthcare practitioners in order to avoid adverse side effects and physical complications.