PAIN APPROACHED NATURALLY

Article by herbalist Dave Hawkins, MH, CNC

Recently I have been reading a lot about pain relievers and decided to do some research regarding the causes of pain and how it can be treated naturally. Of course we are all familiar with the most common pain reliever: aspirin. Aspirin (acetylsalicylic acid) is the synthetic form of salicylic acid that occurs naturally in many plants. Dr. Bayer, a German physician, synthesized it many years ago.

Natural forms of salicylates are found in willow bark, meadowsweet and wintergreen.

Many of you are familiar with NSAIDs (non steroidal anti-inflammatory drugs), ibuprofen, and acetaminophen. One definition I like for this class of drugs is what Dr. Michael Murray refers to as "New Sources Of Aspirin In Disguise". When looking deeper into the use of NSAIDs, you discovery that they are a double-edged sword. They relieve pain but at what price to the body, especially when you have to take high doses. Known side effects include: dyspepsia, peptic ulcerations, liver impairment, and kidney insufficiency.

For over three decades medical literature has warned about the negative side effects.  The use of these drugs is staggering, with over 35 million prescriptions written in 1995 alone and billions of dollars spent on non-prescription OTC NSAIDs. It is estimated that 107,000 people annually are admitted into hospitals with complications from NSAIDs and more than 16500 deaths occur from gastrointestinal bleeding annually. With this problem in mind, medical science has been trying to alleviate this problem.

In 1998, the FDA approved a new class of aspirin-like drugs called COX-2 inhibitors. These are sold under the name Celebrex and Vioxx. Over 2 two million prescriptions were written in 1999 alone. They are superior to NSAIDs with fewer side effects but are more costly. The question becomes: are there natural ways to block COX-2 (cyclooxigenase)?

Let’s look at how inflammation is formed and how the COX-1 and Cox-2 enzymes play a part in it all. Pain is a natural response mechanism of the body when under stress. Stress can be from many sources: injury, muscle tension, and degeneration of joint tissue. Pain due to injury and inflammation is a complex biochemical process involving a hormone substance called a prostaglandin. The Prostaglandin E-2 is the producer of inflammatory processes in the body. Aspirin and NSAIDs block the production of PGE-2 by the use of an enzyme system called cyclooxigenase. It was discovered in 1991 that there are two parts of this enzyme COX-1 and COX-2. COX-1 is a constant physiological housekeeper, so to speak. It is involved in the regulation of day to day cellular and metabolic activity such as maintaining stomach lining integrity, regulating blood flow to the kidneys and balancing blood platelet functions. The COX-2 expresses itself in response to a variety of pro-inflammatory stimuli and is found in the brain, male and female reproductive organs, kidneys and in bone forming tissues. COX-2 regulates prostaglandin E-2 within the cells. Remember inflammation is a vital part of healing and repairing. Aspirin works by inhibiting COX. NSAIDs and aspirin inhibit both forms of COX thus the side effect problems.

Let's look at some natural substances that work to block COX-2.

The first one is the herb turmeric. Turmeric contains a substance called curcumin. Turmeric is long been used in Asia and India in curries. There are several studies that show the anti-inflammatory effects of turmeric. Specifically it inhibits COX-2 in chronic inflammation, colon cancer, crohn's disease, irritable bowel, and have chemo-protective factors. It is safe and without side effects.

·         Ginger root, a relative of turmeric, has been also shown to be anti-inflammatory by blocking the formation of prostaglandin E-2 along similar pathways involving COX-2.

·         The ayurvedic herb boswella contains a substance boswellin that is not a COX-2 inhibitor but shows results when used in combinations with the above-mentioned herbs.

·         Omega -3 fatty acids found in the form of fish oil have been beneficial in reducing pain specifically in treating some cancer, heart disease, and both forms of arthritis.  A recent study found that omega-3 fatty acids (and none of the other fatty acids) dose dependently inhibited the production of Cox-2 without inhibiting Cox-1.

·         Resveratrol is a phytochemical found in the grape skin. It was determined in 1997 that the anti-inflammatory effects were due to Cox-2 inhibition.

The compounds flavanoids and phenolics are classes of plant chemicals that hold some promise as Cox-2 inhibitors. These include substances like quercetin (found in onions, and gingko), genistein (from soybeans), and polyphenols from green tea.

One thing about natural COX-2 inhibitor is that they are slower acting than their synthetic counterpart. It takes weeks for the benefits to be noticed enough to reduce pain. This leads us to a few other substances that can work along side to produce quicker benefits.

The use of willow bark, meadowsweet, and wintergreen as analgesics combined with nervines like skullcap, passion flower and feverfew can help take the edge off pain. The use of cayenne pepper has promise in blocking the formation of substance p in the brain, a natural pain blocker.

The use of b-complex vitamins along with calcium/magnesium can reduce tension in muscles and nourish the nervous system. The use of DL-phenylalnine (a protein amino acid) has shown to increase the level of pain relieving endorphins.  It takes a period of two weeks to be effective.

Some dietary restrictions would apply with the reduction of red meat due to high levels of arachadonic acid, the precursor to PGE-2 formation. Reducing the use of refined and artificial sweeteners along with the elimination of soda pop.

Increasing the use of water is also recommended. One study showed that inflammation has dehydration as part of its pathway.

As with any condition it is important for you to do your homework and consult with your healthcare professional of choice when dealing with specific condition.