We asked Dr. Theresa Oswald, a holistic physician specializing in integrative approaches to pain and rehabilitation, how and why she uses herbs in her work with chronic pain patients.

Q: What is your opinion about using herbs to treat chronic or persistent pain?

A: Herbal medicine has an important role in treating persistent or chronic pain. Before discussing herbs, however, the first thing we need to discuss is diet. To get the most out of any herbal preparation you need to reduce chemicals in your diet that may be counteracting the herb’s desired effect. You can look at it this way: if you were going to use a medication for sleep you probably wouldn’t have a caffeine-loaded double shot of espresso, hoping the sleeping medicine would counteract the stimulating effect of caffeine. Ideally, what you want is a diet that supports the herb’s effect.

Herbal medicine has an important role in treating persistent or chronic pain.

Pain and inflammation are closely related, so reducing inflammation is important. A number of herbs have excellent anti-inflammatory properties, and following an anti-inflammatory diet will enhance the herbs’ effects. While prescription and over-the-counter medicines work regardless of your diet, herbs are more subtle and more sensitive to diet, and they are also gentler on your body.

If you want the most from herbal remedies, it is best to reduce processed foods in your diet and increase fruits and vegetables. Try to get about three cups of fruits and vegetables every day. I prefer vegetables because they usually include more important nutrients that enhance the herbal remedies’ effects.

In addition to diet, herbs have other healing allies that increase their effectiveness—for example, different types of movement, as well as stress reduction techniques like relaxation and breathwork.

Prescription and over-the-counter medicines such as ibuprofen are often the default remedy for pain, and you don’t need to modify your diet or lifestyle for them to work, but they carry side effects. Non-steroidal anti-inflammatory drugs (NSAIDs)—ibuprofen and others—can cause serious gastrointestinal complications. In one study, as many as 81 percent of the rheumatoid arthritis patients who had serious gastrointestinal complications from NSAIDs had no prior gastrointestinal symptoms. All this does not mean, however, that you can’t take a NSAID from time to time or under a doctor’s supervision.

Q: Is there one herbal remedy for treating chronic pain? Or does the remedy depend on the specific condition or type of pain a person is experiencing? Can I use herbs and traditional drug therapy at the same time?

A: Every patient with persistent pain is unique; therefore, no one particular herb will work for everyone. I consider each patient’s overall medical condition, past medical history, other medications, and other herbs being used, before I recommend an herbal remedy. There are several herbs and supplements that are helpful for reducing inflammation in the majority of people.

Prescription medications and herbal medications can interact, so it is extremely important to let your prescribing physician know of any herbal supplements you are taking. With proper guidance it is possible to use herbs and prescription medications together safely. Not all combinations are safe, so please seek expert advice! While homeopathic remedies are not herbs, they can be used with prescription medications without many interactions and are another useful pain relief strategy.

Q: How have patients in your practice benefited from the use of herbs instead of more traditional drug therapy when seeking relief from chronic pain?

A: Herbal remedies have been effective for my patients in reducing pain and improving function. While many of my patients simply prefer using herbs rather than prescription medications whenever possible, patients who are at high risk for gastrointestinal and cardiac-cardiovascular side effects rely on herbs because they cannot take NSAIDs safely. Other types of patients that especially need and benefit from herbal medicines are the elderly, those who are very sensitive to medications, and those needing to avoid potential confusion and sleepiness caused by some pain-relieving prescription medications.

Q: If someone does decide to use herbs for chronic pain, how long can they expect to wait for relief? And how long do patients need to continue taking herbs once they notice symptoms improving?

A: Normally with herbal use, patients see improvement in symptoms within days or weeks. The onset of pain relief is related to the length of time the pain has been going on. Pain of a persistent or chronic nature may take longer to respond to treatment. The duration of herbal use is related to the underlying source of pain. If the pain is related to an acute condition like an injury, the herb is taken until the symptoms resolve. In chronic conditions such as osteoarthritis, where the underlying pain trigger is persistent or recurrent, the herbal medicine is taken long term.

Q: Can you give a couple of examples of herbs you recommend for pain?

A: Two great herbs for inflammation control and muscle pain relief are turmeric and ginger. They are best when used in their natural form. According to Dr. Andrew Weil, whole plants are usually a better choice than isolated components of an herb until proven otherwise. That is why I recommend using turmeric and ginger as cooking spices that can be added to your current diet. Used in this way, they also act synergistically with the nutrients in your food for an enhanced effect.

The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.

—Thomas Edison

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