An herbal guide to natural pain relief

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Chronic pain is debilitating, affects millions of people each year, and is a growing public health problem. In 2010, it was costing the nation up to $635 billion each year. The number of people suffering has grown and the economic cost is likely much higher
The pharmaceutical industry is pouring money into a growing population of people who need pain relief, despite available natural options without the list of side effects and adverse events associated with pain medication
Herbal options for pain are typically the most effective for chronic pain after several weeks. Because they can interact with other herbs and drugs, it's important to consult with a provider familiar with natural options
Consider investigating the use of willow bark, ginger, turmeric, rosehips, Boswellia and feverfew to name a few. The risk-benefit ratio in some herbs is too high, making them a poor choice, such as thunder god vine
Other strategies can help support pain management, such as supplementing with choline and orange essential oil, and choosing the right foods

Chronic pain is debilitating and affects the lives of millions of people each year. While the pharmaceutical industry has contributed to the rising opioid epidemic and death rates by encouraging the use of opioids, there are several herbal solutions to help reduce your pain and improve your quality of life.

In 2021, the CDC1 estimated 20.9% of all adults had experienced chronic pain and 6.9% experienced high-impact chronic pain, which the CDC defined as pain that substantially restricts daily activities. In 2023, an NIH report2 showed that new cases of chronic pain occur more often than diabetes, high blood pressure and depression.

The data from the NIH showed that the rate of chronic pain in U.S. adults increased slightly from 2021 to 21%, but high-impact pain rose over 1% to 8%. The NIH wrote that the links between chronic pain and the opioid epidemic "underscores the urgency to understand and address the issue of pain."3

The high cost of chronic pain is measured in dollars and emotional distress. The economic cost is measured in unemployment, poverty, self-medication with alcohol and street drugs, and health care dollars. A large study in 20104 showed the cost to the nation at that time was up to $635 billion each year. In 2023 dollars that would be equal to $882 billion.5 This points to pain as a major public health challenge.

The Need for Natural Pain Solutions

A lot of money is poured into treating neck and back pain, two of the more common areas of chronic pain. Yet, as the pharmaceutical industry pours more into “discovering” medications that might help alleviate pain, the options typically come with a long list of side effects and some, like Vioxx,6 Darvon and Darvocet,7 are pulled off the market when the side effects include heart problems, stroke and death.

Common side effects from pain medications include constipation, stomach ulcers, nausea, clouded thinking, drowsiness and in some cases, addiction.8 Data also show that men and women perceive pain differently.

Research into gender differences in pain perception9 found that when men and women are exposed to identical pain stimulation, women rate the pain higher on a pain scale. Factors that may affect pain perception include sex hormones, emotions, age, attitude and a learned response from past experiences.

The rising number of people with chronic pain and subsequent economic and emotional costs, gender differences in pain perception and a high number of disrupting and even dangerous side effects from pharmaceutical options point to the need for finding effective natural pain solutions without high costs and significant side effects.

Herbal Options for Chronic Pain

The following alternative herbal options for chronic pain offer a balanced approach. However, it is important to recognize that they can also interact with any drugs you are taking. Before adding herbal remedies to your regimen, it is important to consult with health care providers who are familiar with natural options, such as naturopathic doctors or herbalists. Note that herbal remedies typically work best after taking them for weeks and are not always effective for acute pain.

There are limited data on using herbs in women who are pregnant or breastfeeding and in children, so herbal remedies in this group should be avoided unless they are recommended by a health care provider. Additionally, while some herbs reduce inflammation and pain, the risk-benefit ratio may be too high in some people. Of course, there are also spices and plant extracts that have shown efficacy in treating pain, but the following are herbs that can help with natural pain relief.

1. Willow bark — Extracts from the willow tree have anti-inflammatory properties and have long been used to treat fever and pain.10 The active ingredient, salicin, is similar to aspirin. Willow bark also contains other flavonoids, polyphenols and salicylates that help reduce inflammation in a way that's similar to nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen or ibuprofen.

The most commonly reported side effects are gastrointestinal issues and allergic reactions.11 Children may be at higher risk of Reye's syndrome, and it should be avoided in women who are pregnant since it crosses the placental barrier.

In a 2013 study of 436 patients, those taking willow bark extract with musculoskeletal pain demonstrated a significant reduction in pain. In another study with 128 patients receiving standardized willow bark extract, the researchers found patients experienced relief from mild to fairly severe coxarthrosis or gonarthrosis comparable to that of standard therapies, without the subsequent adverse events.

2. Ginger — Ginger has a high number of compounds called gingerols, which are recognized as anti-inflammatories through metabolizing arachidonic acid.12 The botanical name is Zingiber officinale and it has been used by herbalists for roughly 2,500 years.13

Ginger is found growing natively in tropical countries and has a long list of medicinal properties, including having been used to treat digestive and appetite problems, prevent motion sickness, reduce muscle pain, swelling and arthritis, and relieve hyperemesis gravidarum.

Data describe a delay in therapeutic action, so it is not helpful for acute pain conditions. Side effects can include drowsiness and heart arrhythmias as well as interference with platelet aggregation and increased bleeding time, especially when used with other herbs or drugs that have the same risk of bleeding.

In one double-blind, placebo-controlled, randomized clinical trial with 60 patients suffering from migraine headaches, researchers found those who received ginger and NSAIDs had significantly better clinical responses. Other trials demonstrated ginger could significantly improve pain in knee osteoarthritis and reduce knee swelling.

3. Turmeric — Turmeric comes from the rhizome of the plant and has the active polyphenolic compound called curcumin.14 Traditionally, turmeric has been used as an anti-inflammatory agent that promotes wound healing and has an analgesic effect. Curcumin is known to regulate inflammatory cytokines, and this effect has proved useful in autoimmune diseases such as multiple sclerosis and rheumatoid arthritis.

Curcumin and turmeric also inhibit platelet aggregation, and so caution must be used when using it with other drugs that have a similar potential. Studies have demonstrated a reduction in pain in patients with osteoarthritis and an improvement in quality-of-life scores in women with breast cancer.

4. Rose hips — In standardized trials,15 rose hip powder has been beneficial in reducing pain in people with osteoarthritis without major side effects. In one review of the literature16 researchers found data showing rose hip powder lowered serum measurements of C-reactive protein and over three months, participants experienced a 13% decline in pain relative to no change measured in those taking a placebo.

A meta-analysis of three trials with 287 patients showed standardized rose hip powder consistently lowered pain scores and people taking the rose hip powder were twice as likely to respond as those who took a placebo. Additionally, rose hip powder does not have ulcerogenic effects, nor does it inhibit platelet aggregation.17

5. Devil’s claw — This is a popular medicinal plant native to South Africa that has a reputation for traditional use for the treatment of pain, malaria and liver and kidney problems.18 According to Mount Sinai, there have been several studies that demonstrate a reduction in pain and an improvement in physical functioning after taking Devil's claw for eight to 12 weeks.

When compared against a leading European medication, those taking Devil's claw experienced the same pain relief with fewer side effects. Other data showed it may relieve joint pain and was at least moderately effective in people with arthritis.

6. Boswellia — This herb is also known as frankincense. In a 2020 literature review19 of seven trials and 545 patients, the researchers found that Boswellia helped relieve pain, stiffness and improved joint function leading them to conclude that it could be “an effective and safe treatment option for people” with osteoarthritis.

In a 2018 study,20 patients with osteoarthritis received a combination of curcumin and boswellic acid and experienced a reduction in pain symptoms over 12 weeks.

7. Feverfew — This herb has a long history of use for the treatment of inflammation, headaches and fever.21 In the late 20th century, it was used for migraine headaches. In addition to anti-inflammatory action, it also inhibits serotonin release and platelet aggregation, which increases the risk of bleeding when used with other herbs or medications with the same characteristic.

Clinical studies have demonstrated the administration of feverfew and ginger may be an effective first-line abortive treatment for migraines and feverfew alone may help reduce the frequency of migraine attacks

8. Thunder god vine — This traditional Chinese herb has anti-inflammatory and analgesic effects.22 While it has been useful in patients with rheumatoid arthritis pain, it is also associated with several significant side effects, including renal insufficiency, decreased male infertility, hematotoxicity and immune suppression. Clinical researchers do not recommend use due to the high risk-benefit ratio.

9. Black cohosh — According to The Herbal Academy,23 while black cohosh is more commonly used in women during menopause, it was traditionally used as an antispasmodic for cramping and muscle pain of any type, as well as for nerve-related and spinal cord injury-related pain.

10. Corydalis — This flowering plant is in the poppy family and has been used in traditional herbalism for strong pain.24 However, the herb can have significant side effects, including dizziness and nausea, so it is best used under the careful guidance of an experienced herbalist or physician.

11. Rosemary — Rosemary grows natively along the Mediterranean Sea and in sub-Himalayan areas. It's been used in traditional medicine for headaches, migraine and depression, and as a mild analgesic and antispasmodic. There is evidence that rosemary has significant anti-inflammatory, antioxidant, antitumorigenic and neuroprotective properties as well as clinical effects on memory, pain, anxiety and sleep.25

12. Ashwagandha — Ashwagandha has been used in Ayurvedic medicine for thousands of years to help improve immune health, cognitive function and sleep. A 2016 randomized, double-blind, placebo-controlled study26 analyzed the effect in 60 patients with knee joint pain.

At the end of 12 weeks, the researchers found a significant reduction in pain, stiffness and disability compared to baseline measurements and placebo. The group taking 250 mg showed the earliest improvement at 4 weeks.

More Strategies That Can Help Lower Pain Perception

Although the focus of this article is on a guide to herbal remedies that can help lower or eliminate your pain, I’ll briefly mention other strategies with links to past articles that you might consider using alongside herbs to improve pain management.

• Steer clear of steroids — While steroid injections sometimes lessen the immediate pain, data show they can make the joints worse and over time can increase pain. Additionally, there is a lack of evidence to support using steroids and shots in the knee may be no more effective than a placebo.

• Food — Food is powerful medicine as it can significantly impact inflammation and therefore, pain, in a variety of chronic conditions. Arthritis is one of those conditions. There are over 100 different types that include symptoms of pain, stiffness and swelling.

Food compounds such as sulforaphane, anthocyanins and compounds found in a variety of spices can help lower pain. Conversely, a diet high in sugar and ultraprocessed foods can alter your gut microbiome and promote inflammation.

• Choline — This precursor to acetylcholine is likely an important part of pain relief, yet an estimated 90% of the population is deficient. Groups with the highest risk of deficiency include pregnant and breastfeeding women, endurance athletes, people who drink a lot of alcohol, postmenopausal women and vegetarians and vegans.

• Orange essential oil — Orange essential oil used for massage or aromatherapy has helped significantly relieve pain in women in labor and older adults with moderate to severe knee pain. The oil also helps ease stress and anxiety and boosts relaxation and mood.

Sources and References

An herbal guide to natural pain relief

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