Nutritional Supplements for Chronic Pain
Julian Whitaker, MD
Why turn to dangerous drugs to alleviate arthritis pain when there are so many safe and effective nutritional supplements out there? Here’s an overview of some of my favorite supplements for treating arthritis.
Univestin is a proprietary blend of Chinese skullcap and acacia, combined with ginger, rutin (a flavonoid), and bromelain and papain (plant enzymes). This formula is especially effective at quelling inflammation and pain caused by arthritis. I received a letter from a subscriber to my newsletter, Health & Healing, who had suffered with hip pain since 1988. Refusing to believe his doctor’s proclamation that permanent pain relief was unattainable, he tried every remedy he could get his hands on—so many, in fact, that his “closet looked like a pharmacy shelf.”
Then he read about this herbal pain reliever in Health & Healing and, with his “usual skepticism,” started taking it. He wrote, “To my utmost astonishment and disbelief, the pain started melting away. I began having a feeling I had not had for 17 years—the feeling of wellness.”
Suggested daily dose: 500 mg
EPA, an omega-3 fatty acid in fish oil, is a potent anti-inflammatory. It works in a manner similar to NSAIDs, only better. Rather than dampening the production of prostaglandins across the board, it suppresses only those that cause pain and inflammation. And because inflammation is a primary cause of pain, fish oil is a great therapy for discomfort of any kind.
Concerned about the dangers of prescription painkillers, Joseph C. Maroon, MD, of the Department of Neurological Surgery at the University of Pittsburgh School of Medicine, conducted a study of fish oil’s effects on pain. Over a three-month period, he enrolled 250 patients with back pain, primarily caused by degenerative disc disease, who were taking NSAIDs for pain relief (75 percent were on COX-2 inhibitors). He gave them fish oil capsules containing 2.4 grams of DHA and EPA every day for two weeks, then reduced their daily dose to 1.2 grams and followed them for an average of 75 days.
Here’s what happened: 59 percent discontinued their NSAID medications, 60 percent reported an improvement in overall pain, and a whopping 88 percent said they were so satisfied with the improvement that they planned to keep taking fish oil outside of the study! Plus, only two people reported any type of negative side effect (diarrhea).
Suggested daily dose: 1.2-2.4 g EPA (The number of fish oil capsules varies depending on concentration; check labels.)
Glucosamine and Chondroitin Sulfate
Cartilage is in a constant process of breakdown and rebuilding. Glucosamine simply provides the body with the raw materials needed for cartilage regeneration. Glucosamine has been studied in scores of clinical trials. In one study, 80 patients with arthritis of the neck, joints, or lumbar spine were given either 1,500 mg of glucosamine sulfate or a placebo for 30 days. The glucosamine group experienced significant improvements, compared to the placebo group. The researchers then examined cartilage samples from several of the patients taking glucosamine and found that they showed no signs of degeneration.
Another study matched up glucosamine with ibuprofen (Motrin). Taking the same dose as in the above study or a therapeutic dose of ibuprofen, the NSAID was more effective during the first two weeks of the study in alleviating pain. By the end of the eight-week study period, however, glucosamine had caught up with—and surpassed—ibuprofen. In addition, its benefits were noted after patients stopped taking it. This is further proof that glucosamine is doing much more than providing temporary pain relief.
Chondroitin sulfate is an ingredient in many joint formulas, and it appears to work well in combination with glucosamine. It inhibits enzymes that break down cartilage. It also attracts and holds water, which is very important, as water gives cartilage its resiliency and cushioning effects.
Suggested daily doses: 1,500 mg of glucosamine sulfate; 1,200 mg of chondroitin sulfate
White Willow Bark has a long history as an effective therapy for pain relief. In fact, aspirin was originally derived from the bark of this tree, although today’s synthesized version contains only one of its components. Asalixx is a white willow bark extract with a wider range of active constituents, which contributes to its superior efficacy and safety. In a double-blind trial involving patients with low back pain, this supplement was shown to pack a pain-relieving punch similar to the much more expensive and dangerous COX-2 inhibitors.
Suggested daily dose: depends on form (tea, tincture, etc.)—use as directed; 2 tablets of Asalixx twice a day or as needed
Curcumin is the active ingredient in turmeric (Curcuma longa), the yellow-orange spice in curry. It has perhaps the strongest anti-inflammatory activity of all the medicinal herbs and has been compared to NSAIDs in terms of efficacy. Curcumin is also showing promise as a protector against degenerative disorders of the brain. Look for a product with a standardized extract of the active ingredient curcumin.
Suggested daily dose: 800 mg
Bromelain is an enzyme from pineapple that acts on prostaglandin pathways to reduce pain and inflammation. Take on an empty stomach in divided doses for best results.
Suggested daily dose: Enzymes may be labeled in mg, GDUs, FIPs, or other units of strength. To avoid confusion, use as directed.
Boswellia, an extract from the Boswellia serrata tree, comes from ancient India. Studies of patients with both osteoarthritis and rheumatoid arthritis have noted significant improvement boswellia.
Suggested daily dose: 100-400 mg
Feverfew (Tanacetum parthenium) relieves arthritis and other pain conditions by inhibiting prostaglandin production. Look for products containing a standardized extract of parthenolide.
Suggested daily dose: 100 mg (600 mcg parthenolide)
Ginger (Zingiber officinale), the common cooking spice, also mediates prostaglandin pathways and so alleviates pain and inflammation. Get fresh ginger at the grocery store and eat a little every day, or supplement with 100 mg daily.
Suggested daily dose: depends on form (fresh, ground, tincture, etc.)—use as directed
DMSO & MSM
DMSO (dimethyl sulfoxide) is a sulfur compound that is an excellent therapy for inflammatory conditions. This remarkable substance can be used orally, intravenously, or topically. Most patients with arthritis find topical application the most convenient. Simply rub it on stiff, painful joints. The only downside is a rather strong garlicky odor, especially when used intravenously. This shouldn’t be much of a problem with occasional topical use.
MSM (methylsulfonylmethane) has many of the same properties as DMSO, minus the smell. Its potent anti-inflammatory actions blocks the pain response in nerve fibers. Stanley Jacob, MD, the “father” of DMSO and MSM carried out a study of patients with symptomatic arthritis. Half were treated with 2,400 mg of Motrin daily, and the other half received 3,000 mg of MSM. After one month, both groups noted equal improvements in pain and stiffness. MSM is safe and nontoxic, but some people experience gastrointestinal upset when taking larger doses.
Suggested daily dose: 1,000-4,000 mg of MSM; topical application of DMSO as needed
Cayenne pepper (Capsicum frutescens) has been used therapeutically for centuries. What makes it such an effective arthritis therapy—and what makes it so hot—is a substance called capsaicin. Capsaicin works by depleting substance P, a neuropeptide produced by the nerves that carry pain sensation (the “p” stands for pain). Skin ointments containing capsaicin have been shown to significantly relieve arthritis pain. The first application often causes a burning sensation; however, as substance-P is depleted, this discomfort goes away.
Suggested daily dose: topical application as needed
Penetran+Plus is a topical ointment that contains a nitrogen compound called quaternary amines. Quaternary amines decrease pain by stabilizing the electrical charges of injured cell membranes. Normal cells have a positive charge inside the cell and a negative charge outside the cell. When cell membranes are injured, these electrical charges are disturbed and pain ensues. Penetran+Plus, like many injectable medications used for pain relief, works by reestablishing the electrical balance in cell membranes.
Try rubbing Penetran+Plus into your skin until pain relief occurs, two to three times a day. Results will probably be faster and more reliable in joints closer to the skin surface, such as the hands, ankles, elbows, and knees, compared to the hips and back.
Suggested daily dose: topical application as needed
- Look for these items in your health food store or order by calling (800) 810-6655.
Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2007. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.