Pain (Holistic)
About This Condition
- Rub on topical capsaicin
Block pain signals by applying an ointment that contains capsaicin, a substance found in cayenne peppers, to the painful area four times a day
- Get moving
Take part in a prescribed exercise program to boost the production of your body’s natural painkillers
- Give acupuncture a try
See a qualified practitioner for treatments that activate pain-killing pathways
- Take time for a checkup
Make an appointment with your healthcare provider to find out if your pain is being caused by a treatable condition
About
About This Condition
Pain is a sensation that is transmitted from an area of tissue damage or stress along the sensory nerves to the brain. The brain interprets the information as the sensation of pain.
Substances that decrease pain either interfere with the ability of nerves to conduct messages, or alter the brain’s capacity to receive sensations.
Pain may be a symptom of an underlying pathological condition, such as inflammation. It may also be due to other causes, such as bruising, infection, burns, headaches, and sprains and strains. Use caution when treating pain without understanding its cause—this may delay diagnosis of conditions that could continue to worsen without medical attention.
Symptoms
Symptoms of pain include discomfort that is often worsened by movement or pressure and may be associated with irritability, problems sleeping, and fatigue. People with pain may have uncomfortable sensations described as burning, sharp, stabbing, aching, throbbing, tingling, shooting, dull, heavy, and tight.
Healthy Lifestyle Tips
Body weight may be related to pain tolerance. One study indicated women who are more than 30% above the ideal weight for their age experience pain more quickly and more intensely than do women of ideal weight.1 No research has investigated the effect of weight loss on pain tolerance.
Exercise increases pain tolerance in some situations,2, 3 in part because exercise may raise levels of naturally occurring painkillers (endorphins and enkephalins).4 Many types of chronic pain are helped by exercise,5, 6, 7 though some types of physical activity may aggravate certain painful conditions.8 People who want to initiate an exercise program for increasing pain tolerance should first consult a qualified health professional.
Holistic Options
Transcutaneous electrical nerve stimulation (TENS) is a form of electrical physical therapy that has been used in the treatment of pain since the early 1970s. Pads are placed on the skin and a mild electrical current is sent through to block pain sensations. Many TENS units are small, portable, and may be hidden under clothing. A review of the first ten years of research on TENS described success rates in treating chronic pain varying from 12.5% to 92% after one year of treatment.9 Variations in success rates were attributed to differences in the type of pain the TENS was treating. More current research identifies specific conditions that consistently respond well to TENS therapy:10, 11rheumatoid arthritis, osteoarthritis, low back pain, phantom limb pain, and post-herpetic nerve pain (shingles). Pain caused by pinched nerves in the spine responds poorly to TENS therapy. While a small number of controlled trials have reported no benefit,12, 13 most evidence suggests TENS is an effective form of therapy for many types of pain.14, 15, 16
Relaxation exercises may decrease the perception of pain. Pain increases as anxiety increases; using methods to decrease anxiety may help reduce pain.17 In one controlled hospital study, people who were taught mind-body relaxation techniques reported less pain, less difficulty sleeping, and fewer symptoms of depression or anxiety than did people who were not taught the techniques.18
Acupuncture has been shown to decrease pain by acting on the enkephalin-based, pain-killing pathways.19 In 1997, the National Institutes of Health (NIH) stated that acupuncture is useful for muscular, skeletal, and generalized pain, as well as for anesthesia and post-operative pain. The NIH statement was based on a critical review of over 67 controlled trials of acupuncture for pain control.
Practitioners of manipulation report that it often produces immediate pain relief either in the area manipulated or elsewhere.20 Controlled trials have found that people given spinal manipulation may experience reduction in pain sensitivity of the skin in related areas,21, 22 a reduction in joint and muscle tenderness in the area manipulated,23 and a decrease in elbow tenderness when the neck was manipulated.24 One study showed no effect of lower spine manipulation on sensitivity to deep pressure over low back muscles and ligaments.25 Some researchers have speculated that joint manipulation affects pain by enhancing the effects of endorphins. However, only one26 of three27, 28 controlled studies has shown an effect of manipulation on endorphin levels.
Hypnosis has been shown to significantly reduce pain associated with office surgical procedures that are performed while the patient is conscious (i.e., without general anesthesia).29 People undergoing office surgical procedures received standard care, structured attention or self-hypnotic relaxation in one study. Those using self-hypnosis had no increases in pain during the procedures, compared to those in the other groups. Hypnosis also appeared to stabilize bleeding, decrease the requirement for narcotic pain drugs during the procedure, and shorten procedure time.
Supplements
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
| Supplement | Why |
|---|---|
3 Stars Cayenne Topical (Postherpetic Neuralgia) Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas | A component of cayenne pepper known as capsaicin can be applied as a cream or ointment to soothe the pain of postherpetic neuralgia. The hot component of cayenne pepper, known as capsaicin, is used to relieve the pain of postherpetic neuralgia. In a double-blind trial, a cream containing 0.075% capsaicin, applied three to four times per day to the painful area, greatly reduced pain. In another study, a preparation containing a lower concentration of capsaicin (0.025%) was also effective. Two or more weeks of treatment may be required to get the full benefit of the cream. |
3 Stars Chili Peppers Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas | Capsaicin, an extract of cayenne pepper, appears to work by blocking pain signals and may ease many types of chronic pain when applied regularly to the skin. Capsaicin is an extract of cayenne pepper that may ease many types of chronic pain when applied regularly to the skin. In animal studies, capsaicin was consistently effective at reducing pain when given by mouth, by injection, or when applied topically. A controlled trial in humans found that application of a solution of capsaicin (0.075%) decreased sensitivity of skin to all noxious stimuli. One review article deemed the research on capsaicin’s pain-relieving properties “inconclusive.” However, in several uncontrolled and at least five controlled clinical trials, capsaicin has been consistently shown to decrease the pain of many disorders, including trigeminal neuralgia, shingles, diabetic neuropathy, osteoarthritis, and cluster headaches. For treatment of chronic pain, capsaicin ointment or cream (standardized to 0.025 to 0.075% capsaicin) is typically applied to the painful area four times per day. It is common to experience stinging and burning at the site of application, especially for the first week of treatment; avoid getting it in the eyes, mouth, or open sores. |
3 Stars L-Tryptophan 2 to 4 grams per day | Double-blind research has also shown that oral L-tryptophan can increase tolerance to acute pain. Other amino acids may be beneficial in reducing pain. Animal research has shown that the brain chemical serotonin is involved in pain perception, and some, though not all, preliminary human studies have reported reduced pain sensitivity when people took 2.0 to 2.75 grams per day of L-tryptophan, a precursor of serotonin. In a double-blind study, patients recovering from gallbladder surgery reported less pain when they were given L-tryptophan intravenously in the amount of 7.5 to 15 mg per 2.2 pounds body weight. Double-blind research has also shown that oral L-tryptophan can increase tolerance to acute pain when taken in amounts of at least 2 grams per day. Two double-blind trials found that 3 to 4 grams per day of L-tryptophan along with a low-protein, high-carbohydrate diet reduced pain in people with chronic pain. However, one controlled study did not find L-tryptophan (50 mg per 2.2 pounds of body weight per day) helpful for people with chronic pain around the temporomandibular joint. No research has been published investigating the pain control potential of 5-HTP (5-hydroxytryptophan), another serotonin precursor. |
2 Stars Corydalis Take an amount supplying 75 mg per day of tetrahydropalmatine (THP) | Preliminary reports indicate that THP (an alkaloid from the plant corydalis) may be effective in reducing nerve pain. Preliminary reports from Chinese researchers also note that 75 mg per day of THP (an alkaloid from the plant corydalis) was effective in reducing nerve pain in 78% of those tested. |
2 Stars Phenylalanine 1,500 mg daily | D-phenylalanine (DPA) decreases pain by blocking the enzymes that break down the body’s natural painkillers. Clinical studies suggest DPA may inhibit some types of chronic pain. Certain amino acids have been found to raise pain thresholds and increase tolerance to pain. One of these, a synthetic amino acid called D-phenylalanine (DPA), decreases pain by blocking the enzymes that break down endorphins and enkephalins, the body’s natural pain-killing chemicals. DPA may also produce pain relief by other mechanisms, which are not well understood. In animal studies, DPA decreased chronic pain within 15 minutes of administration and the effects lasted up to six days. It also decreased responses to acute pain. These findings have been independently verified in at least five other studies. Clinical studies on humans suggest DPA may inhibit some types of chronic pain, but it has little effect on most types of acute pain. Most human research has tested the pain-relieving effects of 750 to 1,000 mg per day of DPA taken for several weeks of continuous or intermittent use. The results of this research have been mixed, with some trials reporting efficacy, others reporting no difference from placebo, and some reporting equivocal results. It appears that DPA may only work for some people, but a trial period of supplementation seems worthwhile for many types of chronic pain until more is known. If DPA is not available, a related product, D,L-phenylalanine (DLPA), may be substituted at amounts of 1,500 to 2,000 mg per day. As early as 1981, preliminary human research showed that DPA made the pain-inhibiting effects of acupuncture stronger. One controlled animal study and two controlled trials in humans showed that DPA taken the day before acupuncture increased the effectiveness of acupuncture in reducing both acute dental and chronic low back pain. |
1 Star American Scullcap Refer to label instructions | American skullcap has been historically used to relieve pain. Other herbs that have been historically used to relieve pain (although there are no modern scientific studies yet available) include valerian, passion flower, American scullcap, Piscidia erythrina, and crampbark (Viburnum opulus). |
1 Star Cramp Bark Refer to label instructions | Crampbark has been historically used to relieve pain. Other herbs that have been historically used to relieve pain (although there are no modern scientific studies yet available) include valerian, passion flower, American scullcap, Piscidia erythrina, and crampbark (Viburnum opulus). |
1 Star Jamaica Dogwood Refer to label instructions | Piscidia erythrina has been historically used to relieve pain. Other herbs that have been historically used to relieve pain (although there are no modern scientific studies yet available) include valerian, passion flower, American scullcap, Piscidia erythrina, and crampbark (Viburnum opulus). |
1 Star Passion Flower Refer to label instructions | Passion flower has been historically used to relieve pain. Other herbs that have been historically used to relieve pain (although there are no modern scientific studies yet available) include valerian, passion flower, American scullcap, Piscidia erythrina, and crampbark (Viburnum opulus). |
1 Star Phyllanthus Refer to label instructions | Extracts of phyllanthus plants have shown a marked ability to decrease pain, apparently by decreasing inflammation. With liver-protective properties, they may be safer than drugs such as acetaminophen, which has toxicity to the liver. In animal research, alcohol/water extracts of plants from the genus phyllanthus (25 to 200 mg per 2.2 pounds body weight) have shown a marked ability to decrease pain. This family includes the plants Phyllanthus urinaria, P. caroliniensis, P. amarus, and P. niruri. Like aspirin, phyllanthus extracts appear to reduce pain by decreasing inflammation. Although they are six to seven times more potent than aspirin or acetaminophen in test tube studies, extracts of these plants also demonstrate liver-protective properties, suggesting they may be safer than drugs such as acetaminophen, which has well-documented toxicity to the liver. The usefulness of phyllanthus extracts for treating pain in humans is unknown. |
1 Star Valerian Refer to label instructions | Valerian has been historically used to relieve pain. Other herbs that have been historically used to relieve pain (although there are no modern scientific studies yet available) include valerian, passion flower, American scullcap, Piscidia erythrina, and crampbark (Viburnum opulus). |
1 Star Vitamin B12 Refer to label instructions | Vitamin B12 appears to have pain-killing properties. In people with vertebral pain syndromes, injections of massive amounts of vitamin B12 have reportedly relieved pain. Vitamin B12 has exhibited pain-killing properties in animal studies. In humans with vertebral pain syndromes, injections of massive amounts of vitamin B12 (5,000 to 10,000 mcg per day) have reportedly provided pain relief. Further studies are needed to confirm the efficacy of this treatment. |
1 Star White Willow Refer to label instructions | Willow bark has been used for centuries to decrease pain and inflammation. It appears to work by interfering with the process of inflammation and the pain-producing nerves in the spinal cord. As early as 1763, use of willow bark to decrease pain and inflammation was reported. Its constituents are chemically related to aspirin. These constituents may decrease pain by two methods: by interfering with the process of inflammation, and by interfering with pain-producing nerves in the spinal cord. No human studies have investigated the pain-relieving potential of willow bark, and questions have been raised as to the actual absorption of willow bark’s pain-relieving constituents. The potential pain-reducing action of willow is typically slower than that of aspirin. |
References
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2. Guieu R, Blin O, Pouget J, Serratrice G. Nociceptive threshold and physical activity. Can J Neurol Sci 1992;19:69-71.
3. Fordyce W, McMahon R, Rainwater G, et al. Pain complaint—exercise performance relationship in chronic pain. Pain 1981;10:311-21.
4. Schwarz L, Kindermann W. Changes in beta-endorphin levels in response to aerobic and anaerobic exercise. Sports Med 1992;13:25-36 [review].
5. Ferrell BA, Josephson KR, Pollan AM, et al. A randomized trial of walking versus physical methods for chronic pain management. Aging (Milano) 1997;9:99-105.
6. McCain GA. Nonmedicinal treatments in primary fibromyalgia. Rheum Dis Clin North Am 1989;15:73-90.
7. Kottke TE, Caspersen CJ, Hill CS. Exercise in the management and rehabilitation of selected chronic diseases. Prev Med 1984;13:47-65 [review].
8. Cowan P, Lovasik DA. American Chronic Pain Association: strategies for surviving chronic pain. Orthop Nurs 1990;9:47-9 [review].
9. Tapio D, Hymes AC. New Frontiers in TENS. Minnetonka, MN: LecTec Corporation, 1987, 63-9.
10. Nicholas JJ. Physical modalities in rheumatologic rehabilitation. Arch Phys Med Rehabil 1994;75:994-9.
11. Gersh, MR. Transcutaneous electrical nerve stimulation (TENS) for management of pain and sensory pathology. In Electrotherapy in Rehabilitation. Philadelphia: F.A. Davis Company, 1992.
12. Long DM. Fifteen years of of transutaneous electrical stimulation for pain control. Stereotact Funct Neurosurg 1991;56:2-19.
13. Carroll D, Tramer M, McQuay H, et al. Randomization is important in studies with pain outcomes: systemic review of transcutaneous electrical nerve stimulation in acute postoperative patients. Br J Anaesth 1996;77:798-803.
14. Oliveri AC, Clelland JA, Jackson J, Knowles C. Effects of auricular transcutaneous electrical nerve stimulation on experimental pain threshold. Phys Ther 1986;66:12-6.
15. Lander J, Fowler-Kerry S. TENS for children's procedural pain. Pain 1993;52:209-16.
16. Long DM. Current status of electrical stimulation on the nervous system for the relief of chronic pain. Surg Neurol 1998;49:142-4.
17. Robin O, Vinard H, Vernet-Maury E, Saumet JL. Influence of sex and anxiety on pain threshold and tolerance. Funct Neurol 1987;2:173-9.
18. Rybarczyk B, DeMarco G, DeLaCruz M, Lapidos S. Comparing mind-body wellness interventions for older adults with chronic illness: classroom versus home instruction. Behav Med 1999;24:181-90.
19. U.S. Department of Health and Human Services. Public Health Service. Acupuncture. NIH Consensus Statement 1997;15:1-34.
20. Vernon H. Qualitative review of studies of manipulation-induced hypoalgesia. J Manipulative Physiol Ther 2000;23:134-8.
21. Glover JR, Morris JG, Khosla T. Back pain: a randomized clinical trial of rotational manipulation of the trunk. Br J Indust Med 1974;31:59-64.
22. Terrett ACJ, Vernon HT. Manipulation and pain tolerance: a controlled study of the effect of spinal manipulation on paraspinal cutaneous pain tolerance levels. Am J Phys Med 1984;63:217-25.
23. Vernon HT, Aker P, Burns S, et al. Pressure pain threshold evaluation of the effect of spinal manipulation in the treatment of chronic neck pain: a pilot study. J Manipulative Physiol Ther 1990;13:13-6.
24. Vicenzino B, Collins D, Benson H, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylagia. Pain 1996;68:69-74.
25. Cote P, Mior SA. The short-term effect of a spinal manipulation on pain/pressure threshold in patients with chronic mechanical low back pain. J Manipulative Physiol Ther 1994;17:36-48.
26. Vernon HT, Dhami MS, Howley, TP, et al. Spinal manipulation and B-endorphin: a controlled study of the effect of a spinal manipulation on plasma B-endorphin levels in normal males. J Manipulative Physiol Ther 1986;9:115-23.
27. Christian GF, Stanton GJ, Sissons D, et. al. Immunoreactive ACTH, B-endorphin and cortisol levels in plasma following spinal manipulative therapy. Spine 1988;13:141-7.
28. Sanders GE, Reinnert O, Pepe R, et al. Chiropractic adjustive manipulation on subjects with acute low back pain: visual analogue scores and plasma b-endorphin levels. J Manipulative Physiol Ther 1990;13:391-5.
29. Lang EV, Benotsch EG, Fick LJ, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet 2000;355:1486-90.
Last Review: 06-08-2015
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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.
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