Natural Approaches to Addressing Pain and Inflammation

by Joy Choquette | November 1, 2024

What natural health experts and manufacturers are looking for now in the area of pain and inflammation.

Pain statistics in the U.S. are alarming. From 2019 to 2021, the Centers for Disease Control and Prevention (CDC), tracked chronic pain among adults. The study which compiled those results found that approximately 20.9 percent of adults in the United States suffered from chronic pain.1 Additionally, 6.9 percent of individuals in this country experienced “high-impact chronic pain” which the study defined as resulting in substantial reduction of daily activities.

Why are Americans experiencing pain and inflammation at such high rates? What types of pain are most common and which lifestyle changes might reduce symptoms? And are there natural health supplements which might help? Natural health experts and representatives from manufacturing firms across the nation weighed in.

Different Types of Pain and Inflammation

There are two main types of pain, explained Dr. Elizabeth Livengood, of Livengood Health, based in Arizona. The two types are categorized as acute or chronic pain. “Acute pain is usually from an injury or illness, while chronic pain is often caused by a specific disease process. Injury or illness is often identified and treated quickly in the emergency or primary care setting,” she explained. “Chronic pain often presents a conundrum for the general practitioner and is either completely dismissed by conventional doctors or simply given a Band-aid with pharmaceutical analgesics.”

Acute pain and chronic pain aren’t always exclusive of each other, however. Dr. Serena Goldstein, of Serena Goldstein, ND LLC, located in Florida stated, “Acute pain can turn chronic, which can sometimes last many months to years, compared to acute issues that are much shorter duration.”

Dr. Jacob Teitelbaum (Hawaii), author of From Fatigued to Fantastic, stated that there are additional types of pain to consider. These include muscle pain caused by low energy in the muscles, neuropathic pain, and central sensitization or “brain pain” associated with microglial activation. “In chronic pain, all three of these are usually present, along with acute and chronic inflammation,” he said. “There are numerous inflammation pathways, with some of the most critical being COX (cyclooxygenase), LOX (lipoxygenase), and microglial activation. The latter is most common as any pain or inflammation becomes chronic.”

Erin Stokes, ND, medical director at WishGarden Herbs, located in Colorado, stated that when discussing inflammation, it’s important to re-establish that inflammation is a normal physiological response. “Inflammation is a key component of the body’s defense mechanism and is vital to the healing process,” she noted. “It’s when inflammation is sustained, and becomes chronic over time that health issues can arise. Pain is generally a result of the inflammatory response, and there’s a complex interplay between different components, including the ever-expanding field of neuroplasticity,” she stated.

Pain and Chronic Disease: What’s the Connection?

If one experiences chronic pain, does that increase the likelihood of also experiencing chronic disease? Or does chronic disease most often result in chronic pain?

Dr. Livengood explained, “Pain is often an inflammatory response. Hence, reducing pain is required to reduce inflammation and vice versa.”

Dr. Goldstein added that there are several reasons why pain and inflammation can effect chronic disease in the body. “The mechanisms of pain and inflammation tend to affect the quality of blood vessel integrity, stress levels, and hormone levels, to name a few,” she noted. This in turn, has some effects on the physiology of common chronic disease ailments, Dr. Goldstein explained, such as high blood pressure, obesity, high cholesterol and type 2 diabetes.

Fred Cohen, MD, headache specialist with Headache123, a practice in New York, stated that there is a clear link between pain, inflammation and chronic disease in the body. “Inflammation is generally a key contributing factor to chronic disease. Inflammation is the body’s immune response to any kind of injury, infection or harmful stimuli,” he said. “Sometimes the body mistakenly identifies its own tissues as harmful and attacks them, leading to autoimmune conditions. Chronic diseases can develop when inflammation persists over a prolonged period. Pain is typically a consequence of chronic disease and inflammation, rather than a contributing factor to their development.”

Chief Executive Officer at mBIOTA Labs, a manufacturer based in California, Nicola Wodlinger, stated that the extent between to which inflammation drives chronic disease and pain is still being studied closely. “Emerging research shows us that inflammation is not just the body’s defensive response to injury or infection,” she said. “It can be a risk factor for developing an issue in the first place. In other words, it shows up first. Viewing inflammation as both a defender and aggressor in the body marks a paradigm shift that will deeply impact the types of solutions offered to patients,” Wodlinger noted.

What Lifestyle Changes Might Reduce Pain and Inflammation Symptoms?

The experience of pain and inflammation is unique to each individual, said Dr. Cohen, who noted that both stress and anxiety and common contributors. Many factors can trigger stress though, and individuals need more than a pat answer like, “just reduce your stress,” to be helped. These things will always be part of life, he stated, but it’s crucial for one to know how to manage these feelings. “When patients share their stressors with me, I discuss strategies to help mitigate their effects, and if needed, refer them to therapy,” Dr. Cohen said.

Dr. Stokes added that stress can play a large role in inflammation in the body. “As a naturopathic doctor, my focus is always on addressing the underlying cause of an issue, so the first thing to look at is why chronic inflammation exists in the first place. For example, we know that long-term inflammation can be caused by the continued release of stress hormones over time. It can also be caused by a poor diet that is high in trans fats.”

Sleep is another essential factor in reducing inflammation, and it’s something Dr. Cohen always looks at with his patients. “Our brain relies on neurotransmitters and neuropeptides for thinking, feeling, and acting. Like any fuel, using these creates waste products, many of which are pro-inflammatory. During sleep, the brain activates the glymphatic system, which helps clear these inflammatory byproducts,” he explained. “This is why you feel groggy when you’re tired—poor sleep leads to the buildup of these waste products, increasing inflammation.”

Dr. Livengood noted that pain and inflammation are often exacerbated by spiritual and social pain. In the past few years, she noted, Americans have been under an incredible amount of stress. Seeing a traditional doctor, as she mentioned previously, isn’t necessarily going to “cure” anyone of their pain or inflammation. But it may mask their symptoms. Dr. Livengood recommends a different approach. “Identifying the cause of pain is paramount and leads to a variety of treatment options,” she noted. “If depression and anxiety are present, natural practitioners should consider a holistic approach that includes herbs, nutrients and lifestyle changes.”

Nutrients that support serotonin and dopamine production may also be important such as 5-HTP, tyrosine, B6, folate and omega-3s as well as vitamin D, Dr. Livengood recommended. Additionally, she said, “Reproductive and thyroid hormones should be checked via lab testing and brought into optimal ranges utilizing bioidentical replacements. Finally, lifestyle factors need to be coached on regular basis to include anti-inflammatory diet changes, meditation, gentle exercise and positive socialization.”

Natural Health Supplements That May Help

Kate Hill, senior product manager at Boiron USA, Pennsylvania, stated that homeopathy can offer a lot of benefits when it come pain and inflammation. “Arnica montana is well-known for reducing muscle soreness, swelling and bruising,” said Hill who noted it’s particularly popular post-injury or surgery recovery or after intense physical activity. “Arnica is the active ingredient in Boiron’s Arnicare line of unscented topical gels, creams and oral pellets and tablets. In homeopathy, Harpagophytum, commonly known as devil’s claw, is also used for its analgesic properties,” explained Hill. The ingredient has traditionally been used to relieve pain, especially around arthritis traditionally. “This plant-based active ingredient can be found in Arnicare Arthritis Cream to address minor joint pain, muscle pain and stiffness due to arthritis,” Hill stated.

Reducing inflammation overall in the body is one of the most important things someone can do when it comes to relieving pain. Dr. Cohen stated that “must haves” when it comes to natural health products which may reduce pain and inflammation vary depending on the individual’s condition and symptoms, “Inflammation can be triggered by numerous factors, both internal and external, such as stress, anxiety, diet, nutrition and sleep, making it challenging to give a one-size-fits-all answer,” he said. When it comes to headaches, things are a little more clear cut and Dr. Cohen recommends supplements like magnesium and vitamin B2. He said that there is also strong evidence to suggest that omega-3 fats play a key role in reducing inflammation. “I encourage my patients to increase their intake of omega-3-rich foods—like salmon, sardines, flaxseeds, walnuts and olive oil—and/or consider taking fish oil supplements.”

Dr. Teitelbaum, too, recommends an increase in omega-3 intake. Doing so, he said, will decrease inflammation through the prostaglandin E2 pathway. “What I use in my practice is EurOmega-3, as one capsule a day replaces seven large fish oil pills.” He also recommends balancing the COX and LOX pathways utilizing “. . . a unique highly absorbed curcumin plus boswellia. Which suppresses both of these pathways. This can easily be done with a mix called Curaphen (by EuroMedica) which is a pain relief miracle,” stated Dr. Teitelbaum.

At Vireo Systems, Inc., in Tennessee, CEO and founder, Mark C. Faulkner, stated that one of the biggest changes he’s noticed in recent years is an overall increase in holistic topical pain relief options. “The topical version of Amino Activ has had a significant jump in usage in athletic training and physical therapy clinics,” Faulkner pointed out. He attributes this to the increasing knowledge practitioners have about the side effects of NSAIDs (non-steroidal anti-inflammatory drugs).

For Dr. Stokes at Wishgarden Herb Herbs, turmeric is a must-have in treating pain and inflammation. “Turmeric is an ancient root that has been ingested by people from all over the world and is a particularly important plant in ayurvedic medicine, where its use dates back 5,000 years,” she explained. “Turmeric is widely known for promoting healthy inflammation levels. The primary active compounds in turmeric are curcuminoids, which give the root its distinctive yellow-orange color. And the most widely studied of the curcuminoids is curcumin. Curcumin has been the subject of hundreds of clinical studies investigating its role in supporting healthy inflammation.”

Dr. Goldstein has several natural health supplements she’d recommend to clients looking to potentially alleviate or prevent pain and inflammation. These include turmeric and boswellia, which are especially good when paired together, St. John’s wort and corydalis, a Chinese medicine herb. “In fact, turmeric and boswellia can act like NSAIDs, and inhibits a few different pathways of inflammation,” she noted. Topical cayenne or arnica blends may be warranted as well especially if some areas are particularly painful, she said.

Concerns and Benefits Around Pain & Inflammation Products

“Practitioners, and their patients, want products that are safe and effective,” shared Ashley Dorner, business development manager at EuroMedica, a manufacturer in Wisconsin. “Products that are easy to dose are key. When the products are available in different dosage amounts and delivery forms, patient compliance is greatly increased,” Dorner stated. Likewise, practitioners are also looking for quality ingredients that are ethically sourced. “In our experience at EuroMedica, the most commonly sought ingredients for relief of occasional pain or inflammation are BCM-95 curcumin and BOS-10 Boswellia.*†

Dayna Dye, education content writer at Life Extension in Florida, stated that when it comes to pain relief and natural health supplements, safety is paramount. “Pharmaceutical options are associated with possible side effects—some severe—and some drugs are addictive,” she said. “Nutritional options may provide relief without the same risks as prescription drugs.” That said, Dye added that it’s advised that people seeking pain relief follow the advice of their health care practitioner in this and other areas.

Wodlinger noted that simple may be best when it comes to natural treatment for pain and inflammation. “When using medical nutrition to fight pain and inflammation, the fewer ingredients, the better. You want to provide the body with the essential nutrients that it needs to function and nothing more, avoiding the additives and irritants that could be causing the inflammation,” she said.

Who’s Buying? What’s the Market Like Now?

Hill stated that the market for natural health products which may alleviate pain and inflammation has shifted. “The types of people buying these products and their motivations have evolved due to factors like increased awareness of more holistic offerings, aging populations and changing perceptions around traditional or more conventional medicines,” she noted. As older generations experience more pain—usually joint pain—they look for alternatives to traditional pain medicines which frequently come with side effects. “Women, particularly in the 35 to 65 age range, are significant consumers of more natural pain products as they seek alternatives to conventional medications for long-term management,” Hill explained.

Likewise, younger adults—those in the Millennial and Gen Z range—are showing a growing interest in more holistic health care solutions, Hill said. “This group is prioritizing sustainable, clean, and plant-based solutions for managing their everyday pain. In light of the opioid crisis, they are more wary of typical pharmaceuticals and prefer those medicines that align with a more holistic approach to self-care,” she said.

Dorner stated that she too, has noticed some changes in who is looking for supplements that may help alleviate or prevent pain and inflammation. “The demographic of those purchasing pain and inflammation products is diverse and has increased in recent years,” said Dorner.* “Current buyers include the geriatric population, athletes and weekend warriors. Recently, we’ve also seen an increase in younger, health-conscious adults who are interested in using dietary supplements as part of their overall health strategy.”

At Vireo Systems, Inc., Faulkner stated that the main purchasers and/or prescribers of holistic, non-toxic pain and inflammation products are integrative medicine practitioners, osteopathic doctors, chiropractors, registered dieticians and informed consumers. “The biggest increase we have seen is the pleasant increase in ‘mainline’ medicine doctors that seem more open to blending integrative health into their traditional practices as alternatives to their formulary of pharmaceutical options.”

Studies Around Pain & Inflammation

Dr. Teitelbaum noted that recent research shows that chronic pain dramatically increases the risk of dementia. “For example, a study showed that having at least five areas of pain, which is the case in many with chronic pain and the vast majority of people with fibromyalgia is associated with the brain showing signs of being eight years older than its chronological age.2

With upwards of a quarter of the population suffering needlessly with chronic pain, Dr. Teitelbaum explained, along with a growing epidemic of dementia, this very treatable area begs to be addressed.

Dye said that while many health savvy consumers have sought out nonpharmaceutical, nontoxic remedies for minor health complaints in the past, the number of individuals interested in natural treatments has increased in recent years. In part, she explained that this is due to awareness of the opioid drug use/abuse epidemic. This has, “soured people’s opinions concerning prescription pain relief, thereby increasing the selection of natural options,” she said. “Serious adverse events, defined as death, major medical effect or hospitalization as a result of opioid pain reliever use were reported for 19,480 individuals in the U.S. during a seven-year study period according to data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System Poison Center Program,” Dye noted.3

Though pain and inflammation rates continue to rise, healthy alternatives both in the form of supplements and lifestyle changes which may prevent or alleviate both are also growing.

*DSHEA

†Occasional muscle pain and inflammation due to exercise or overuse.

References:

1 Rikard SM, Strahan AE, Schmit KM, Guy GP Jr.. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. DOI: http://dx.doi.org/10.15585/mmwr.mm7215a1.

2 Zhao, W., Zhao, L., A Chang, X., Lu, X., Tu, Y. Elevated dementia risk, cognitive decline, and hippocampal atrophy in multisite chronic pain. 2023. Proceedings of the National Academy of Sciences. V 120, N 9. doi:10.1073/pnas.2215192120.

3 Murphy DL et al. Comparative Rates of Mortality and Serious Adverse Effects Among Commonly Prescribed Opioid Analgesics. Drug Saf. 2018 Aug;41(8):787-795. doi: 10.1007/s40264-018-0660-4.

Healthy Take Aways

• More than 20 percent of adult Americans suffer from chronic pain.
• The two most common forms of pain are acute (shorter term) and chronic (longer term).
• Pain, inflammation and chronic disease are often linked.
• Stress and anxiety are often contributors to pain and inflammation.