Acupuncture is becoming increasingly popular in the west as a remedy for pain. A less well-known fact is that Chinese herbs are also extremely effective in treating pain. Like acupuncture, herbal medicine can address any type of pain, regardless of its origin. This includes visceral (organ) pain, or musculoskeletal pain resulting from tissue degeneration, overuse or sport injuries.
Over three hundred Chinese herbs are commonly and combined into formulas to address, in nuanced and complex ways, the roots of physiological dysfunction and pain.
For musculoskeletal pain, Chinese herbs can help speed healing of injuries and reduce complications or likelihood of re-injury. Chinese herbs reduce swelling and inflammation, break up accumulations of blood and fluids and restore normal circulation to injured areas.
So, in contrast to pharmaceutical pain medication, Chinese herbs do not have negative side-effects. When prescribed by a skilled herbalist, they stimulate healing and improve physiological function, i.e. "positive side effects"
How Herbs are Administered for Pain:
Chinese herbs are most commonly taken internally, either in the form of teas cooked from raw herbs, pills, or powdered extracts. From the Chinese sports medicine (or martial arts) tradition, we also have many ways of applying herbs to injuries externally--in the form of liniments, poultices, plasters and soaks.
Chinese herbs are almost never used singly. Rather they are used in formulas (with anywhere from two to 20 herbs in combination). Formulas allow a multi-pronged approach to disease processes or pain syndromes.
I'm hoping to write more soon about herbal first-aid and injury treatment strategies.
Here I simply want to introduce some of the ways in which Chinese herbs are used to address pain.
In Traditional Chinese Medicine, herbs are grouped into categories based on physiological function. I'll review some of the categories most commonly involved in the treatment of pain syndromes.
Pain Caused by Lack of Circulation of Qi & Blood:
There is a famous Chinese saying: "Bu tong ze tong, tong ze bu tong" which means "free flow: no pain, no free flow: pain." A fundamental strategy for relieving pain in Chinese medicine is to re-establish proper circulation of energy, blood or body fluids.
Two major categories of pain-relieving herbs are:
1. Herbs that Regulate Qi, and
2. Herbs that Invigorate Blood.
Pain resulting from the lack of energetic circulation (or Qi stagnation) is dull and achy in nature. Its location is more difficult to specify. Pain resulting from Blood stasis, on the other hand, is sharp, deep, and easily localized.
Qi stagnation or Blood stasis occurring in the organs manifests as pain in the chest or abdomen. In western terms, this can be related to physiological organ dysfunction or degeneration related to any number of disease processes. It can relate to increased blood viscosity or fluid accumulation resulting from inhibited circulation.
There are several herbs in the Chinese pharamacopeia that treat pain in the chest and abdomen due to qi stagnation and blood stasis. Many of the qi moving herbs are citrus peel (the famous chen pi, or aged tangerine peel) or fruits and flowers (even rosebuds).
Pain in the extremities, low back or head is attributable to qi and blood stagnation in the meridian pathways. It is easy to understand how the impact of an injury or overuse of a body part can impede proper circulation. With an impact, blood flows to an injured area, bringing white blood cells and nutrients to clean up, heal and rebuild the injured area. Part of the healing process is clearing this stagnation of blood and fluids and restoring proper circulation.
Some famous blood-moving herbs are salvia root (dan shen), which has a particular affinity for the heart, turmeric (yu jin) --pictured right, peach kernels, safflower flowers, and frankincense and myrrh (which are used frequently in healing traumatic injuries).
Inflammation is basically the flow of blood and immune-agents to an injured area. Part of the injury healing process is to reduce inflammation in order to restore normal circulation and blood flow to an injured area. The Chinese pharmacopeia has a wide range of herbs used to clear heat and dampness from the body. These are often used to treat pain and injury characterized by redness, swelling and inflammation.
Some herbs which clear heat and dampness are gardenia fruit (zhi zi)--pictured on the left-- and a trio of herb known as the "three yellows" or "three huangs:" huang qin or skullcap/scutellaria root, huang lian or coptis rhizome, and huang bai or phellodendron cortex. The three huangs have an affiinity for the chest, upper abdomen and lower abdomen respectively. Together, they clear heat, inflammation and infection from the whole body.
Some chronic pain is considered, from a Chinese medicine perspective, to result from "pathogenic factors," such as cold, dampness and/or wind, which have entered muscles, joints, bones or connective tissue as a result of prolonged injury or weakness. These factors -- cold, dampness, wind -- cause pain by disrupting the circulation of Qi and blood in the injured areas. Again, there is a range of herbs to choose from which clear these "invading pathogenic factors," warm the body and restore healthy circulation. In selecting specific herbs to be used, careful attention must be given to the nature and pattern of pain:
- Pain characterized by wind tends to migrate from joint to joint.
- Cold-pain is severe, fixed, worse with cold weather, and characterized by reduced joint mobility.
- Damp-pain is characterized by fixed pain, swelling, heaviness and numbness.
A variation on this is hot painful obstruction, characterized by redness, swelling and inflammation of the joints characteristic of rheumatoid arthritis. Herbs that dispel wind, heat and dampness are used in treating this kind of pain.
Bone-Healing & Kidney-Strengthening:
Another category of herbs that is frequently used in the treatment of pain is herbs that tonify the Qi of the Kidneys. Chronic low back pain is often due to Kidney Qi weakness. Also Kidney tonics strengthen and heal broken bones. Du zhong (eucommia bark)--pictured left, gou ji (cibota rhizome), and xu duan (Radix Dipsaci Asperi) are some examples of herbs that tonify the Yang of the Kidney, heal fractures and alleviate back pain.
Herbs that Guide to Body Regions:
Finally, certain herbs have particular affinity to certain parts of the body. They are often added to a formula specifically to guide herbs to an injured or painful area. For example:
The herb, niu xi, or achyranthes root has an affinity to the lower body. Amazingly, it also invigorates the blood and expels blood stasis and strengthens bones and connective tissue and heals joints. It is frequently used in formulas for patients with low back or knee pain.
The twigs of the mulberry tree, or sang zhi -- pictured right, have an affinity for the shoulders and arms, where they help alleviate joint pain characterized by wind & dampness.
Gui zhi, or cinnamon twigs--pictured below, also guide to the shoulder. Cinnamon is warm, whereas mulberry twigs are slightly cooling. So, in treating shoulder pain, we need to consider whether the pain is characterized more by cold or heat.
Chuan xiong, translated as Szechuan lovage root or ligusticum, has an affinity for the head, moves blood, treats blood stasis and expels wind. It is an important herb to consider in treating headaches due to common cold, fatigue or weakness. (However, we want to be extremely cautious in using this herb to treat migraines or any headaches resulting from excess blood flow or energy in the head, since chuan xiong basically increases blood circulation and raises energy to the head.)
General Tonification & Regulation:
A Chinese herbal pain formula may combine a number of different herbs to address pain from different angles, as discussed above. In cases of chronic (non-acute) pain, a skilled herbalist will always consider the underlying constitutional weaknesses or imbalances of the patient. Why is the pain lingering? Why do the injuries not heal? Why is there chronic inflammation? A formula for chronic pain will always address these underlying imbalances. Most commonly, Qi and Blood need to be tonified. The organs responsible for the production must be strengthened and regulated so that affected tissues are supplied with enough nutrients to heal. If there is low-grade inflammation, herbs will be used to clear what is called "deficiency" heat. And so on.
Chinese herbs are amazing.
If you or someone you care about suffers from pain, consider herbal medicine along with acupuncture and other pain management regimens. Also, if you sustain an injury, take advantage of Chinese herbs and acupuncture to speed your healing and prevent chronic pain and reinjury.