Back pain can be debilitating and have a big impact on our ability to perform day to day activities. In 2014-15, one in six people in Australia reported that they had back problems of varying nature.¹ There are a variety of things that can cause back pain, including injury, bad posture and conditions like osteoarthritis.¹ Some research* also suggests that we may need to consider nutritional deficiencies, like vitamin D.² So let’s have a closer look at some supplements we can use that may help to manage and relieve back and other joint pain.
Vitamin D Deficiency Drives Chronic Pain
Chronic low back pain has been found to be linked to vitamin D deficiency in a Saudi Arabian study.* ² Participants with chronic low back pain of unknown cause were tested for vitamin D deficiency, and subsequently treated with a vitamin D supplement. It was found that 83% of patients with low back pain were also vitamin D deficient (this seemed to be more prevalent in women) and there was a significant improvement in back pain after vitamin D supplementation.² Another study* has found there to be some association between chronic pain (widespread) and low serum vitamin D levels, but interestingly, this association was only evident in women, not in men.³ These studies indicate that when one is experiencing chronic back pain where no other cause is evident, it may be worthwhile checking vitamin D status. Important to note is that in both the above studies, vitamin deficiency was evident and pain reduced on correction of vitamin D status. ²’³ It is not certain that Vitamin D supplementation in the absence of deficiency would have any effect on back or joint pain. Speak to your doctor about having your vitamin D levels checked.
Fish Oils to Fight Inflammation
The essential fatty acids in fish oil have anti-inflammatory benefits, ⁴ and as such may be helpful in pain management. In a study* involving 250 participants with back and neck pain, subjects were asked to take 2.4g essential fatty acids (EPA and DHA) for 2 weeks then reduce it to 1.2g and gradually wean off. After about 75 days, 60% of participants reported an improvement in pain. ⁴ To give you an idea of how much fish oil these quantities of essential fatty acids equate to – you would need to take approximately 8 regular fish oil capsules daily, then weaning down to 4 capsules daily to get the trial dosage. Some more concentrated fish oil supplements are available to reduce the amount of capsules needed daily.
Curcumin to Combat Pain
Curcumin is the most active constituent in turmeric root and is starting to become a popular choice for pain relief and management, especially when it comes to joint pain and inflammation. Various studies* have shown Curcumin to have anti-inflammatory benefits ⁵ and patients given the Merivaᵀᴹ Curcumin in clinical trials* have shown a significant decrease in inflammatory markers and pain scores.⁶ Why would you choose a Curcumin supplement rather than taking Turmeric? Well, really, it depends on which health benefit you’re trying to achieve. When it comes to reducing inflammation, curcumin has specifically shown anti-inflammatory benefits, ⁷ while for other applications, Turmeric whole root extract with all its constituents might be more suited. ⁸ While taking Turmeric will provide Curcumin as well, bear in mind that Curcumin only makes up about 2-5% of turmeric root.⁹ This means that if you’re relying on the spice to provide you with anti-inflammatory benefits, you would need to take substantial amounts to achieve this and take it with some sort of fat to aid its absorption.
Boswellia to Beat the Ache
Boswellia is used in herbal medicine to help manage inflammation and pain. It is also known as Indian Frankincense,¹⁰ and research* has shown that this herb is able to block the formation of some inflammatory mediators called leukotrienes.¹⁰ The resin of the plant is collected from the trunk of Boswellia trees, where it flows out of an incision in the bark over the period of about a month. After this, it is left to harden and then it gets broken down into varying grades of powder/granules.¹¹ Interestingly, a Boswellia tree can only yield good quality resin for about three years before the quality decreases. After this it needs to be left to rest for several years.¹¹
Research* has shown the benefit of Boswellia in the management of inflammatory conditions including mild osteoarthritis. In one study* conducted in India and involving 30 patients, for example, Boswellia was found to help with the reduction of pain and swelling and improvement of range of motion in mild osteoarthritis of the knee.¹² Another study* in healthy volunteers also showed positive results in terms of increased pain threshold with Boswellia treatment. Boswellia is also well tolerated by most people.¹³
Ginger to Get Relief
Ginger has been used for centuries, both in food and as a medicine.¹⁴ In the 13th and 14th centuries it was even considered a very valuable item of trade, one pound of ginger being worth as much as a sheep! ¹⁵ It is used in cooking for its flavour profile and we still use ginger commonly in herbal medicine for its many therapeutic benefits. Among these is its anti-inflammatory action and its ability to help reduce pain. It has been shown to reduce muscle pain after exercise over time when taken longer term ¹⁶’ ¹⁷ and it has also shown benefit in reducing pain in people who suffer from mild osteoarthritis. ¹⁸ This herb is a powerhouse of pain relieving benefits.
Devil’s Claw to Diminish Discomfort
This herb is named after the shape of its fruit and grows natively in Southern Africa. It is bitter to taste and as such is used traditionally for digestive complaints. It has also been used for over 50 years in Europe to relieve pain. ¹⁹ Devil’s Claw has shown potent anti-inflammatory and pain relieving activity, though it tends to work better with consistent rather than acute use. ¹⁹ Traditionally, it has been used to relieve pain, and research* has shown it to be beneficial in managing mild osteoarthritis and back pain. ²⁰ One study* conducted in the UK over a period of eight weeks found that treatment with Devil’s Claw significantly reduced pain and stiffness and improved quality of life scores and function in patients with osteoarthritis. ²¹ Devil’s Claw is devilishly good and should be amongst your top herbs for consideration when looking for complementary pain relief.
Willow Bark to Wipe Away Pain
Willow bark has a long history of use, with some reports dating back to 500BC! By the 18th century it was a popular treatment for pain and fever relief. ²² Willow Bark contains salicin and it is believed by many that a common medication was developed from this compound in Willow Bark. However, this is not the case – it was actually developed from the salicin in Meadowsweet, ²³ a different herb used commonly for digestive complaints.²⁰ In herbal medicine today, Willow Bark is often used to help with joint pain, lower back pain and musculoskeletal pain.²³ One study* found willow bark to significantly reduce the severity of lower back pain,²⁴ while another* showed it to be beneficial in relieving the pain of mild osteoarthritis.²⁵ Another reason making Willow Bark a good choice for pain relief is that in many cases results have been seen within 1 week of treatment, ²³ which is good news for anyone suffering from joint or lower back pain.
When it comes to back and joint pain, there are some good options for the relief of pain and discomfort available. However, please be aware that unexplained, chronic or severe pain needs to examined by a doctor so they can investigate the pain and find the underlying cause and treat it appropriately.
1. Australian Institute of Health and Welfare, 2018 “Back problems snapshot”, cited on 28/08/2018, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/what-are-back-problems
2. Al Faraj, S. & Mutairi, KA 2003, “Vitamin D Deficiency and Chronic Low Back Pain in Saudi Arabia”, Spine, Vol. 28(2), pp. 177-179.
3. Atherton, K.; Berry, DJ; Parsons, T et al. 2009, “Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey”, Annals of the Rheumatic Disease, Vol. 68, pp. 817-822.
4. Maroon, JC & Bost, JW. 2006, “Omega-3 acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain”, Surgical Neurology, Vol. 65, pp. 326-331.
5. Braun, L. & Cohen, M. 2015, “Herbs and Natural Supplements, 4th Edition – Chapter: Turmeric”, Churchill Livingstone, Chatswood NSW, Australia.
6. Belcaro, G; Cesarone, MR; Dugall, M et al. 2010, “Product-evaluation registry of Meriva, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis”, Panminerva Med, Vol. 1(1), pp. 55-62.
7. Aggsrwal, BB & Sung, B in O’Brien, S. 2018, “Turmeric vs Curcumin: Which should you take?” cited on 30/8/18, https://www.healthline.com/nutrition/turmeric-vs-curcumin#turmeric-vs-curcumin
8. O’Brien, S. 2018, “Turmeric vs Curcumin: Which Should You Take”, cited on 30/8/18, https://www.healthline.com/nutrition/turmeric-vs-curcumin
9. Webb, M. 2015, “Curcumin Reduces Degenerative Disc Disease Pain”, Natural Medicine Journal, Vol 7(6).
10. Moncivaiz, A., reviewed by Wilson, DR 2017, “Boswellia (Indian Frankincense)”, cited on 30/8/18, https://www.healthline.com/health/boswellia#research
11. Siddiqui, MZ, 2011, “Boswellia serrata, A potential anti-inflammatory agent: An overview”, Indian Journal of Pharmaceutical Sciences, Vol. 73(3), pp. 255-261.
12. Kimmatkar, N; Thawani, V.; Hingorani, L. & Khiyani, R. 2003, “Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – A randomized double blind placebo controlled trial”, Phytomedicine, Vol. 10, pp. 3-7.
13. Prabhavathi, K.; Chandra, SJ; Soanker, R & Reni, PU 2014, “A randomized, double blind, placebo controlled, cross over study to evaluate the analgesic activity of Boswellia serrata in healthy volunteers using mechanical pain model”, Indian Journal of Pharmacology, Vol. 46(5), pp. 475-479.
14. Braun, L. & Cohen, M. 2015. “Herbs and Natural Supplements – 4th Edition, Chapter: Ginger”, Churchill Livingstone, Chatswood, NSW Australia.
15. Rosengarten, 1969 in Braun, L. & Cohen, M. 2015. “Herbs and Natural Supplements – 4th Edition, Chapter: Ginger”, Churchill Livingstone, Chatswood, NSW Australia.
16. Black, CD & O’Connor PJ, 2010, “Acute effects of dietary ginger on muscle pain induced by eccentric exercise”, Phytotherapy Research, Vol 24(11), pp. 1620-1626. [Abstract]
17. Black, CD; Herring, MP; Hurley, DJ & O’Connor PJ, 2010, “Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise”, The Journal of Pain, Vol 11(9), pp. 894-903. [Abstract]
18. Altman, RD & Marcussen KC 2001, “Effects of a ginger extract on knee pain in patients with osteoarthritis”, Arthritis Rheum Vol 44(11), pp. 2531-2538.
19. Braun, L. & Cohen, M. 2015, “Herbs and Natural Supplements – 4th Edition; Chapter: Devil’s Claw”, Churchill Livingstone, Chatswood NSW, Australia.
20. Bone, K & Mills, S. 2005, “The Essential Guide to Herbal Safety”, Elsevier/Churchill Livingstone, USA.
21. Warnock, M.; McBean, D; Suter, A; Tan, J & Whittaker, P. 2007, “Effectiveness and safety of Devil’s Claw tablets in patients with general rheumatic disorders”, Phytotherapy Research, Vol 21(12), pp. 1228-1233. [Abstract]
22. Hedner & Everts, 1998 cited in Braun, L. & Cohen, M. 2015, “Herbs and Natural Supplements – 4th Edition, Chapter: Willow Bark”, Churchill Livingstone, Chatswood NSW, Australia.
23. Braun, L. & Cohen, M. 2015, “Herbs and Natural Supplements – 4th Edition, Chapter: Willow Bark”, Churchill Livingstone, Chatswood NSW, Australia.
24. Chrubasik, S.; Eisenberg, E; Balan, E; Weinberger, T et al. 2000, “Treatment of Low Back Pain Exacerbations with Willow Bark Extract”, The American Journal of Medicine, Vol 109, pp. 9-14
25. Schmid, B; Lüdtke, R; Selbmann, HK, Kötter, I et al. 2001, “Efficacy and Tolerability of a standardized Willow Bark Extract in Patients with Osteoarthritis: Randomized Placebo-controlled, Double Blind Clinical Trial”, Phytotherapy Research, Vol. 15, pp. 344-330.