Beyond Pot: Many Plants Offer Options for Natural Pain Relief

Much like the marijuana plant, herbs such as arnica, bromelain, and evening primrose oil can also provide pain-relieving effects.

with Ilene Ruhoy, MD, and Nancy Cotter, MD, FACN, CNS


Although cannabis continues to make most of the health headlines, other plant options for pain management may get their day in the sun as more patients seek alternatives to opioids and pharmaceuticals in general.

“I don’t think anyone can argue with the state of pharmacologic analgesia today,” says Ilene Ruhoy, MD, PhD, a neurologist and founder of the Center for Healing Neurology in Seattle, Washington. "The opioid crisis is one thing — 130 people a day die from opiate overdose in the United States,”  she says, “but even with non-opiate type medications, some are still habit-forming, many have a suboptimal response, and almost all have side effects, some of which can persist. It is important to note plants have been used for generations for a wide range of medicinal purposes including pain.”  

Dr. Ruhoy gave a presentation on plant-based pain relief at the 2019 annual meeting of the American Academy of Neurology (AAN). Her discussion included some plants that have been the subjects of clinical studies for pain relief but are not yet approved by the Food and Drug Administration (FDA)—see details below.

"I was happy about how excited a large group of my fellow neurologists were at learning about plant-based analgesia overall," Dr. Ruhoy says. "I have been practicing integrative neurology for several years now and was really inspired by others at the annual meeting. There was quite a bit of interest in cannabis since it is such a hot topic these days, but many were interested to discuss an overall plan of combination of plants instead of reliance on just cannabis," she notes.

Evening primrose oil has been shown to help repair nerve damage, thus relieving certain types of relieve pain. (Source: 123RF)

Besides Marijuana, What Plants Can Help Relieve Pain?

Different plants have shown some ability to relieve specific types of pain, according to Dr. Ruhoy’s AAN talk. Arnica, for example, is an herb with a long history as an ingredient in topical pain relief products. Bromelain, an enzyme extracted from pineapple juice, has been used to treat pain and muscle spasms, while capsaicin, the ingredient that makes hot peppers hot, also has been used for pain relief. Devil's claw, an herb related to sesame, has shown some effectiveness for relieving arthritis pain, as well as fever and indigestion. Evening primrose oil, extracted from the seeds of the evening primrose plant, has shown success in repairing nerve damage.

Of note, turmeric, the common cooking spice related to ginger and similarly ground from a root, has drawn attention in the rheumatology community as a treatment for the pain associated with osteoarthritis and rheumatoid arthritis. Turmeric is one of the few plant pain products that has been studied in multiple clinical trials, and a meta-analysis published in the Journal of Medicinal Food showed that approximately 1,000 mg/day of curcumin, the active ingredient in turmeric, was effective for relieving arthritis pain. Read more about turmeric for arthritis.

Plant-Based Pain Relief: How to Get Started

Individuals living with chronic pain who want to explore plant-based pain treatments can keep it simple, says Dr. Ruhoy. "Patients should ask their doctors about recommendations of non-pharmacologic options for pain control. Questions should include what plants work best for their type of pain, what plants work synergistically for optimal effect, and how they can best to be used."

While she has seen patients benefit from using plant-based medicines under her supervision, she hopes that more randomized, controlled trials will be conducted to provide doctors with reliable evidence so they can feel more confident about plants as pain relievers. "These types of studies are large, costly, and often burdensome, but they are so important in medicine," she emphasizes, noting that she, among others, who incorporate plant-based medicine have taken courses over the years to learn more of herbal preparations and that provides a comfort level when recommending use to patients.

Appropriate use is the key if you are considering plant-based medicine for pain, agrees Nancy Cotter, MD, FACN, CNS. Remember that “natural” is not the same as “safe,” says Dr. Cotter, the physician lead for integrative health at the Veterans Administration (VA) and an assistant clinical professor of physical medicine and rehabilitation at Rutgers’ New Jersey Medical School.

Consult with a medical professional when you are dealing with a significant health condition, she emphasizes, "It is important to know about synergy [that is, the combined effects] among ingredients, side effects, and drug-nutrient interactions." Even patients simply seeking pain relief should get advice from a nutritionist, physician, or another healthcare provider, says Dr. Cotter. "They can save you time in terms of sequencing and combining treatments, and using quality nutrients from quality sources."

When patients are able to find the right fit, the benefits of plant-based medicines include "significant reduction in pain, increased vitality, and return to wellbeing," Dr. Cotter says.

However, she points out that supplements are just that—supplemental—to a supportive diet and lifestyle. "The most successful approach in chronic pain is a multimodality plan, including nutrition, movement, mind-body and structural approaches," she advises. 

Helpful Resources

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health cites nonpharmacologic management of pain as one of its top research priorities, and their HerbList mobile app offers users the latest science-based information on herbs and herbal products. The NCCIH website offers fact sheets on a range of herbs, as well as a place to download the app(

For more information about plants for pain relief, Dr. Ruhoy also suggests the website of  Tieraona Low Dog, MD (, as well as Natural Medicines (, a subscription-only site that allows users to search herbs and natural supplements for information about effectiveness and potential interactions with other medications.

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Updated on: 07/08/19
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