Control of pain with topical plant medicines

doi:10.1016/S2221-1691(15)30342-7

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Open Access funded by Hainan Medical University

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ABSTRACT

Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.

Keywords

Traditional healing;
Liniment;
Topical preparation;
Pain control

1. Introduction

Pain can be difficult to treat, especially chronic pain. Fibromyalgia, neuropathic pain and chronic back pain are routinely treated with oral opioids, such as hydrocodone and oxycodone. A recent systematic review found no convincing evidence that oxycodone is of value in pain treatment from fibromyalgia, diabetic neuropathy, postherpetic neuralgia or neuropathic pain[1]. Osteoarthritis pain is frequently treated with oral nonsteroidal anti-inflammatory drugs (NSAIDs). When the NSAIDs are inadequate for pain control in osteoarthritis or rheumatoid arthritis, stronger agents are used such as corticosteroids, hydroxychloroquine, sulfasalazine, leflunomide, auranofin, etanercept, infliximab, anakinra and methotrexate. This is called the Carpenter approach[2]. If the hammer does not work, get a bigger hammer. All of these agents have serious adverse effects. Methotrexate can kill patients if an excessive dose is used.

Of course, NSAIDs were discovered based on the structure of aspirin, a monoterpenoid, which comes from meadowsweet, Filipendula ulmaria. Opioids are alkaloids that come from the opium poppy, Papaver somniferum. The problem with these agents is that large doses are taken orally or by injection, travel throughout the body and have toxic effects where they are not needed. NSAIDs are used in chronic pain conditions, but are not effective for most patients[ 3]. NSAIDs cause 100 000 ulcers in the USA every year according to the Centers for Disease Control. Of these, 10 000 patients die. NSAIDs also damage the kidneys and have other adverse effects. Opioids cause seizures and respiratory depression. They cause 14 000 deaths every year in the USA according to the Centers for Disease Control. They also cause addiction and tolerance such that after a couple of weeks, patients have to increase the dose to get any pain relief.

This review will point out that there is a better way to treat pain than by giving large oral doses or injections to treat pain in the brain and brain stem. Liniments and other topical preparations can be used that are applied in small amounts to the skin where they are needed. Analgesic molecules in the preparations penetrate the skin in small but sufficient amounts, act where they are needed and are rapidly cleared from the skin and the body.

Cheryl & ethnovet

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Thursday, 9 April 2015