Let’s be frank: Pain sucks. We can experience pain for many reasons: Sometimes it is short-term and felt for a few hours to a few days; other times, pain is chronic and lasts weeks to months—or longer. Depending upon frequency and severity, pain can impact our activities and lives in a negative way. Being able to effectively relieve pain is important—to rest, recover, and heal up in the case of acute pain, or improve levels of functioning and capacity for daily activity in the case of chronic pain.

Most people are familiar with over-the-counter pain medications such as ibuprofen, acetaminophen, naproxen, and aspirin, as well as stronger prescribed drugs such as codeine and morphine. But many natural products and supplements also help reduce pain frequency and severity! You may be familiar with the use of turmeric or its active compound curcumin, as well as omega‑3s for reducing inflammation and thus chronic pain, or glucosamine for joint pain. For topical uses, capsicum, arnica, or menthol creams are popular. But there are many more! Here are a few lesser-known natural products that may also provide relief from various pain.

Boswellia

Boswellia extract is an herbal preparation similar to turmeric in its action and effect. It comes from Boswellia serrata, a tree native to India, Africa, and the Middle East. When taken orally, boswellia extract appears to reduce osteoarthritis pain and improve joint function, apparently by reducing the production of inflammatory mediators, thus decreasing pain and inflammation.

Daily dosing varies based upon the percentage of boswellic acids in a product—100 mg of a product containing 30% boswellic acid is equivalent to 300 mg of one containing 10% boswellic acids. So, different commercially prepared products containing boswellic acid may vary widely in suggested dosing.

In general, studies suggest that the effective daily dosage of boswellic acids typically ranges from 100 to 250 mg daily for long-term use, but dosages as high as 1,600 mg per day have been studied as well (typically only for 30 days). Boswellia is generally considered safe and is well tolerated, even when taken for extended periods of time (up to six months).

Devil’s Claw

Devil’s claw (Harpagophytum procumbens) is another botanical that has been traditionally used for pain, especially joint pain. Recent studies support this, specifically due to glycosides (plant chemicals) found in high amounts in devil’s claw. These glycosides appear to help reduce pain by exerting an anti-inflammatory effect similar in action to that of ibuprofen. Studied dosages vary widely, between 100 and 2,400 mg per day, for up to 12 weeks. Devil’s claw is generally well tolerated but appears to interact with a variety of medications and conditions, so consulting with a health-care practitioner before use is warranted.

Willow Bark

Willow bark has been used traditionally for pain and fever as it contains salicin, a potent anti-inflammatory. A very similar compound, acetylsalicylic acid (also known as ASA), is the key ingredient in aspirin. Used around the world, white willow bark—also known as Salix alba—is available today in supplement form and can be used very similarly to aspirin for pain relief and inflammation, as it reduces inflammation on a cellular level, thus reducing the pain sensation.

Supplement dosages usually range between 120 to 240 mg of salicin per day for up to 6 weeks. Like boswellia, salicin content varies by product, with a percentage range from 6.7% to 30.7%. Thus, the recommended dosing (in weight) for commercially available products may be much greater than 120 mg per day.

Like aspirin, caution should be used with white willow bark, especially when treating viral infections in children (don’t!), while taking other antiplatelet/anticoagulant medications, or if you are experiencing stomach ulcers or are sensitive to salicylates. In short, it is important to treat products containing white willow bark similarly to aspirin in terms of cautions and contraindications.

PEA

Shifting away from herbal options comes palmitoylethanolamide, or PEA for short. It is a naturally occurring substance that our body makes in times of stress, inflammation, and injury. PEA is also found in fatty foods, especially in egg yolks, milk, soybeans, peanuts, and some types of tree nuts. PEA is thought to reduce pain by local anti-inflammatory effect as well as increasing the effect of endocannabinoids (pain-modulating molecules that our body naturally produces).

When taken in supplement form, the frequency and severity of chronic pain appears to diminish. One study suggested 300 mg PEA taken once or twice a day for 8 weeks reduced pain and improved function in people affected by arthritis. Another study suggested that 300 mg taken up to four times a day for two months reduced pain severity in those affected by chronic pain, with a five-fold reduction in pain occurring within the first two weeks.

These studies also provided comforting safety data on PEA: Minimal major side effects were reported in studies when PEA is taken at suggested dosages and for short-term use (up to three months at a time). There are also no known drug or condition interactions with PEA. PEA can be taken orally or applied topically to areas in pain, but if you’re considering trying PEA for pain, consider choosing a micronized or ultramicronized PEA for optimal absorption and effectiveness.

DMSO

Finally, dimethyl sulfoxide, often abbreviated to DMSO, appears to help promote healing and reduce pain when applied topically. In studies, products containing 50% DMSO or more, when applied topically, appeared to provide pain relief compared to placebo, especially in the case of complex regional pain syndrome and arthritis (both osteoarthritis and rheumatoid arthritis). DMSO is thought to provide pain relief by blocking nerve signalling, thus reducing pain perception. It may also reduce inflammation on a cellular level by acting as an antioxidant.

Unlike PEA, there are some side effects associated with DMSO, the most noticeable being a garlic-like taste in the mouth. DMSO also interacts with many medications and should be used with caution (or not at all) with certain health conditions. Consult your health-care practitioner to ensure it is a good option for you. When choosing DMSO, be sure to purchase human‑ or pharmaceutical-grade DMSO, tested in a reputable and accredited laboratory.

Conclusion

While many of the options discussed above are usually well-tolerated, it is important to note that natural health products, while natural, can be very powerful and are not always safe for everyone. Health status, medical conditions, and other supplements and medications (both prescribed and self-prescribed) can interact in negative ways. Be sure to read the label carefully, and consult your local health-care practitioner, naturopathic doctor, or pharmacist before starting a new natural health product to ensure it is safe for you to take.

Dr. Katie DeGroot, BSc, ND, MScN

Dr. DeGroot is an Alberta-registered naturopathic doctor who also holds a Master of Science in Nutrition. She offers nutritionally focused care and has a special interest in digestive issues and supportive mental health-care.

drkatiedegroot.ca