Not long ago, a 50-year-old woman came to my office suffering from severe arthritis pain in both hands. I gave her a bean-sized dab of a homeopathic gel that she applied directly to the skin on her hands. After a few applications in the span of 30 minutes, her pain was reduced by 90o/o. She did not need to apply the gel again for two weeks.

I witnessed a similar result with a retired National Football League player. He had severe chronic hip pain from past injuries. With one application of the gel, his pain was relieved by 70%o for two full days.

The relief that these people experienced has given them each a new lease on life. But here's the best news—unlike pharmaceutical pain relievers, which often cause gastrointestinal upset or damage to internal organs, natural therapies can reduce pain without adverse effects.

WHAT ARE YOU TAKING FOR PAIN?

Most Americans take too many pharmaceutical pain relievers. An estimated 175 million American adults take over-the-counter (OTC) pain relievers regularly. About one-fifth of Americans in their 60s take at least one painkiller for chronic pain on a regular basis.

There has been a lot of news about the life-threatening risks of anti-inflammatory medications such as rofecoxib (Vioxx) and celecoxib (Celebrex), two pain relievers that had been heavily prescribed by conventional doctors to treat the chronic pain of arthritis and similar conditions. Vioxx was pulled off the market by its manufacturer, Merck, following research that linked it to increased risk of heart attack and stroke. Celebrex is undergoing post-marketing clinical trials to determine whether it poses similar risks and now carries warnings about adverse effects, such as abdominal pain, diarrhea and edema (water retention).

Of course, pain-relieving drugs can be a blessing in the event of injury, severe acute migraines or diseases, such as terminal cancer. A number of years ago, when I had a wisdom tooth extracted, I received a local anesthetic. Afterward, I went to an acupuncturist for pain relief so I wouldn't need any painkillers. For about one hour after the acupuncture, I was fine—but then the pain-relieving endorphins wore off. I tried a few natural remedies, but when the pain became excruciating, I resorted to the OTC pain reliever acetaminophen (Tylenol). That did the trick.

But many people use painkillers on a regular basis for several months or even years, which increases the risk of dangerous side effects. For instance, people who rely on acetaminophen increase their risk of developing stomach ulcers, liver disease and kidney disease. If you regularly take Celebrex or an OTC nonsteroidal anti-inflammatory drug (NSAID), such as aspirin or naproxen (Aleve), you run the risk of kidney and stomach damage. Regular use of NSAIDs also increases risk of heart attack, according to the FDA.

BETTER RESULTS, FEWER RISKS

Before you take any remedy, it's important for your doctor to identify what is causing your pain. Remember, pain is your body's distress signal that something is being irritated or damaged. Sometimes we protect ourselves by reacting instinctively. If you touch something hot, for example, you eliminate the pain by quickly pulling back your hand.

But what if your back hurts? You may need a pain reliever—but back pain also can be a signal that you're harming your body by bending or sitting the wrong way. You may need to address the underlying cause to prevent further injury. Pain receptors are found in the skin, around bones and joints—even in the walls of arteries. If a muscle is torn, for example, a pain signal is released from fibers in the shredded tissue.

In light of the dangers from prescription and OTC drugs, what safe alternatives are available to you? There are many natural supplements that I recommend.

NATURE'S PAIN RELIEVERS

If you take prescription or OTC pain medication, work with a naturopathic physician, holistic medical doctor or chiropractor who will incorporate natural pain fighters into your treatment regimen. With his/her help, you may be able to reduce your dosage of pain medication (natural pain relievers can be used safely with prescription or OTC painkillers)—or even eliminate the drugs altogether.

Natural pain-fighting supplements are even more effective when combined with physical therapies, such as acupuncture, chiropractic, magnet therapy or osteopathic manipulation (a technique in which an osteopathic physician uses his hands to move a patient's muscles and joints with stretching, gentle pressure and resistance). Physiotherapy (treatment that uses physical agents, such as exercise and massage, to develop, maintain and restore movement and functional ability) also is helpful.

Here are—in no special order—the best natural pain relievers, which can be taken alone or in combination…

  • White willow bark extract is great for headaches, arthritis, muscle aches and fever. In Europe, doctors prescribe this herbal remedy for back pain, and recent research supports this use. One study conducted in Haifa,Israel, involved 191 patients with chronic low-back pain who took one of two doses of willow bark extract or a placebo daily for four weeks. Researchers found that 39o/o of patients taking the higher dose of willow bark extract had complete pain relief, compared with only 6o/o of those who Pain Relief were taking a placebo. The participants who benefited the most took willow bark extract that contained 240 mg of the compound salicin,the active constituent in this herbal remedy. (Aspirin is made from acetylsalicylic acid., which has many of the chemical properties of salicin.) However, aspirin can cause gastrointestinal ulceration and other side effects, including kidney damage. Willow bark extract is believed to work by inhibiting naturally occurring enzymes that cause inflammation and pain.

I recommend taking willow bark extract that contains 240 mg of salicin daily. In rare cases, willow bark extract can cause mild stomach upset. Don't take willow bark if you have a history of ulcers, gastritis or kidney disease. It also should not be taken by anyone who is allergic to aspirin. As with aspirin, willow bark extract should never be given to children under age 12 who have a fever-in rare instances, it can cause a fatal disease called Reye's syndrome. 'Willow bark extract has blood-thinning properties, so avoid it if you take a blood thinner, such as warfarin (Coumadin). For low-back pain, you may need to take willow bark extract for a week or more before you get results.

  • Methylsulfonylmethane (MSM) is a popular nutritional supplement that relieves muscle and joint pain. According to StanleyJacob, MD, a professor at Oregon Health & Science University who has conducted much of the original research on MSM, this supplement reduces inflammation by improving blood flow. Your cells have receptors that send out pain signals when they're deprived of blood. That's why increased blood flow diminishes pain.

MSM, a natural compound found in green vegetables, fruits and grains, reduces muscle spasms and softens painful scar tissue from previous injuries. A double-blind study of 50 people with osteoarthritis of the knee found that MSM helps relieve arthritis pain. Start with a daily dose of 3,000 mg to 5,000 mg of MSM. If your pain and/or inflammation doesn't improve within five days, increase the dose up to 8,000 mg daily, taken in several doses throughout the day. If you develop digestive upset or loose stools, reduce the dosage. If you prefer, you can apply MSM cream (per the label instructions) to your skin at the painful area.

This product is available at health-food stores and works well for localized pain. MSM has a mild blood-thinning effect, so check with your doctor if you take a blood thinner.

  • S-adenosylmethionine (SAMe) is a natural compound found in the body. The supplement is an effective treatment for people who have osteoarthritis accompanied by cartilage degeneration. SAMe's ability to reduce pain, stiffness and swelling is similar to that of NSAIDs such as ibuprofen and naproxen, and the anti-inflammatory medication Celebrex. There's also evidence that SAMe stimulates cartilage repair, which helps prevent bones from rubbing against one another. A 16-week study conducted at the University of California, Irvine, compared two groups of people who were being treated for knee pain caused by osteoarthritis. Some took 1,200 mg of SAMe daily, while others took 200 mg of Celebrex. It took longer for people to get relief from SAMe, but by the second month, SAMe proved to be just as effective as Celebrex.

Most patients with osteoarthritis and fibromyalgia (a disorder characterized by widespread pain in muscles, tendons and ligaments) who take SAMe notice improvement within four to eight weeks. Many studies use 1,200 mg of SAMe daily in divided doses. In my experience, taking 400 mg twice daily works well. It's a good idea to take a multivitamin or 50-mg B-complex supplement daily while you're taking SAMe. The vitamin B-12 and folic acid contained in either supplement help your body metabolize SAMe, which means that the remedy goes to work faster.

  • Kaprex is effective for mild pain caused by injury or osteoarthritis. It is a blend of hops, rosemary extract and oleanic acid,which is derived from olive leaf extract. Rather than blocking the body's pain-causing enzymes, these natural substances inhibit pain-causing chemicals called prostaglandins.

In a study sponsored by the Institute for Functional Medicine, the research arm of the supplement manufacturer Metagenics, taking Kaprex for six weeks reduced minor pain by as much as 72o/o. I recommend taking one 440-mg tablet three times daily. Kaprex is manufactured by Metagenics (800-692-9400, www.metagenics.com), the institute's product branch. The product is sold only in doctors' offices. To find a practitioner in your area who sells Kaprex, call the toll-free number. Kaprex has no known side effects and does not interact with other medications.

  • Proteolytic enzymes, including bromelain, trypsin, chymotrypsin, pancreatin, papain and a range of protein-digesting enzymes derived from the fermentation of fungus, reduce pain and inflammation by improving blood flow. You can find these natural pain fighters at health-food stores in products labeled "proteolytic enzymes." Take as directed on the label. Bromelain, a favorite of athletes, is available on its own. Extracted from pineapple stems, bromelain reduces swelling by breaking down blood clots that can form as a result of trauma and impede circulation. It works well for bruises, sprains and surgical recovery. If you use bromelain, take 500 mg three times daily between meals.

Repair is a high-potency formula of proteolytic enzymes that I often recommend. It is manufactured by Enzymedica (to find a retailer, call 888-918-1118 or go to utuu.enzymedica.com). Take two capsules two to three times daily between meals. Don't take Repair or any proteolytic enzyme formula if you have an active ulcer or gastritis. Any enzyme product can have a mild blood-thinning effect, so check with your doctor if you take a blood thinner.

  • Pain Med is the homeopathic gel that gave such quick relief to the patients I described at the beginning of this article. It is remarkably effective for relieving the pain of arthritis, muscle soreness and spasms, sprains, strains, stiffness, headaches (especially due to tension) as well as injuries, including bruises.

Pain Med is a combination of nine highly diluted plant and flower materials, including arnica, bryonia, hypericum and ledum. Like other homeopathic remedies, it promotes the body's ability to heal itself. A bean-sized dab works well for anyone who has pain. It should be spread on the skin around the affected area. Following an injury, use it every 15 minutes, for a total of up to four applications. As the pain starts to diminish, apply less often. Do not reapply the gel once the pain is gone. Pain Med does not sting, burn or irritate the skin. It is clear, has no odor, does not stain and dries quickly. Because it has so many uses and works so rapidly, Pain Med is a good first-aid remedy to have on hand. Call GM International, Inc., at 800-228-9850, or go to www.gmipainmed.com to order.

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