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Topical Pain Relievers: The Herbal Approach

Topical Herbs For Pain Relief

Now that we’ve reviewed common (conventional) topicals for pain, let’s look more closely at the wide range of herbal remedies available.

First, a quick but essential rule about using herbs. You’ll be more successful in treating pain if you make a differential diagnosis. To make a differential diagnosis, answer the following questions.

  • What does the pain feel like? Is it sharp, dull, throbbing, electric, piercing, aching, spasming?
  • How severe is it?
  • When did it start? Is this chronic pain, or acute?
  • What is the “temperature” of the pain? Does it feel hot to the touch? Cold? Is the area swollen, or red?
  • Where exactly is it located? Could it be referral pain? (i.e. Pain in your neck that you feel in your forearms; see a dermatome map to make sense of this.)
  • What makes it better or worse (heat, ice, stretching, rest)?
  • Does it have a particular pattern (i.e. always hurts first thing in the morning, gets worse at night, etc)?

Now that you better understand the pain you’d like to treat, it’s likely that you can better treat it. Below are common kinds of pain, and my favorite topical herbs to bring relief. Know that the language of Traditional Chinese Medicine (TCM) is rich in metaphor, and that these metaphors are used to understand the body. Below, we’ll differentiate between different types of pain.

Cold Pain

According to Traditional Chinese Medicine, “cold” can cause qi and blood to contract and congeal, creating stagnation, pain, and stiffness. Cold will tend to affect the low back and the joints, and pain associated with “coldness” tends to feel deep, achy, and stiff. Typically, there is no redness or swelling; heat and pressure applied to the area feels good.

Examples of “cold” pain include old injuries that have been overly iced or controlled with common pain relievers, like aspirin and ibuprofen. This type of pain can also worsen on cold days. The pain of osteoarthritis, fibromyalgia, chronic low back pain, and menstrual cramping often involve this concept of “cold.”  If it’s stiff and achy in the morning, and a heating pad feels good on the area, try one of the herbal remedies below.

Hot Ginger Compress (from Guido Mase’s wonderful book, The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants)

  • 3 teaspoons ginger powder or six 1/4 inch slices of peeled, fresh ginger root
  • 1 cup of water
  • a clean piece of cloth (I like ripping up my old, soft flannels for this)
  • Make a really strong tea (if using fresh root, simmer slices for 20 minutes; you may have to add more water)

Saturate the cloth with this warm ginger tea. Wring it. Apply cloth directly to area of pain. (This is especially awesome for low back pain and pelvic pain associated with menstruation.)

Green Willow Liniment

This is a formula from the Tuina Department of the Anhui College of Chinese Medicine. Herbs in this formula warm the channels, move qi and blood, and strengthen the tendons, ligaments, and bones. Great for stiff, achy joints that loosen up in a hot shower or with movement.

Hot, Damp, and Wind Pain

I lump these together since in chronic conditions they often show up together (or in some combination of two).

Hot Pain: Pain associated with heat tends to feel warm to the touch and will often throb and swell. Hot pain can arise from chronic conditions (like rheumatoid arthritis) or from acute injures (see below for more on acute injuries).

Damp-Heat Pain: Typically the joint swelling of autoimmune issues involve both heat and “dampness” and require cooling herbs, as well as herbs that will deal with the additional element of damp. Dampness can manifest at swelling, edema, and a sensation of heaviness anywhere in the body, but often affects the joints.

Wind Pain: If the pain moves around, or involves spasms or constriction, then “wind” is also involved. An Epsom salt bath is a favorite for muscles in spasm, or muscles that won’t release.

Below is my liniment of choice for pain that involves elements of wind, damp, or heat (or any combination of the two of these). Awesome for those with RA or other autoimmune conditions that leave the area hot and swollen.

Three Angels Liniment: This Chinese herbal formula is based on San Miao San (Three Wonders Powder). Herbs in this liniment clear heat, eliminate dampness, and free the joints (help increase range of motion).

Hot Pain: Acute Sprains and Strains

Acute injuries in this context refers to injuries in which the skin has NOT been broken. A rolled ankle, twisted knee, or stubbed toe/finger is a good example.

An acute injury, like a sprain/strain always involves some amount of heat. Though ice might feel good immediately after an injury, it’s controversial to whether ice should be used in the healing process for longer than the initial days of an injury. See my recommendation below.

Day 1-2: Upon initial injury, use ice and elevation to reduce swelling for the next couple of hours. Between icings, use topical arnica.

Use a San Huang San poultice a night for the next couple of days. Wrap and go to sleep. If you don’t have San Huang San, continue to ice and elevate for 15 minutes at a time every couple of hours. San Huang San, in my opinion, is more effective than ice in early-injury care. Ideally, the initial injury would be iced, then treated with San Huang San for the next two days. (See more on San Huang San below.)

San Huang San: Known as “herbal ice.” An incredible formula that will reduce swelling and pain when used correctly. See more about it here.

Day 2-10: When the area is no longer acutely inflamed (no longer feels warm to the touch), alternating warm and cold is the best approach (10 minutes ice, 15 minutes of a warm wrap or soak). This is basic hydrotherapy, and gets fresh blood into the area by constricting and dilating the blood vessels.

Combined with hydrotherapy, use a formula that will deal with “blood stasis” and quicken healing. Shaolin Dee Dat Jow is something that everyone should have in their first aid cabinet.

Shaolin Dee Dat Jow Liniment: Dee Dat Jow is Cantonese for die da jiu, fall and strike wine. This formula was transmitted by the Shaolin monastery, the famous Chinese monastery where martial arts were practiced and developed. Herbs in this formula move qi and blood, free the flow in the channels, and alleviate pain.

Topicals for Overuse

Sometimes, people don’t really fit in the category of “cold’ or “heat” and they complain that parts of their body just feel “tired” and “overused.” I hear this a lot from those who work in the food industry (wait staff and cooks), hair stylists, cashiers, farmers, and runners.

Zheng Gu Shui: Zheng Gu Shui means “heal bone water.” This is awesome for the kind of joint pain that comes from overuse, including carpel tunnel and tennis elbow. Zheng Gu Shui moves qi and blood, breaks up blood stasis, stops pain, relaxes muscles and tendons, and is said to speed up the process of healing broken bones.

(Helpful hint: If you work on your feet, or deal with plantar fasciitis, apply this liberally to the bottom of your feet and let it dry before putting on shoes/socks.)