Chronic pain is often difficult to treat and can be frustrating for
both patient and doctor. However, natural medicine is sometimes beneficial
in treating certain conditions that cause chronic pain. While some
natural remedies for chronic pain work by a direct analgesic effect,
most of the effective treatments are aimed at addressing the cause
of the pain. Thus, a treatment that is effective for one type of painful
condition may provide little or no relief from the pain caused by a
In my experience, the pain of fibromyalgia improves in approximately
50% of cases after intravenous administration of magnesium, calcium,
B vitamins, and vitamin C (the Myers' cocktail).1 Some patients
do not improve until they have received a total of four weekly injections.
After improvement occurs, maintenance injections can be given, as needed,
usually every two to four weeks, or less often in some cases. Intravenous
nutrient therapy tends to be more effective if other abnormalities
associated with fibromyalgia are addressed, such as food allergy and "sub-laboratory
Another potential cause of chronic musculoskeletal pain that can mimic
fibromyalgia is vitamin D deficiency. People who live at northern latitudes,
stay indoors, or cover themselves completely with clothing or sunscreen,
are at risk of developing vitamin D deficiency. Obesity, old age, malabsorption,
or avoidance of vitamin D-fortified foods such as dairy products, also
increase the risk of becoming deficient in vitamin D. The best diagnostic
test for vitamin D deficiency is the serum concentration of 25-hydroxyvitamin
D. Some investigators believe that the lower limit of the standard
laboratory reference range is too low, and that many patients in the
low-normal range can benefit from vitamin D supplementation. While
the optimal dose of vitamin D is not known, a growing body of evidence
suggests that the RDA of 400 IU/day is not sufficient for some people.
Long-term supplementation with 1,000 IU/day of vitamin D appears to
be safe for adults, and some investigators have suggested that as much
as 4,000 IU/day is safe.3 Despite the apparent safety of relatively
high doses of vitamin D, there are probably significant differences
in individual tolerance to the vitamin. Consequently, vitamin D therapy
should be undertaken with respect for its potential toxicity. Early
manifestations of vitamin D toxicity may include hypercalciuria and
nephrolithiasis; more advanced toxicity can cause hypercalciuria and
soft-tissue calcification. When using large doses of vitamin D, appropriate
laboratory monitoring should be done. There is some evidence that vitamin
D3 (the type of vitamin D sold over the counter and produced in the
skin) is safer than vitamin D2 (the form contained in some prescription
vitamin D preparations).
Migraine headaches can often be prevented by identifying and avoiding
allergenic foods and by avoiding vasoactive amines such as tyramine
and possibly phenylethylamine (present in chocolate). Oral supplementation
with magnesium (200 to 600 mg per day), riboflavin (400 mg per day),
coenzyme Q10 (150 mg/day) and the herb feverfew have each been reported
to reduce the recurrence rate of migraines. When a migraine does occur,
the pain can usually be eliminated or greatly reduced within a matter
of minutes by intravenous administration of magnesium4 or the Myers' cocktail.
The pain associated with rheumatoid arthritis may respond to the avoidance
of allergic foods or to supplementation with nutrients such as zinc,
copper, fish oil, and gamma-linolenic acid from borage oil. The symptoms
of osteoarthritis may be relieved by glucosamine sulfate, chondroitin
sulfate, niacinamide, or ginger.
There is anecdotal evidence that supplementation with approximately
10 grams of vitamin C per day will occasionally relieve the pain caused
by cancer, although it is not clear how vitamin C works. There is one
older report that daily injections of 20–30 mg of vitamin K relieved
cancer-related pain in more than 80% of 115 patients with advanced
A direct analgesic effect has been reported for topical capsaicin (Zostrix®;
a component of chili peppers) in the treatment of pain caused by postherpetic
neuralgia or diabetic neuropathy. Topical application of capsaicin
depletes from the skin a compound known as substance P, which is one
of the body's mediators of pain. While capsaicin does not appear
to influence the disease process, it does provide worthwhile symptomatic
relief in some cases. Capsaicin tends to cause transient burning of
the skin during the first few days of application.
D,L-phenylalanine has also been reported to exert a direct analgesic
effect, supposedly by inhibiting the breakdown of certain endorphin-like
compounds in the body. In my experience, however, and in the experience
of some of my colleagues, D,L-phenylalanine is not particularly effective
as a treatment for pain.
Natural medicine is certainly not effective against all cases of chronic
pain, and the results tend to be disappointing when the pain is caused
by cancer, hip or vertebral fractures, severe arthritis, or other debilitating
conditions. However, because the treatments discussed here are relatively
safe and non-addictive, an appropriate therapeutic trial should be
considered for individuals dependent on opiates, non-steroidal anti-inflammatory
drugs, analgesics, or other pain-relieving medications.
1. Gaby AR. Intravenous nutrient
therapy: the "Myers' cocktail." Altern
Med Rev 2002;7:389–403.
2. Gaby AR. "Sub-laboratory" hypothyroidism and the empirical
use of Armour thyroid. Altern Med Rev 2004;9:157–179.
3. Vieth R, et al. Efficacy and safety of vitamin D3 intake exceeding
the lowest observed adverse effect level. Am J Clin Nutr 2001;73:288–294.
4. Bigal ME, et al. Intravenous magnesium sulphate in the acute treatment
of migraine without aura and migraine with aura. A randomized, double-blind,
placebo-controlled study. Cephalalgia 2002;22:345–353.
5. Kubovic M, et al. Analgesic property of vitamin K. Proc Soc
Exp Biol Med 1955;90:660–662.