There are two main types of chronic pain. One is continuing pain that is clearly associated with a known physical problem. Arthritis, or pain in joints, is an example of chronic pain that is connected to a known physical problem.

The second type of chronic pain is pain that is not associated with a clear physical cause—the “nothing wrong” kind of chronic pain. Lower back pain is frequently in this category. All-over bodily pain (musculoskeletal pain) is another type of agonizing pain without apparent cause that doctors frequently dismiss, misdiagnose and mistreat. These kinds of pain can be extremely frustrating for doctors and patients. You know you’re in pain, but doctors can find “nothing wrong.” Fortunately, the latest research discoveries reveal there are real causes and natural solutions to these kinds of pain.

In this article you will learn about the latest research on safe, effective solutions to both kinds of chronic pain. One of the most exciting discoveries in recent years is the powerful effect of natural vitamin D3—the sunshine vitamin—on pain. Knowledge about vitamin D3 is one of the most important scientific breakthroughs of the decade and my personal top health story for 2007. For complete news about vitamin D3, look for the full report in the next issue of Natural Health News Report. Boswellia serrata is another natural solution to inflammation and pain with powerful new research to back up its effectiveness.


Doctors have known about the inflammation-pain connection since ancient times. A Roman physician who lived from about 30 B.C. to 45 A.D. described the features of inflammation as redness, warmth, swelling and pain. This is natural. When an injury, illness or invasion by pathogen occurs, the body sends white blood cells to the area to attack the problem and one of the results is pain. Once the immune system succeeds in resolving the problem, the inflammation and pain go away. That’s normal. What’s not normal is the continuation of either the inflammation or the pain.

Natural solutions don’t just mask the pain. They support the body’s normal inflammation response—by bringing inflammation and pain down once they’ve done their job. This is especially important for seniors. Inflammation doesn’t come down as effectively once you are over age 60. Once it’s triggered, inflammation in seniors tends to stay elevated. Natural solutions can help your inflammation and pain levels return to normal. In a very recent clinical study of osteoarthritis patients, those who took the natural pain remedy boswellia continued to have lower pain and inflammation one month after the study ended. The group taking an NSAID saw their pain return.[i]


In a startling new breakthrough about “nothing wrong” pain, Professor Min Zhuo of WashingtonUniversityin St. Louis, Missouri, reports that the brain is the culprit for lasting pain with no physical cause. Why? Inflammation etches pain into the memory part of your brain. The brain then “remembers” and mimics the pain long after the physical source of the pain has disappeared. That’s why doctors can’t find anything wrong—you are feeling the pain due to signals from your brain, but the physical problem is no longer there. High levels of inflammation increase levels of a protein responsible for persistent pain.[ii]


The study by Professor Zhuo supports other advanced research in pain that has discovered that lowering inflammation and retraining the brain are two important keys to pain management.

Contrary to conventional ideas taught in most medical schools, pain does not start at the site of the injury or disease. Pain actually begins in the brain. When your cells are damaged, your nerve fibers deliver a message of “stimulation” to the spinal cord that relays that message to the brain. The brain then combines the new message with its own thinking. The combined message from the spinal chord and your thinking is relayed to more parts of the brain and the brain decides how you are going to feel pain.

Research has shown that if you think you are going to feel pain, your brain agrees with you and “decides” to feel pain more strongly. If you don’t expect to feel pain, you are much more likely to not feel pain or feel it less strongly. Fear, depression, anxiety and negative expectations lead to more pain. Utilizing brain training, meditation, guided imagery and other ways to affect your thinking about pain can be very effective. In fact, the leading experts on pain agree that the brain is the key to controlling pain.[iii]

Because so many areas of the brain are involved in pain, Dr. Karen Berkley, a neuroscientist at Florida State University, says that there’s no one “magic bullet” solution. Most doctors are trained to find the one “best” medication or treatment and apply it to everyone. If one treatment doesn’t work, then they try another. Pain doesn’t work that way, says Dr.Berkley. According to her, the most effective treatment of pain uses an “ensemble” or integrated collection of different treatments—not just one.


People who are depressed are more than twice as likely to have chronic pain compared to people who are not depressed say researchers at the Stanford School of Medicine. Headaches and backaches are most commonly found in depressed people. Chronic pain is a symptom of depression that is often overlooked. Which comes first? Scientists don’t know, but they believe that perception of pain could be greater in depressed people.[iv]

In a study published in the 2005 Proceedings of the National Academy of Sciences, Dr. Robert Coghill and his research team discovered that positive expectation was as powerful as a shot of morphine for relieving pain. Positive expectation reduced activity in the area of the brain that process pain.[v]

It’s hard to have positive thoughts when you’re depressed and it’s hard to feel positive when you’re in pain. Natural solutions such as thought retraining can help. Having adequate levels of vitamin D may also contribute to relieving both depression and pain.


Low back pain is one of the most common types of chronic pain. However, don’t sign up for surgery. Spinal operations for chronic low back pain aren’t effective say two prestigious medical journals. The frequency of lumbar fusion operations has risen from 11,000 procedures in 1996 to 37,000 in 2001. A study in the Canadian Medical Association Journal (August 16, 2005) concluded that lumbar fusion surgery didn’t work better than physical therapy combined with cognitive/behavioral training. An article in The European Spine Journal (December, 2005) reviewed all of the published studies on invasive treatments for lower back pain. Their verdict? Don’t do it! Facet joint, epidermal, trigger point, sclerosant injections and spinal stenosis are not recommended. See below to find out what does work for low back pain.

What about surgery for that arthritic knee? Nope. Arthroscopic surgery for osteoarthritis is ineffective says The New England Journal of Medicine (2002;347:81-8) Patients studied for two years after surgery never did better than the placebo group, and at times the placebo group did better! Conclusion: this $5,000 procedure is a waste of money and your health for relieving the pain of osteoarthritis.







To learn more about the dangers of inflammation and what to do about them, I recommend my book The Cardiologist’s Guide to Anti-Aging, Antioxidants and Resveratrol.


This is not a complete guide to natural pain remedies, but it does represent the wide variety of natural pain supplements that have supportive research evidence.

The National Institutes of Health report that the most common types of chronic pain are low back, migraines, arthritis, “fibromyalgia”, shingles, neuropathy, cancer, and traumatic injury. You’ll find natural solutions for all these types of chronic pain in this guide.


Vitamin D3

Patients who were in pain from a wide variety of problems, and who were also deficient in vitamin D, needed twice the dose of morphine to reduce pain as those who were not deficient. Pain caused by vitamin D deficiency alone responds poorly to opiates and other analgesics.[vi] If you have severe chronic pain for any reason, insist that your doctor test your vitamin D levels.

Baikal skullcap

Baikal skullcap (Scutellaria baicalensis) has been used in Chinese medicine for inflammatory conditions. It was recently discovered that it is effective in inhibiting age-related inflammation.[vii] [viii]

Turmeric (Curcumin)

Curcumin, the active ingredient in the curry spice turmeric, has over 2000 published research studies examining its anti-inflammatory and antioxidant properties. It inhibits both COX-2 and LOX inflammatory enzymes and has been shown to be effective against arthritis and other inflammatory diseases. It is one of the best known herbal anti-inflammatories. It reduces inflammation and mild pain in approximately one week. Absorption and effectiveness is enhanced by a proprietary black pepper extract Bioperine™. [ix]


Naturally found in onions and apples and available as a supplement, quercetin is a potent general anti-inflammatory.[x]


Resveratrol is most commonly found in grapes, grape juice, red wine and the herb Polygonum cuspidatum. It is a powerful antioxidant as well as general anti-inflammatory.[xi]


Feeling pain in every muscle and joint is sometimes diagnosed as fibromyalgia or, most frequently, somatisation. Somatisation is what doctors call it when they think it’s “all in your head” and “nothing’s physically wrong with you.” Well, the latest research proves there is often something physically wrong and a simple vitamin can cure it.

Vitamin D3

Out of 33 women with severe musculoskeletal pain, 90.9% were diagnosed as having “nothing physically wrong with you.” All women were tested for vitamin D and all were deficient. After treatment with 800 IU of D3 plus 1000 mg calcium daily, given orally or intramuscularly, 66.7% responded and were pain free within 2.84 months. Patients had suffered two and a half years before correct diagnosis and treatment. [xii] (I think it’s possible that the others would have responded to higher doses of vitamin D3.)

The Mayo Clinic also reported that of 150 patients with persistent nonspecific musculoskeletal pain, 93% were deficient in vitamin D. All had initially been misdiagnosed as “nothing physically wrong.”[xiii]


Vitamin D 3

I think you are seeing a trend here, aren’t you? Of 360 patients who had low back pain with no obvious cause, 83% had abnormally low levels of vitamin D. After treatment with oral vitamin D at 5,000-10,000 IU daily, 95% of patients improved.[xiv]

Devil’s Claw

A Cochrane Review found strong evidence that daily doses of 50-100 mg Devil’s Claw (Harpagophytum procumbens) was equivalent to 12.5 mg of Vioxx in pain relief.[xv]

White Willow Bark

This natural herb contains the same active ingredient as aspirin, but it does not have the same side effects on the stomach. Those who are allergic to aspirin, however, may also be allergic to white willow bark (Salix alba). Two trials have found that daily doses of 120 mg were as good as 12.5 mg per day of rofecoxib.[xvi]


A German observational study of 2,564 patients with chronic low back pain showed that after 9.7 sessions of acupuncture over 6 months, 45.5 % demonstrated clinically significant improvement and the number of days with pain was decreased by half. [xvii]


Boswellia serrata

Boswellia has been used for thousands of years to treat conditions that we now know are caused by inflammation. Boswellia reduces inflammation by blocking different inflammatory enzymes than NSAIDS. Boswellia blocks TNF-alpha, 5-LOX, and HLE. It is the only anti-inflammatory compound discovered so far that inhibits all of these enzymes.[xviii] Boswellia has been shown to be effective in reducing pain of osteoarthritis.[xix]

Boswellia decreased arthritis pain and inflammation more than the NSAID valdecoxib during a seven-month trial. Joint health and function increased each month and the results were more lasting in the group that took boswellia. One month after the trial was over, the boswellia group’s scores for pain and inflammation remained low, while the NSAID group increased back to near baseline levels. [xx]

Boswellia products that contain 30% AKBA, a compound in boswellia that has the most effect on reducing the inflammatory enzyme 5-LOX, have been shown to be as effective as ibuproben and prednisone.[xxi] One of the advantages of boswellia is that it works quickly to relieve the pain of osteoarthritis—within two weeks for most people.

Hops extract

Most people know that the herb used in beer is hops. But few people know that an extract of hops can reduce inflammation and associated pain by isolating the actions of inflammatory enzymes such as prostaglandin E2.[xxii]

Cat’s Claw

A vine from the Amazon, Cat’s claw (Uncaria tomentosa and Uncaria guianensis), is commonly used to treat arthritis and osteoarthritis. It appears to work by inhibiting inflammation caused by TNF-alpha.[xxiii]

Turmeric (Curcumin)

The latest research shows that curcumin inhibits the specific type of inflammation in osteoarthritis.[xxiv]

Devil’s Claw

A 2007 review found that Devil’s Claw (Harpagophytum procumbens) had strong evidence for the treatment of painful osteoarthritis.[xxv]

Unsaponifiable avocado soybean fraction

The same review gave this natural treatment a thumbs up.[xxvi]


The National Institutes of Health study (GAIT) found that 80 percent of 1500 people reported that glucosamine and chondroitin were significantly more effective at reducing moderate to severe knee pain than placebo. It took from two weeks to two months to perceive benefits.


Listening to Mozart decreased the pain of osteoarthritis in seniors.[xxvii]


Vitamin D3

Having a low level of vitamin D may raise your risk of developing rheumatoid arthritis.[xxviii] Maintaining an adequate level of vitamin D may help you maintain optimal bone mass if you receive corticosteroid treatments for rheumatoid arthritis.[xxix]

Cat’s Claw

Forty people with rheumatoid arthritis who were receiving prescription medication treatments were also given cat’s claw (Uncaria tomentosa) or placebo for 24 weeks. Joint pain was reduced by 53% in those taking cat’s claw compared to 24% on placebo. Those taking cat’s claw continued to improve.[xxx]

Boswellia serrata

Boswellia is a natural plant resin that helps reduce immune cells that raise inflammation and increase immune cells that reduce inflammation. Basically, it helps your body get back to normal after an injury or illness, without lingering inflammation. In rheumatoid arthritis, it may help suppress the overactive immune cells that cause ongoing inflammation and cell damage.[xxxi] Look for boswellia products that contain at least 30% AKBA, a compound in boswellia that has the most effect on reducing the inflammatory enzyme 5-LOX.


Bromelain from pineapple has anti-inflammatory effectiveness.

Hops extract

An extract derived from hops alpha acids reduced the inflammatory COX-2 enzyme by 56% compared to a 62% reduction for ibuprofen. The hops extract was as potent as ibuprofen but gentler on the stomach.[xxxii]

Vitamin E

Vitamin E was found to be more effective than placebo in reducing joint pain in rheumatoid arthritis.[xxxiii]

Fish oil and olive oil together

There was significantly more improvement in suffers of rheumatoid arthritis when fish oil was taken along with olive oil over a period of 12 weeks. The two oils together helped reduce pain, stiffness, fatigue and improved hand grip.[xxxiv]


Five weeks of classical massage therapy, ten 20-minute sessions, reduced pain and elevated mood compared to conventional medications.[xxxv]


Acupuncture treatments reduced pain of rheumatoid arthritis by up to 52%.[xxxvi]


Vitamin D and Calcium

Two case studies showed that women treated with vitamin D and calcium cited major reduction in headache attacks within two months.[xxxvii]


Three trials found that feverfew reduces the frequency of migraine attacks and reduces pain, nausea and vomiting. [xxxviii]


Topical essential oils


In a study with 30 people who used topical geranium oil, all had significant reductions in pain due to shingles. Those who used the highest percentage of geranium oil (100%) had more pain relief than lower percentages. Skin reactions may occur, especially at the higher concentration.[xxxix]


A case study of one 76-year-old woman who had suffered from shingles pain for three years revealed that she had tried a variety of natural and conventional treatments without relief. Her doctor recommended she apply two to three drops peppermint oil to the affected areas. She had a stinging sensation that lasted two minutes followed by complete relief of pain for approx six hours. Repeated applications were necessary but resulted in redness of skin. Oil diluted to 80% did not cause redness but relief was not as strong.[xl]


Acetyl L-Carnitine

In a study with 1200 people, acetyl L-carnitine significantly reduced pain and improved nerve function in diabetic neuropathy. This natural supplement also helped heal damaged nerves and form new nerve fibers.[xli] It also relieved pain from other neuropathies, including those resulting from cancer chemotherapy.[xlii]

Alpha Lipoic Acid

The use of alpha lipoic acid either intravenously for three weeks or orally has shown great effectiveness in reducing pain and other symptoms in diabetic neuropathy.[xliii]


Vitamin D3

Men with prostate cancer taking 2000 IU a day of vitamin D3 improved functionality and quality of life.[xliv]

Acupuncture, Massage, Mind-body, Music

Researchers from the SloanKetteringCancerCenterin New Yorksupport the effectiveness of acupuncture, massage therapy, mind-body interventions, and music therapy to reduce cancer pain. The authors conclude that such therapies have an important role in modern cancer pain management.[xlv]


Vitamin D3

Research has shown that depression and negative expectations can increase pain. Recent research on vitamin D3 is encouraging in reducing depression and improving a sense of well being that may reduce perception of pain.[xlvi] Vitamin D reduced depression in people with seasonal affective disorder better than treatment with bright light.[xlvii]


Mirror therapy

Phantom limb pain occurs in at least 90% of limb amputees. Using mirror therapy, phantom limb pain decreased in 100% of patients. Pain was not reduced by mental-visualization or covered-mirror treatment. Researchers think that pain relief may be due to the activation of mirror neurons in the brain.[xlviii]


  1. Find a pain specialist who’s up to date on the latest research about the brain, pain, and alternative treatments. It may take some diligence on your part as there are fewer than 2,000 pain specialists in theU.S.Take the time to find a good one. It can make a huge difference in effectively treating your pain.
  2. Embrace new ways to end your pain such as cognitive and behavioral training to change the way you think and react to pain. It often takes only three or four sessions to be effective. Find a cognitive/behavioral pain specialist—they don’t have to be a doctor.
  3. Challenge yourself to eat a healthy, low-inflammation diet, walk or do chi gong or yoga daily, and take the right natural supplements.
  4. Insist on being tested for vitamin D NOW! If you are deficient, make sure you take enough vitamin D3 to establish adequate levels. (The latest research indicates you can safely take up to 5,000 IU of D3 a day and it may take several months to reach optimal levels.) If your doctor isn’t knowledgeable about vitamin D3, ask him or her to refer you to someone who is.
  5. Get a massage as often as you can afford it. Inquire at local massage schools. They often have clinics that are very reasonable.

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[ii] Zhuo M, et al. Upregulation of forebrain NMDA NR2B receptors contributes to behavioral sensitization after inflammation. J Neurosci. 2005 Nov 30;25(48):11107-11032.

[iii] University of Manchester (2006, December 23) Pain relief effectiveness down to mind-set? ScienceDaily Human Pain Research Group

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[xvii] Weidenhammer W, et al. Acupuncture for chronic low back pain in routine care: a multicenter observational study. Clin J Pain. 2007 Feb;23(2):128-35.

[xviii] Brower V. Ancient herb suppresses inflammation. Life Extension Foundation, March 2007: 71-75.

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[xx] Sontakke S, et al. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of the knee. Indian J Pharmacol. 2007;39(1):27-29.

[xxi] Brower V. Ancient herb suppresses inflammation. Life Extension Foundation, March 2007: 71-75

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[xxiv] Shakibaei M, et al. Suppression of NF-kappaB activation by curcumin leads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinase-9 in human articular chondrocytes: implications for the treatment of osteoarthritis. Biochem Pharmacol. 2007 May 1;73(9):1434-45.

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[xxvii] J Adv Nursing 2003;44:517-24.

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[xxxi] Ammon HP. Boswellic acids in chronic inflammatory diseases. Planta Med. 2006 Oct;72(12):1100-16.

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[xxxiv] Berbert A, et al. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition 2005 Feb;21(2):131-36.

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[xxxvii] Thys-Jacobs S. Vitamin D and calcium in menstrual migraines. Headache. 1994 Oct;34(9):544-6.

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