Managing pain: solutions and ways to support from a herbal medicine perspective
I originally wrote this blog piece for The Practice Rooms blog and it was featured in July 2026. Reposting here
Chronic pain often becomes more than a physical symptom: it can affect mobility, lifestyle, sleep, mood, work, relationships and confidence. For many people, chronic pain changes how they plan their day, how much energy they have, and how they feel in their own body. It can change what they are and are not able to do, whether that is hobbies, relationships or work. Often the conventional approaches to dealing with pain can come with quite difficult questions around the risk versus reward around the side effects or the long term use of painkillers.
A medical herbalist will not just think “Which herb is good for pain?” Instead, the herbalist will look at the whole person through detailed case history taking, observation, and clinical findings, if necessary. In a consultation, they will explore where the pain is felt, how it behaves, what improves or aggravates it, and whether it feels sharp, burning, cramping, aching, inflammatory, cyclical or nerve-like. They will also ask about digestion, circulation, hormones, sleep, stress, medication, medical history and the emotional impact of living with pain. All of these questions goes into understanding the pain, the root cause, other impacts and how the herbalist might best treat the patient. It goes well beyond herbs with analgesic properties, though that will often be an aspect of treatment.
This wider picture matters because chronic pain rarely exists in isolation. Poor sleep may lower pain tolerance. Stress can increase muscle tension, sensitivity, and inflammation. Reduced movement may lead to stiffness or deconditioning. Low mood can make pain feel more overwhelming. Supporting a patient means understanding the different pain pathways, inflammation, nervous system regulation, tissue repair, and the energetics of a person (hot/cold/dry/moist) to create the best treatment for symptom relief and targeted treatment of underlying conditions.
A starting point often may be topical herbal treatment if the pain is localised. Creams, oils, balms or ointments can be blended to apply directly to the painful area. Depending on the presentation, a herbalist may choose warming herbs to encourage circulation, cooling herbs to soothe heat and irritation, or relaxing herbs for tight muscles. Common topical ingredients include capsicum, wintergreen, lavender, peppermint, rosemary, St John’s wort infused oil and devil’s claw. These can offer temporary relief and give clients a practical tool they can use between appointments.
A medical herbalist will also typically prescribe internal medicine for a patient. This could be given as a tea, tincture (herbal extract in alcohol/water), powder or capsules. The choice depends on the person, their other conditions, the type of pain and any medicines they take and always needs to be made by a qualified medical herbalist. Herbalists often work with specific herbal actions. Anti-inflammatory herbs may be considered where inflammation is part of the picture; nervous system herbs may be used when pain is linked with tension, stress or poor sleep; and circulatory or antispasmodic herbs may be chosen when pain involves stiffness, cramping or muscle spasm. Examples sometimes used in clinical herbal practice include turmeric, ginger, frankincense, willow bark, meadowsweet, cramp bark, valerian, skullcap, oats, nettle and devil’s claw. Chronic pain can take many different shapes – from nerve pain, to muscular pain to reproductive pain and it is important that those forms of pain are all treated in the best way and not lumped into one category of pain.
Alongside herbs, lifestyle and diet support is central. A medical herbalist will often make both diet and lifestyle advice. For example, patients may benefit from gentle pacing rather than pushing through pain and then crashing. Small, regular movement, warmth, stretching, breathing practices, rest breaks and sleep routines can all help reduce the overall burden on the nervous system and help the body recover. Food can also be part of the conversation: regular meals, adequate protein, colourful plants, omega-3 rich foods and hydration may support tissue repair and healthy inflammatory responses.
Emotional support is just as important as the herbal remedies and is an important part of the patient/practitioner relationship. Chronic pain can be invisible, unpredictable and exhausting, and herbal support will often address these concerns as well through herbs that are emotionally supportive, for example, rose. Patients need to be believed, heard and involved in decisions about their care. Helpful questions include: “What would feel like a meaningful improvement for you?” “What activities matter most?” and “What makes a flare more manageable?” This not only will help focus the treatment pathway, but can also be a helpful benchmark to encourage patients to see their progress during chronic pain.
Trouble Falling Asleep vs Waking in the Night – Understanding Different Types of Insomnia
When people speak of insomnia, it is important to understand how that might manifest for the person, which is why when you see a medical herbalist they will spend a significant amount of time understanding what shape insomnia takes for you and ask you questions on falling asleep, waking up, what time you wake up, and what might make it worse or better, as well as your normal night time routine.
Trouble falling asleep is called sleep onset insomnia whilst waking in the night is called sleep maintenance insomnia. Oftentimes, sleep onset insomnia can be caused by stress or anxiety, with circulating thoughts, a disrupted circadian rhythm or poor sleep hygiene. Sleep maintenance insomnia can be caused by pain, underlying conditions such as GERD, hyperthyroidism, stress, hormonal reasons or other reasons. When you see a herbalist, they will likely you ask you questions about what time of night you wake up as that make help them understand likely causes and effectively treat you.
A herbalist will craft a blend that is specific to your case of insomnia and you as a person. For example, some people respond very well to valerian as a powerfully relaxing herb, but other people find it too stimulating. This is something that can be discussed with your herbalist and the blend can be adjusted if this is the case. Herbs have specific actions and a herbalist may blend one that has a mixture of actions to support you. For example, ashwaghanda and reishi are both herbs that might be suitable to include for someone with insomnia, but their action is more adaptogenic rather than a sedative. Other herbs might be supportive around other areas of insomnia, like motherwort for sleep palpitations or schisandra for circadian rhythm disruption. There are some herbs that are classed as relaxants/sedatives/nervines which are particularly indicated for insomnia such as California poppy and passionflower but it is important to always see a qualified herbalist to give you a tailored and safe recommendation as herbs can vary between gentle sleep support (which is important, don’t discount chamomille!) to stronger sedative herbs.
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When Good Sleep Hygiene Isn’t Enough: How Herbal Medicine Can Support Better Sleep
Sleep hygiene advice can be helpful, but if you are still lying awake at night, waking frequently, or feeling exhausted during the day, it may be time to look deeper.
Many people experience sleep difficulties, and there is rarely a one-size-fits-all solution. If you are struggling to sleep, you may have already been advised to improve your sleep hygiene by reducing blue light exposure before bed, limiting caffeine, keeping your bedroom cool, or creating a consistent evening routine. These recommendations are worthwhile, and a herbalist may well discuss them with you during a consultation. However, for some people, sleep hygiene alone simply is not enough, especially if you have already tried these changes without success.
Why Sleep Problems Deserve Attention
Good, restful sleep is essential for overall health. During sleep, the body has an important opportunity to recover, repair, regulate hormones, and support the nervous and immune systems. When sleep is poor, the effects can be felt the very next day through low energy, reduced concentration, irritability, or difficulty coping with stress. Over time, ongoing sleep disruption may also affect cardiovascular health, immunity, metabolism, and mental wellbeing.
Sleep difficulties can also become harder to shift the longer they continue. If you feel stuck in an unhelpful sleep pattern, seeking support sooner rather than later can make a real difference.
How a Herbalist Looks at Sleep
When you see a herbalist about sleep, they will take time to understand the bigger picture. This usually includes your full medical history, current health concerns, stress levels, energy, digestion, pain, mood, medications, lifestyle, and the details of your sleep pattern. For example, you may find it difficult to fall asleep, wake during the night, wake too early, feel unrefreshed in the morning, or notice that your sleep changes during stressful periods.
By exploring what your sleep looks like and what may be contributing to the problem, a herbalist can offer individualised support. This may include diet and lifestyle advice, alongside a herbal medicine formula tailored to your needs. In some cases, this might be a sleep tea or tincture taken in the evening. In others, it may be more appropriate to use a daytime blend to support underlying factors such as chronic stress, anxiety, muscle tension, pain, or nervous system dysregulation.
Herbal Support Is Not One-Size-Fits-All
Different sleep patterns may call for different approaches. A herbalist may consider herbs traditionally used to support relaxation, circadian rhythm, the stress response, muscle tension, pain, or a busy mind. The aim is not simply to “knock you out”, but to support the systems that may be preventing you from sleeping well in the first place.
This individual approach is especially important because herbs are not suitable for everyone in every situation. A qualified medical herbalist will take safety, medications, health conditions, and your wider wellbeing into account before recommending a formula.
If you have tried improving your sleep hygiene but are still struggling, it may be time for more targeted support. Working with a qualified medical herbalist can help you explore the possible reasons behind your poor sleep and create a personalised plan to support better rest and overall wellbeing. If this is something you are experiencing, I would love to help you take the next step towards more restful sleep. Book a consultation with me or head over to the about section to find out more about me and what I can offer