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.
