Book Notes: Pain Free 1-2-3
Chapter 11: Natural Therapies
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Boswellia inhibits leukotriene synthesis by inhibiting 5-lipooxygenase activity. It also decreases the activity of human leukocyte elastase (HLE).
Other nutrients are also critical for nerve healing. One such element is lipoic acid (not in the vitamin powder), 300 to 1000 mg per day (see Chapter 8). Alpha lipoic acid is an antioxidant which has been shown to be especially beneficial for diabetic neuropathy. Another study showed that it was also helpful in relieving “burning mouth syndrome.” This syndrome is characterized by chronic pain on the tongue and sometimes the anterior palate and lips without any visible lesions. It is most often seen in postmenopausal women and has characteristics of being neuropathic pain. In a study of 60 patients, half received 200 mg of lipoic acid 3 times a day or a placebo for 2 to 5 months. Ninety-seven percent of the patients improved as compared to 40 percent of those in the placebo group. Thirteen percent had complete resolution of their pain, and another 74 percent had “decided improvement,” whereas none of the placebo patients had this level of improvement. Almost all the patients showed some improvement by 2 months, with 73 percent still showing benefit at the end of 12 months despite having stopped the treatment.32 The fact that lipoic acid helps in several kinds of neuropathies suggests it is worth trying in others as well, especially since it is quite benign and not very expensive.
Turmeric contains curcumin, which can inhibit platelet aggregation and prostoglandin synthesis. Turmeric and curcumin have been shown to be effective antioxidants, with curcumin being the most potent component. A study of 45 days of supplementation with curcumin showed marked decreases (60 percent ) in the level of serum lipid peroxide.
St. John’s Wort is best known for its effectiveness in the treatment of depression. It has, however, also been found to be helpful in treating neuropathic pain. In one study using approximately 1000 mg a day of St. John’s Wort for 5 weeks, approximately 20 percent of the subjects had a good response. The effect was modest however, not quite reaching statistical significance.48 This study is a good example of the difference between clinical and statistical significance. Although there was clinical benefit that justifies trying it in some refractory and severe cases, the number of patients in the study was small enough that the effect did not reach statistical significance.
