Evidence Based Alternative Medicines in Pain Management

What is it about?

Pain is an unpleasant sensation but indeed it is one of the vital alarm systems in human body. It helps in the recognition of various stimuli of intensities that could be potentially harmful to the tissue. In comparison to short-lasting acute pain, chronic pain persists even after the resolution of the initial cause and often loses its protective value, rather producing unwanted effects. Pain of any origin, if it persists, may become resistant to standard treatments, greatly affecting the patients’ quality of life. Therefore, advancing our understanding of the pathogenesis of chronic pain is crucial to identify novel therapeutic approaches. There are several therapeutic approaches which are used for the effective management of pain including use of drugs and alternate measures.

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Why is it important?

The use of medicinal plants in the management of pain is as old as man himself. In this connection, G. R. Donald et al. investigated the antinociceptive activity of Zanthoxylum piperitum DC essential oil in various animal models. The oil showed marked antinociceptive effect in formalin-induced acute pain model and glutamate-induced nociception. However, capsaicin-induced nociception and carrageenan induced paw edema were not antagonized by the Z. piperitum oil. Similarly, a Malaysian research group studied the antinociceptive effect of methanolic extract of Clinacanthus nutans leaves in vivo. After producing significant pain reliving effects in acetic acid induced abdominal constriction, formalin-induced paw licking, and hot-plate tests, extract was subjected to the determination of possible mechanism. This antinociceptive activity was fully antagonized by naloxone (a nonselective opioid antagonist) but was partially reversed by L-arginine (L-arg; a nitric oxide [NO] precursor), Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME; NO synthase inhibitor), or their combinations thereof.