Managing Chronic Pain with Herbs & Natural Support

Maria Noël Groves, RH (AHG)• Clinical Herbalist & Owner of

Bestselling Author of

Body into Balance &Grow Your Own Herbal Remedies

Allenstown, NH | WintergreenBotanicals.com

About MeClinical Herbalist: • Wintergreen Botanicals Herbal Clinic & Education Center• Registered Herbalist with the American Herbalists Guild• 20+ Years in Herbal Medicine• Graduate of the SW School of Botanical Medicine

Educator: Live and online herbal study courses, guest lecturer at Herbal Academy, MUIH, AHG Symposium, and more

Author & Journalist: • Body into Balance (2016) best-selling, award-winning• Grow Your Own Herbal Remedies (2019)• Freelancer for Herb Quarterly, regular contributor to Remedies,

Taste for Life, Mother Earth Living, Mother Earth News

On My Website & Mailing List• Info on my classes, consults, books (of course!)• Seasonal recipes• Virtual herb walk• Recommended books, websites• Where to get herbs• Free class notes and videos• Blog full of articlesWintergreenBotanicals.com

A Natural Approach to

Inflammation & Pain

Yes, We Can Manage Pain Naturally & With Herbs

We have NO silver bullets, but long-term, natural pain reduction methods

will often have…• More meaningful reduction in pain

• Fewer side effects• Great side benefits!

• Better promotion of overall health• Reduced need for conventional therapies that have

more serious side effects.

Pain is Everywhere• 100 million Americans suffer from chronic pain• Nearly four times the number of people affected by

diabetes and more than diabetes, heart disease, and cancer combined

• Muscle pain = most common type of pain, especially back pain, migraines, headaches, and neck pain

• Lower back pain is the leading cause of disability worldwide • ½ of working Americans experience back pain each year • 80 percent of people affected by it at some point in their lives

AAPM, ACA

Pain is the Fire Alarm• Pain signals that something is wrong, it’s the fire

alarm or task-master• Listen to that signal: causes, triggers, patterns• Conventional pain meds work wonders for

immediate relief (they turn off the fire alarm), BUT with side effects, and they often inhibit or impair the healing/repair response

• Holistic approaches (which seek to put out the fire)are slower, more subtle, and more individualized, but they have side benefits

AAPM, ACA

Key Concepts• Pain is a taskmaster, not a symptom to suppress.• We do not have an NSAID herbal equivalent. It’s

more individual and nuanced than that.• Herbs work better with diet and lifestyle changes.• Use constitution, energetics, and client patterns to

choose the best herb(s) and protocols for the person.• Proper doctor diagnosis is ideal, if possible.• Also address the client’s stress levels and mental

space (flower essences, tea rituals, breathing exercises, meditation…).

Always be thinking…What is the root cause?

What are the triggers?

What are the individual’s patterns, constitution, energetics?

Cascade TheoryPain triggers can have MANY potential underlying

causes and patterns. Flare ups are often the results of a cascade of

inflammatory triggers that overwhelm the body’s natural homeostasis.

Knowing the key triggers and learning how to limit them will aid your success. It’s different for everyone.

Common Pain Triggers• Inactivity• Diet: poor diet, inflammatory foods, nutrient

deficiencies, specific food triggers(poor gut health is often interlinked)

• Stress, mood, cortisol, lack of mind-body balance• Insomnia, lack of good sleep• Blood sugar dysregulation • Injury, posture, structural issues (often made

worse via inactivity or unsafe activity)• Toxin/pollution and enviro allergen exposure

Anti-Inflammatory

Diet & Lifestyle

Anti-Inflammatory Diet• Whole Foods• Lots of Plants!• Berries, Veggies• Rainbow of Color• Low/Moderate

Glycemic• Nuts, Seeds, Good Fats

• Omega 3s – clean wild seafood and fish

• Mushrooms, Legumes• Fiber-Rich Foods• Tea, Herbs, Spices• Low in animal foods;

focused on pasture-raised, grass fed, wild

You are not only what you eat but also what you can digest! Bitters, broths, etc. are also useful.

Omega 3-Rich Foods & SupplementsEPA/DHA (and, with proper conversion plant ALA omega 3s) à basis for anti-inflammatory compounds in the bodyalso a component of cell and nerve lining• Fish: Wild-caught fatty fish (salmon, sardines,

mackerel, herring/kippers, black cod/sablefish, trout)• Plant sources: flax oil/seeds, chia, hemp, walnuts,

purslane (less potent but nice)• Food is best, ensure freshness, goes rancid quickly• Fish oil is 6 to 8 x more concentrated than flax and

plant ALA’s hard to convert to usable EPA/DHA• 14-16 pills = 1 Tbl oil = 4.5 Tbl ground seed

Anti-Inflammatory Lifestyle• Beyond Food….• Regular activity/movement, ideally daily,

particularly gentle and moderate intensity• 7 to 9 hours of good sleep every night• Stress-management• Mind-body balance (meditation, yoga, tai chi…)• Time outdoors• Community connections, gratitude, spirituality• Reduced exposure to toxins and environmental

pollutants

A Natural Protocol Approach• Target to the individual (WHY?)• Incorporate diet & lifestyle support as appropriate• Create (or use) 1-2 pain formulas/remedies

(perhaps a mix of topical or food + internal)• Give it 2-3 months to start seeing resultsMake sure it’s do-able for the person. You can edit and add new things as time goes on.Try to include things that will make an improvement quickly alongside the long-term stuff.

Pain & Inflammation Compounds to

Know

Instigating Pain & Inflammation• Substance P: a neurotransmitter secreted by the

nerves and inflammatory/immune cells that sends pain signals to the brain and increases inflammation

• Prostaglandins: hormone-like compounds created from arachidonic acid (AA, a type of fat) that often promote but sometimes resolve inflammation

• COX-2: a pro-inflammatory enzyme that aids the conversion of AA to prostaglandins, which is stimulated by cytokines and other compounds

• Leukotrienes: pro-inflammatory eicosanoids associated with pain and allergy that are made from AA via the enzyme 5-LOX

Immune Connection• Histamine: an inflammatory compound of the

immune system associated with allergies that increases your perception of pain

• Cytokines: proteins secreted by the immune system in response to infections, cell injury, and other conditions that affect cell communication, which can often (but not always) be pro-inflammatory. Interleukins and tumor necrosis factors are inflammatory cytokines that increase the production of substance P and prostaglandins.

Triggers & Markers• Glutamate: an amino acid in food and produced by

the body that can increase or decrease the perception of pain in the brain

• Cortisol: a hormone associated chronic stress and blood sugar imbalance that ultimately prevents the body from being able to down-regulate inflammation, leading to increased inflammation throughout the body

• CRP: a protein secreted into the blood by the liver, the levels of which rise in response to inflammation, which has made it a good marker for overall inflammation in the body

Photo: EurekAlert!/Cherry Marketing Institute

Core Anti-Inflammatory

Herbs

Turmeric (Curcuma longa)• Nice starter herb for most chronic inflammation• Most research is on curcumin but many constituents

are beneficial in turmeric• Multiple anti-inflammatory actions & pathways,

particularly COX-2 inhibition• May support rheumatoid, osteoarthritis, IBD, aches

& creeks – better in combo w/other pain herbs• Works best long-term, with fat, heat & black pepper

Popular as an antioxidant, anti-inflammatory, liver detox/protective, cardioprotective, anticancer, mild digestive bitter herb. Possible CYP herb-drug contra.

Lopresti, Sanmukhani, Weil, Mosley, Shoba, Gardner

Maria’s Golden Milk• 4-8 ounces of milk (cow, coconut, almond, oat)• ½ to 1 teaspoon turmeric powder• 1 teaspoon honey or to taste• Pinch nutmeg • Pinch cardamom• Pinch black pepper • Optional: ¼-½ tsp ashwagandha • Heat milk, stir in herb powders

and sweeten to taste. Enjoy 1-2x per day.

Ginger (Zingiber officinale)• For Cold & Muscle Tension: Warming, moving• Circulation enhancing, mildly blood thinning,

decreases inflammation in the blood vessels• Helpful in cold, stagnant pain, cold constitutions• Topical/internal pain support: migraines, back

aches, menstrual cramps, arthritis• Good dry (hotter) or fresh (milder, more complex)• Stimulates digestion, eases nausea, fights bugs• Can be too hot and blood thinning for some,

careful in GI inflammation and reflux

Frankincense/Boswellia (B. serrata)• Consider in allergy-inflammation comorbidity• Reduces leukotriene and 5-LOX (allergies, auto-

immune, pain, cancer, asthma, GI inflammation)• Also inhibits other inflammatory pathways including

COX-2, IL, TNF, IFN, and others• Promising osteoarthritis alternative to NSAIDs• Boswellia + Turmeric more effective than celecoxib

(Celebrex) for osteoarthritis• RDBPC turmeric vs turmeric + boswellia – both

better than placebo but much better in combination• May interact w/some meds via CYP enzymes

Studies: Ammon 2010, Ammon 2016, Image: betternutrition.com

Tart Cherry Juice• Anti-inflammatory food• Several studies on exercise-induced injury• Arthritis results promising but weak• Also antioxidant rich• Cardio and UT tonic• Supports detox, eases gout• Source of melatonin, regular use improves sleep,

relieves insomnia• Read the ingredients list – look for 100% cherry!

Photo: EurekAlert!/Cherry Marketing Institute

Stress-Pain Connection

Ashwagandha (Withania somnifera)• Nice background mood/inflammation support:

favorable studies for various types of pain, often in combo with turmeric and boswellia

• Slightly warming, calming yet stimulating, anti-fatigue, anti-inflammatory, mood elevator, repro/fertility/libido

• Boosts thyroid in subtle hypo/Hashimoto’s, immune modulatory, muscle retention/strength

• Appears safe for mood alongside most meds• Spirit/Strength of the Horse - In India: use 1 year =

strength and vitality of a stallion for the next 10 years• Caution: hyperthyroid, thyroid meds, nightshadesClinical experience, Singh Review, Sharma, ABC, Bhattacharya, Verma, Dar, Jahanbakhsh, Choudhary

Holy Basil (Ocimum sanctum)• Also called Tulsi, Sacred Basil. Newer Latin name

O. tenuiflorum (Rama, Krishna, Amrita varieties, Kapoor?) O. gratissimum (Vana) also usedO. africanum?? (Kapoor, Temperate) – easy to grow

• COX-2 inhibitor, calming, excellent support• Aromatic, uplifting, calming, balances cortisol,

induces parasympathetic, nootropic, hypoglycemic• Long medicine/spirit use in India. Zen-like state• Lovely in tea! Or anyway you like it. Local = best• Careful in hypoglycemia, thyroid, fertility, vata

people, makes some people feel highClinical experience, Winston, Cohen, Mondal, Sampath,Bhattacharyya, Saxena, Jamshidi

Additional Anti-

Inflammatories

Bromelain, Pineapple & Proteolytic Enzymes

• Protein digesting enzymes (which includes bromelain found in the stem and core of pineapple)

• Best on an empty stomach to potentially help break down inflammatory compounds

• With food is more apt to support digestion• May provide pre- and post-support for

exercise-induced injury, sore muscles, etc.

Image Credit: Mental Floss/iStock

Bonus Slide

Green Tea (Camellia sinensis)• White à Green à Oolong à Black “True Tea”• Less antioxidants and more caffeine w/processing• Antioxidant & anti-inflammatory powerhouse• Excellent morning cuppa for general inflammation

reduction, though some are sensitive to xanthines• Also supports metabolism/weight, blood sugar, heart

health, hypertension (diuretic), lipids, mood, immune (cold, cancer, flu)

• Decaf is not as potent but still ok.• 1% cayenne enhances cancer killing 100xs (in lab)

Rosemary (Rosmarinus officinalis)• Potent COX-2 inhibitor (an NFKB, etc.), now the

main ingredient in Zyflamend• Boosts memory in food (low) doses, improves

memory though high doses worsened it• Also improves circulation, antioxidant, digestive• Warming, diffusive, bitter, aromatic• Best fresh in tea, tincture, food• Best in synergist doses – 5-15% of blend, a few

sprigs fresh per day, etc.

Cinnamon (Cinnamomum spp.)• True/sweet/Ceylon or cassia• Useful anti-inflammatory, for cramps, flavor• Hypoglycemic, improves insulin sensitivity (not

for type 1 diabetes, careful with meds, too)• Anti-inflammatory, anti-microbial, gut healing• Astringent, anti-diarrheal, constipating• Delicious in tea! Use sticks or chips to avoid

sludge. Also nice in cold water (especially Ceylon sticks) as a lightly flavored drink.

• Powder added to food, gets slimy

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Herbal Aspirins• Salicylate compounds that inspired aspirin• Cooling, anti-inflammatory, mild NSAID-like

action (not really getting to root of problem)• Can be used topically and internally for acute

inflammation if needed. Not as strong as OTC.• Varying strength• Willow, poplar, aspen = moderate• Meadowsweet = mild but gentle on stomach• Wintergreen, birch = caution in large doses for

kidneys and liver, EOs can be quite toxic

Muscle Pain, Tension, Spasm

& Relaxation

Mag or Cal/Mag Powder Relaxes Nerves & Muscles - Pain - ConstipationMagnesium especially

prevents & may stop… • Headaches • Muscle & menstrual

cramps• Over-exertion pain• Also eases constipation• Relaxes nerves

With Calcium• Provides electrolytes• Strengthens bones• Helps w/growing pains Strong nettle tea may work similarly with regular use.

Blue Vervain (Verbena hastata )• Physical & emotional tension/spasm support• Water-loving tall wildflower, can cultivate• Relaxes emotional and physical tension (ticks, spasms,

headache, neck/shoulder tension)• Nerve pain, insomnia, sciatica, immune- and sleep-

pain patterns• Also bitter, digestive, liver tonic/detox, metabolic

wobbles, immune/diaphoretic, nervine• Very bitter! Supports vagal tone• Just a few drops to a few squirts of tincture

Wood Betony (Stachys officinalis)• Be aware that Pedicularis shares common names

“betony” and “wood betony” – varies by brand• Bitter, relaxing mint-family herb• Classic antispasmodic for headaches• Mildly mood-boosting and calming, nervine• Consider in nervous indigestion• Use fresh or dry, tincture, tea, etc. Rare commercially.• Flavor is so-so but ok with better-

tasting herbs in tea

Darcey Blue, Midura, Grieve

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Pedicularis (Pedicularis spp.)• GREAT skeletal muscle relaxer, not usually sedating,

but…• Generally only available wildcrafted from small

companies (Pine’s Herbals, Elk Mountain Herbs), and it can be a threatened in its ranges

• Semi-parasitic (be aware what it’s associated with as it can pick up other plants’ constituents)

• Sometimes called “betony” or “wood betony” which is confusing with the Stachys, which shares both commonname. Additional names lousewort, parrot’s beak, elephant’s head

7Song, Moore

Kava (Piper methisticum)• Numbing, relaxing pain support as needed• Binds to GABA receptors: benzodiazepine-like

anxiolytic w/o side effects, addiction, withdrawal• Excellent in acute anxiety and GAD, fast-acting• Numbing to tongue, emotions, muscle tension• “Friendly” herb for ceremony and business• Polynesian herb of tropical places, root used• Serious history of adulteration and resulting

toxicity from using aerial partsImage Credit: Ginger Webb

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California Poppy (Eschscholtzia california)• Sedative, mild-moderate pain reliever• Safe, nonaddictive “opiate fuzz” though not

technically containing opioids(I would be cautious and avoid in someone with a history of opioid addiction or refer to someone who has more experience in this area.)

• Useful for whirling thoughts• For bad sleep/wake cycles• Use whole plant. Best fresh in flower and seed,

roots strongest. Often adulterated.Clinical experience, traditional use,

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Hops (Humulus lupulus)• Classic sleep, sedating, hypnotic herb• Also potent anti-inflammatory, pain support• Energetically cooling• Phytoestrogenic

(night sweat support)• Very bitter, blood sugar

lowering, antimicrobial• Use fresh strobiles• Tastes like IPA beer

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Skullcap (Scutellaria lateriflora)• Mint family semi-perennial, picky about where it

grows, may or may not come back.• Likes moist, dappled sun, near rivers, sandy spots

on the edge of water (w/bugleweed, wild mint) • Sedative/calming nervine – sleep, anxiety• For the overstimulated, hyper-reactive • Pain, digestion, nerves - cools, calms• Fresh or freshly dried. Often adulterated + poor

quality. May over-sedate some. Careful w/meds.

Adulteration/ABC

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Additional Sedative-Antispasmodics• Valerian• Jamaican Dogwood (strong, caution, lower dose or

in formula works best, adulteration is common)• Wild Lettuce (whole fresh plant = feeble,

concentrated latex is stronger)• And plenty of others

• Use buds and flowers: Most focus on essential oil but also used as tea, tincture, hydrosol, etc. (strong)

• Useful for pain + relaxation. Various studies on EO + surgery pain. Aroma and ingestion calm, disperse energy, useful in “stagnant depression” (David Winston), sleep, anxiety.

• Note potential estrogenic and anti-androgenic effects, also antimicrobial.

• Prefers dry, sunny, open, sandy/rocky spaces• Find a variety for your climate: hidcote, munstead

Lavender (Lavandula angustifolia)

Various studies, Winston

Peppermint (Mentha spp.)• Menthol, peppermint essential oil, and crude

peppermint leaf can all be used (strongest à gentlest)

• Potent antispasmodic, particularly on contact• Enteric coated pills for GI spasm, IBS, IBD• Topical for back pain, neck pain, headaches• 10% peppermint EO comparable to 500 mg Tylenol

for tension headache• Cream w/3% pep, marjoram, lavender & black

pepper EO significantly reduced neck pain

Grigoleit & Grigoleit, Kline, Göbel, Ou

Additional Topical Options

Homeopathic Arnica• Bumps - Bruises - Aches & Pain - Trauma• This plant is POISONOUS in herbal form if

ingested (ok above 1X homeopathically)• Safe topically & homeopathically (diluted)• May prevent or heal bruises• Reduces aches and pains from injury, overwork• Do not use it on broken skin• Sometimes works immediately• Homeopathic = safe for kids

Comfrey (Symphytum officinale)• Deep Healing - Pain – Trauma – Sprains – Injury

– Contusion – Arthritis • Infused Oil/Topical Preparations for bruises,

sprains, strains, arthritis, physical trauma, pain, deep healing

• Flower Essence: Deep Healing, including pain• Potentially cumulatively toxic internally due to

liver-toxic PAs. Slight but much lower risk for absorption through skin w/topical use.

• New studies show nearby plants pick up PAs LVarious Pain Studies, Tolf, ComfreyCentral.com, de la Foret, Dharmananda, In Soil: Nowak - SciHub, Selmar – SciHub, Poke around PubMed (check off Review and Clinical limits)

St. John’s Wort (Hypericum perforatum)• Wound-healing, pain-relieving (especially nerve)• Targets nerves internally and externally. Nervine.

Nerve healing/restorative. Light sunscreen.• Internally: May ease depression (long-term),

MANY herb-drug RX. Very safe topically, though.

• Any hot pepper will do! Capsaicin cream• Capsaicin (heat) in the pepper depletes substance P

– a neurotransmitter that sends pain signals from the skin to the brain. Also increases circulation.

• May burn at first, but usually relief from pain, itching, nerve irritation over time

• Used for pain, arthritis, Herpes. Best in cold pain.• Heat and hot water will increase burn intensity• Be careful when applying, hard to wash off hands –

irritating to genitals, eyes, etc.

Cayenne (Capsicum annuum)

Mood, Nerves, Pain & Supporting

Nerve Damage Repair

Stepping Back• Stress, insomnia, and mood issues can worsen pain

and vice versa (which is why SSRIs and serotonin-based drugs are often prescribed)

• Especially true in fibromyalgia, chronic pain,chronic fatigue syndrome, some cases of Lyme,disability

• Alongside more traditional pain support, consideradding in herbal and lifestyle approaches for moodhormones, neurotransmitters, and generalwellbeing

Lion’s Mane (Hericium erinaceus) • This delicious edible mushroom just might do the

impossible: grow and repair nerves• Promotes nerve growth/repair, contains nerve

growth factors. Dementia, brain trauma, stroke, etc.• Japanese study on elders with dementia,

3 grams of powdered lion’s mane (6 caps divided) performed better on cognitive tests at 2, 3, and 4 months compared to placebo

• Other studies suggest it supports mood• Other Hericium spp. = seem similar, interchangeable

St. John’s Wort (Hypericum perforatum)

• Potent nervine and neurorestorative• Better known as an antidepressant and topical

nerve pain healer• May be used internally for nerve healing• Best fresh, buds/flowers (redder = better), with

lemon balm, maybe turmeric, short shelf life• Many herb-drug RX – serotonin syndrome

risk, liver CYP enzyme clearance (tryptophan and 5HTP have fewer but some herb-drug RX)

• Various other possible contraindications

Ng, Lawvere, Winston

Also consider...• May include sedatives, nervines, adaptogen,

neurorestoratives/nootropics, mood herbs• Gotu kola: nervine, adaptogen, nootropic,

neurorestorative, connective tissue and vascular• Blue Vervain• Adaptogens: holy basil, ashwagandha, reishi,

rhodiola• Muscle pain/antispasmodic/sleep herbs• Topical SJW, cayenne, peppermint• Nutrients: Vitamin D, magnesium, omega 3s

Joint Support & Repair

Joint/Cartilage-Related Supplements• Usually animal sourced• May reduce inflammation, cushion joints• Long-term use may support joint repair• Glucosamine (vegan sources available)• Chondroitin• Collagen (vegan genetically engineered possible)• Gelatin/Cartilage• Hyaluronic acid (vegan sources available),

also available as prescription injection

Bone Broth• Contains many joint-supportive compounds• Per ~ 1 gallon water in a stock pot• 1-2 chicken carcasses, chicken feet, some

marrow/shank bones, knuckle bones… (If desired, roast first for more flavor)

• Splash of vinegar (optional for mineral extraction)• Salt to taste• Whatever else you like!• Simmer 3-24 hours. Strain. Freezes well.• Optional to simmer strained broth

uncovered to condense for ice cubes.

Horsetail (Equisetum arvense)• Richest source of silica (besides rice shoots)• Improves collagen, bone, joints, elastin, skin

hair, nails, connective tissue matrix• Flexibility, strength, resilience (not brittle)• Also used topically and internally for wound

healing (vulnerary) and pain, allergy-induced• Internally anti-inflammatory, immune-

modulatory, reduced TNF-a and IL-10• RA study: drug efficacy 17% à80% w/horsetail• Harvest from clean sources, best dry, tinctured

(useful but no silica), super infused, or decoctedmcdonald-back pain, Asgharikhatooni- topical, Jiang/RA,Farinon/antigen-induced arthritis in rodents

Solomon’s Seal (Polygonatum biflorum)• Woodland perennial, excellent in shade, dappled

sun, part-shade, striking green thick stems• Lubricating, moistening, cooling• Tendon, ligament, and joint support, promotes

healing, regulates tone• Excellent for sprains, arthritis, etc.• Eases inflammation and pain• Internal is best but topical

helps, too

mcdonald-back pain and Solomon’s seal, Wood

Mullein (Verbascum thapsus)• ROOT (before flowering) used for this use• Though some find leaf somewhat useful, too• Joints, tendons, ligaments – vitality, flexibility,

alignment, not too tight nor too loose• Support alignment, back pain, etc.• Sprains, strains, injuryAlso consider Lilac Flower Essence à for spine support and feeling more unburdened

mcdonald, Wood, lilac/Tolf

SprainsSprain – Strain - Arthritis

Blend to take internally and apply topically• Solomon’s Seal• Horsetail• Mullein Root• Maybe BoswelliaTopical comfrey oil (shake vigorously w/tintures)Topical diluted peppermint EO

Bonus Slide

Topical Pain Rub Recipe IdeasChoose the appropriate herbs for your type of pain using all tincture/liniment, oil, or a mix of both.

Tincture +/or OilSt. John’s Wort ! !Gotu Kola ! !Cayenne ! !Solomon’s Seal ! !Horsetail ! !Mullein Root ! !Arnica !Comfrey !Boswellia !Shake vigorously before use if combining oil + tinctureAdd few drops EO or FE if desired.

Gin Raisins RecipeOld-timer remedy that may support joints and reduced arthritis pain (both osteo and rheumatoid). Is it the juniper in the gin? Polysaccharides in raisins?• Golden raisins• Cover with gin• Loosely cover w/cloth or paper towel• Let bubble for two weeks, add more gin if needed

to keep covered• Then put on regular lid• Enjoy ~ 7-10 raisins daily

KilhamImage Credit: Arthritis.org

Bonus Slide

Flower Essences are Your Friends!Emotional & Physical Pain Support

• Comfrey: Deep Healing• Blue Vervain: similar to herb• Lavender: spirit calm• Lilac: unburdened, spine support• Dandelion: joy, letting go of

tension… and many more FE!Use few drops on tongue/drink, add 3-5 drops to your tincture blendMore Info: lichenwood.com, FES Flower Essence RepertorySources: Co-create your own or buy Lichenwood, FES (big brand), Delta Gardens, Green Hope Farm (alcohol-free), others

Additional Concepts, Thoughts & Herbs

Bonus Slide

Detoxification & Alteratives• Alongside primary pain protocols, especially

consider in arthritis, autoimmune, EBV, Lyme, and of course in gout

• Avoiding food irritants (allergic, inflammatory)• Periodic fasting, vegan diet, maybe Paleo• Alteratives – keep eliminatory channels open and

healthy: nettle, juniper, tart cherry, red root, boneset (caution – PAs), teasel, dandelion, burdock, celery, parsley, etc.

• Movement, bath, sweat, skin brushing

Bonus Slide

Deep Immune Support/Modulation• Alongside primary pain protocols, especially

consider in autoimmune, RA, EBV, Lyme• Avoiding food irritants (allergic, inflammatory)• Medicinal mushrooms, especially reishi, possibly

cordyceps. (Chaga may irritate/inflame??)• Astragalus• Alteratives & Adaptogens• General anti-inflammatories including turmeric,

possibly also horsetail, bone broth

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Cannabis, THC & CBD• This is not my specialty but it’s nonetheless definitely

worth mentioning• Many people are seeing significant pain reduction (as

well as better mood, less anxiety…) with topical and/or internal cannabis products including CBD-only or CBD-forward products

• Increasingly available depending on your state• Quality, formulation, and potency vary widely• Learn more from trustworthy sources including

Tammi Sweet, Jody Noe, Ethan Russo, Kevin Spellman, Rochelle Baca, Medicinal Cannabis Conf.

Image Credit: Motley Fool/Getty

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Maria Noël GrovesWintergreen Botanicals

Allenstown, NH 603-340-5161

maria@wintergreenbotanicals.com

Bestselling Author of Body into Balance &Grow Your Own Herbal Remedies

Allenstown, NH | www.WintergreenBotanicals.com