Page 361 Guide to Pain Management in Low-Resource Settings

Chapter 48

Herbal and Other Supplements

Joel Gagnier

What is the defi nition Other activities followed, including international con-
of natural health products? ferences and research exchanges.

Natural health products include vitamins, minerals, What supplements are
herbal medicines, homeopathics and other naturally de- best for acute pain?
rived substances (e.g., glucosamine, bee pollen) to pre-
vent or treat various health conditions. Surgical procedures and acute trauma may be ad-
In the developing world, it would be advis- dressed by several natural health products. For exam-
able to consult local elders or healers to determine lo- ple, the homeopathic remedies Arnica and Hypericum
cal plants or foods that may be used. You should get may be useful prior to and after surgery. Arnica is par-
instructions on how to use them safely. Traditional ticularly useful for decreasing pain, bruising discolor-
knowledge from a respected elder, healer, or tribal chief ation, and discomfort in the patient. Homeopathic Hy-
may be reliable information. Always think about the pericum is very useful to heal incisions and eliminate
risk/benefi t ratio, since natural health products might pain. Th ese remedies can be given orally at 200C po-
contain “unnatural” ingredients, such as heavy metals or tencies every 2–4 hours on the day prior to surgery and
other contaminants. Th erefore, the use of natural health after surgery until the incision is healed. For acute trau-
products depends on mutual trust between the care- ma to muscles, ligaments, and tendons, topical creams
giver and the healer, since there are few evidence-based or ointments containing Harpagophytum procumbens
data and standardized products available. (Devil’s claw), Capsicum frutescens (cayenne), homeo-
It is advisable to seek cooperation between the pathic Arnica, or methylsulfonylmethane (MSM) may
“offi cial” and “unoffi cial” medical sector, both to broad- be applied 3–4 times per day on the aff ected site as
en therapeutic options and to avoid counterproduc- long as the skin is intact.
tive interactions. Some initiatives have undertaken this
task. For example, in 1998 a task force was set up by the What supplements are best
Ministry of Health in Ghana to identify the credible Na- for neuropathic pain?
tional Healer Associations. Six such healer associations
were identifi ed. Th ese associations came together to Peripheral neuralgias, if caused by malnutrition, may
form the nucleus of the Ghana Federation of Traditional be treated by supplementation with vitamins. Vitamins
Medicine Practitioners’ Associations (GHAFTRAM). E, B , B , B , and B are essential for adequate nerve
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Guide to Pain Management in Low-Resource Settings, edited by Andreas Kopf and Nilesh B. Patel. IASP, Seattle, © 2010. No responsibility is assumed by IASP 349
for any injury and/or damage to persons or property as a matter of product liability, negligence, or from any use of any methods, products, instruction, or
ideas contained in the material herein. Because of the rapid advances in the medical sciences, the publisher recommends that there should be independent
verifi cation of diagnoses and drug dosages. Th e mention of specifi c pharmaceutical products and any medical procedure does not imply endorsement or
recommendation by the editors, authors, or IASP in favor of other medical products or procedures that are not covered in the text.