Muscle-Skeletal Pain and the Gut Connection

Pain is a word that is used to describe a wide range of experiences that all humans encounter. There are many different patterns that occur throughout life that are considered to be painful and, ‘pain’ itself is not a disease, illness or syndrome but is a symptom of many. In the most literal sense, pain refers to any physical sensation that is unpleasant and causes one to take evasive action. It is also a signal that communicates to our brains that we must become aware of some dysfunction and make the necessary changes to make it stop. As herbalist and bodywork Tammi Sweet says, "Pain is a signal to change your behavior". That can mean many things including lifestyle and diet, but also mental and emotional behaviors, attitudes and thought processes. Evasive action is not always the most appropriate either. Changing our behavior can mean to stop evading something and explore more deeply into the core of any issue or injury in search of hidden or repressed feelings or matters. Sometimes what is called for is for us to actually move more deeply into ourselves and embody our unique Earthly form more completely. I taught Yoga for many years and always encouraged my students to find their 'edge' where they were not in pain but were stretching themselves, gently, beyond their comfort zone. This requires that we move our awareness into tight and sometimes scary places and re-associate or, some would say, occupy places that we may rather ignore.

Muscle-skeletal pain, in its physiological manifestation, is a message that indicates that tissue damage has occurred or is imminent without behavioral change due to injury, prolonged spasm or constriction, or buildup of metabolic waste and is sometimes mixed in with related nerve pain. When we sit in one position for an extended period of time, like while typing on the computer, we often begin to feel the discomfort of pain that signals us to change position or get up and move around before tissue damage results. It is also well documented and scientifically proven that the brain can project pain anywhere in the body without any apparent physiological condition. 

Conventional treatment for muscle-skeletal pain predominately focuses on alleviating the physical sensation by palliating the pain pathway that sends the neurological signal from the point of injury to the brain. Although sometimes pain relief is appropriate and merciful, it does not address the underlying cause and, when solely relied on for any extended period of time, can actually exacerbate the condition.  Traditional Herbal Medicine responds to pain from a holistic perspective by not only attending to the physiological discomfort, but by seeking the underlying pattern that has created the dis-ease. From a vitalist perspective, pain is produced by the vital force and is a function of our internal self-healing mechanism. (For more on Vitalism go here: http://clinicalherbalism.com/about/vitalist-tradition/)

An herbal perspective on pain will take into account the type of pain, the tissue state at the site, and how that stands in relationship to all of the other systems and functions of the entire individual including the psychological, social and cultural settings. The pain is generally not the focus of the herbal protocols I offer although, I will always do whatever is possible to ease the discomfort as stress is a major contributor to the cycle of chronic pain and anyone who is in pain is under stress. Along with stress, the major factors to consider initially are nutrition, constitution, metabolism, past memory of pain and , first and foremost, gut integrity. The condition of the tissues of the digestive system can play a major role in many illnesses because of what is known as “Leaky Gut”

Leaky gut is unrecognized by conventional medicine but well-conceived in Western Herbalism as a significant component of muscle-skeletal pain and its corresponding illnesses. In fact, some famous herbal doctors of history have contended that leaky gut is the source of all human dis-ease. Leaky gut, in its simplest terms, refers to dysfunctional gut permeability. The delicate meshwork of epithelial cells that line the small intestine allowing digested food to be assimilated into the bloodstream becomes loose and the mesh becomes more porous allowing undigested particles back into our system. These accumulate in the tissues overwhelming our cells and swamping our metabolic and eliminatory processes. This inhibits our cellular fire that is required to transform and receive nutrition and release waste, and impedes the smooth flow of life force. In an attempt to alleviate the situation our immune system is called in via the inflammatory process whereby fluids build up in an attempt to flush and eliminate. When this is ongoing and consistent, the transaction becomes ineffective and we develop what is known as Damp Accumulation. This is basically pathological stagnation or as would be said in Chinese medicine, stuck  blood or Chi and results in chronic pain and inflammation.

The health and balance of the digestive system is of primary importance when we seek to identify the source of any muscle-skeletal condition and it is necessary to attend to. Anything else that we attempt to do will not be sustainable or permanent if there is a continuous assault of toxins entering the system through the gut. Customarily, any herbal formula for pain will be complex and include an individualized set of herbs that address the symptoms of pain, the nervous system, a diuretic to increase fluid metabolism, sometimes and anti-spasmodic, and alteratives all of which I will discuss further in future posts. For now we’ll focus on re-creating digestive integrity as a first step to creating overall health and well-being

We are all born with a porous membrane lining our digestive tract as this allows for optimum absorption of colostrum from our mothers and a fertile environment for colonization by lots of friendly bacteria. When this happens effectively we can absorb nutrients quickly and establish a protective microbial community that will ensure a healthy immune system and provide a formidable defense against ‘bad’ bacteria.  Shortly after birth the permeability of this cellular matrix begins to tighten up to provide a barrier that will only allow fully digested and optimal foods to be accepted into the blood stream. .When this doesn’t happen or when we acquire ‘leaky gut’ later in life there are several factors that contribute. Food allergens are major subsidizers of digestive irritation as are food preservatives and NSAIDS(non-steroidal anti-inflammatory drugs). Anything that decreases the healthy bacteria in the gut also leaves the tissue exposed and open to irritating food particles, bad bacteria, and irritation from digestive secretions. Eliminating any possible allergen is tantamount along with re-introduction of beneficial microbes with a good quality pro-biotic supplement along with ‘prebiotics’ or substances that will provide food for the bacteria such as miso. Symptoms of leaky gut can be subtle or severe but often appear as constipation, diarrhea, gas, bloating and can further manifest into colitis, irritable bowel and acid reflux.

Herbs that will encourage the healing of the digestive tract:

Plantain-Plantago spp.

Plantain grows prolifically on lawns, in meadows and backyards everywhere. Plantain is soothing to mucus membranes and appropriate for all wound healing. It is cooling, moistening, softening and astringent tightening tissues and reducing the possibility of leakage while maintaining a healthy moisture level. It is also a drawing agent as it can draw out any infection or foreign material leaving any wound soothed and free of microbes. The leaves can be gathered anytime but some herbalists say that they are stronger after the first frost. Leaves can be dried or used fresh for tea or made into tincture.

Dose: Tea-1/2 tsp. of dried leaves or 1 tsp. of fresh steeped in one cup of boiling water. Drink 2x per day.

Tincture: 20-40 drops 2-3 x per day

Calendula-Calendula officinalis

Calendula has a long history of use as a wound remedy and is anti-inflammatory, anti-spasmodic,  astringent, anti-microbial and lymphatic. It’s anti-spasmodic properties are particularly helpful when there is intestinal spasm or colic as in Irritable bowel or colitis. It’s great for any cramping where there is irritation and need for soothing. Its lymphatic properties can help remove stagnation a improve the movement of  debris and undigested food particles in the digestive system It’s slightly warm and this too can encourage movement although if someone is particularly hot in their digestion it can create further irritation. This is more of an issue with the juice or tincture and is less so if it has been dried and taken as tea.

Dose: Tea of dried flowers-1/2 tsp. to a cup of boiling water. Juice or sucuus of flowers-1 tsp-tbsp. 1x per day. Tincture-20-30 drops 2-3 x per day

Meadowsweet-Filipendula ulmaria

The best remedy for any stomach issue at all as far as I’m concerned. Meadowsweet normalizes hydrochloric acid secretion whether it’s too high or too low. It also contains salicin or salicylic acid which provides pain relief in the same manner as aspirin but without the stomach irritation. Meadowsweet is actually soothing to the stomach provide compounds that buffer and synthesize its pain relieving properties. Meadowsweet is also astringent and so can be used to tone and tightening the digestive meshwork. It is anti-inflammatory and cooling so can be used for diarrhea, chronic gastritis, colitis and ulcers. It also tastes sweet and lovely and makes a great addition to any tea.

Dose: ½ teaspoon of dried leaf and flower for tea in 1 cup of boiling water. Tincture-20-30 drops 3x per day

Skullcap/American Skullcap-Scutellari lateriflora

Skullcap is a bitter mint and great in addressing any stress related issues regarding the digestive tract, which there almost always is. Stress can create irritation in the stomach and irritation in the stomach can create stress. Skullcap sedates, soothes and calms nervous irritation and relieves colic, spasm and flatulence due to nervousness and excess fire in the small intestine. It combines well with Chinese/Baikal Skullcap.

Dose: Tea made with warm(not boiling) water. 1/2 dried Skullcap leaf to 1 cup of warm water. Tincture: 15-20 drops 2-3x per day.

Baical Skullcap/Chinese Skullcap-Scutellaria Huang Qin

Baikal Skullcap is a cooling, anti-inflammatory and antibacterial and does not have many actions in common with Scutellaria lateriflora but makes a great formula when combined. It is also an excellent astringent and digestive bitter so it will tighten tissues, prevent leakage and promote digestive secretions increasing the likelihood of complete assimilation of food. It is also an immune regulator and will treat allergies so being an excellent choice for anyone with any food sensitivity. It is great in combination with American Skullcap.

Dose: tincture-20-40 drops 2-3 x per day or in a formula of half Baikal Skullcap and half American Skullcap

Yarrow-Achillea millefolium

Is an all-around wound healer and regulator of blood flow. It is cooling and drying and it is considered and astringent, tightening tissues, so is one of the top herbs employed to stop bleeding. It is also a blood decongestant and so helps to breakup clots and removes stagnation. This makes it excellent for the digestive tract as it will heal irritation, reduce inflammation and promote the healthy flow of fluids to and from the surface tissues that will bring in fresh oxygen and nutrients and eliminate waste. It is also an appetite stimulant and promotes the secretion of bile encouraging optimal assimilation.

Caution: Avoid during first trimester of pregnancy

Dose: Fresh juice-2 tsp. per day

Tea- ½-1 tsp. dried or fresh yarrow to one cup of boiling water

Tincture:20-40 drops 2-3 x per day

Wise Water

Wise Water is a formula made from a combination of three herbs specifically to encourage health and healing in the digestive tract. It also supports and nourishes the immune and nervous systems.

Ingredients:

Cumin Seed-Cuminum cyminum: Promotes digestion and helps you absorb and use nutrients. It is antioxidant, cooling and is high in Vitamin C and A

Coriander-Coriandrum sativum: promotes the elimination of toxins and metabolic waste via the kidneys while it’s bitter and pungent flavors stimulate digestion, relieve gas, bloating, and stomach cramps. It is anti-inflammatory and cooling yet regulates digestive and metabolic “fire”.

Fennel Seed-Foeniculum vulgare- Reduces gas, bloating and regulates autonomic contractions of the small intestine relieving abdominal spasm. Useful for irritable bowel, colitis, heartburn and any  general digestive discomfort

Recipe: Combine a ¼ teaspoon of each and add to 1 ½ quarts of water. Boil for 5 minutes. Turn off heat. Place in a non-plastic thermos, pan or vessel and let steep at least 15 minutes before drinking. Drink throughout the day. Can be taken daily for up to 3 months

Sources:

Kate Gilday: Lectures and conversations over many, many years

David Winston, Herbs for Digestion-Audio Cassette

Tammi Sweet: Lecture at 2013 Women's Herbal Conference, A&P online course-http://tammisweet.com/ 

Paul Bergner: Audio CD, Vitalist Treatment of Acute Symptoms