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COMBINING MEDICINAL HERBS WITH MASSAGE THERAPY:CHRONIC INFLAMMATION MANAGEMENT

Updated: Jun 7, 2023



MUSCULOSKELETAL INFLAMMATORY CONDITIONS AND THE BODYWORKER PERSPECTIVE

Swelling, redness, heat and tenderness are the notorious four for diagnosing an inflammation. Inflammation is like stress: if occurs for a short period and with the right timing is immensely beneficial, but when it lingers for too long it can be severely detrimental (1). From the bodyworker perspective, the help that we can offer in chronic (but also acute) inflammatory conditions include manual lymphatic drainage, gentle mobilisation and the correction of musculoskeletal imbalances that might have resulted. We might as well terminate our session by suggesting to our client some stretching or strengthening exercises in combination with rest or other lifestyle adaptations.


THE ROLE OF HERBS IN REGULATING INFLAMMATION

Medicinal herbs contain compounds termed bioactive phytochemicals which, when absorbed, positively interact with the physiological processes of the body. Usually, most herbs have few main compounds that are accountable for their properties; nevertheless, they may have dozens to hundreds of less bioactive phytochemicals that work in a synergistic fashion to increase bioavailability, enhance potency or minimise toxicity of the most bioactive compounds (3). That is why often herbs have little to no side effects, while unfortunately there is plenty of evidence that the most commonly prescribed NSAIDs can have detrimental consequences on the digestive system (4) and even impair the growth of articular cartilage (5). In regard to inflammation, herbs work by directly inhibiting inflammatory factors, by promoting lymphatic flow or by supporting the body’s excretory channels in removing pro-inflammatory agents. To target an inflammatory condition, herbalists would probably prescribe a blend of herbs which have all the three aforementioned properties.

POPULAR ANTI-INFLAMMATORY HERBS

TURMERIC RHIZOME (Curcuma longa radix)

Turmeric has gained such an outstanding popularity in recent times to the point that the Western market has put this yellow rhizome in the hall of fame of the cure-all herbs. In specific to inflammation, the medical literature mostly focussed in studying its yellow pigments, called curcuminoids. Curcuminoids have shown to be potent anti-inflammatory in vitro, in animal studies and in human trials (6); their mechanism of action involves the inhibition of several cytokines and enzymes which exert a pro-inflammatory action.

How to take it: golden milk, tablets and fresh juices


FRANKINCENSE RESIN (Boswellia serrata)

The most active family of compounds identified in frankincense are called boswellic acids and they have shown to be strong inhibitors of pro-inflammatory enzymes like 5-lipoxygenase and COX-2 (8). There are few studies on frankincense relevant for us bodyworkers: a study from 2007 evaluated the efficacy of frankincense for knee OA in a dosage of 333mg a day; it resulted that most participants started experiencing a significant decrease in inflammation symptoms just after 2 months (9). The remarkable finding from this study is that the anti-inflammatory effects persisted for a month after the administration of frankincense was over.

How to take it: Tablets.


DEVIL’S CLAW (Harpagophytum procumbens)

Devil’s claw is native to the Kalahari Desert in African continent and its name comes from the peculiar shape of its hooked fruits.

One of the most in-depth review on devil’s claw has been published by McGregor et al. in 2005 who collected evidence on the inhibitory action of its main bioactive compounds, rightly called harpagosides and procumbides on inflammation mediators such as TNF and thromboxane. The review and concludes stating that daily supplements of devil’s claw can be a promising side-effects-free long-term treatment for managing arthritis and rheumatisms (11).

How to take it: Tablets or ethanol extract

CELERY SEEDS (Apium graveolens fruct)

Celery seeds have been used traditionally since the middle ages as a remedy for rheumatisms, gout and water retention. Celery seed extract is not a strong inflammatory per se’, but it is a diuretic and detoxifier, promoting the removal of uric acid and other toxic by-products from joints and soft tissues (13) Because of these cleansing properties, celery seeds are a wonderful remedy to combine with traditional anti-inflammatory herbs.

How to take it: Tea, powder or ethanol extract

BURDOCK ROOT (Arctium lappa)

Differently from other remedies, it is not clear which pharmacologically active compounds burdock manufactures, but from a nutritional point of view it is like a chemical minestrone: it has a little bit of everything. Vitamins, minerals, bitter compounds, prebiotics and many more (14). What we can be sure of is that burdock works very well in clearing toxic pro-inflammatory compounds out of the tissues. One study on 36 patients with diagnoses knee osteoarthritis showed that consuming burdock root tea for 6 weeks significantly reduced inflammatory markers and remarkably increased endogenous antioxidants (15).

How to take it: Tablets and ethanol extract


CONCLUSION

Discovering new and effective ways to empower our clients in getting better can be considered part of our homework as massage therapists . Herbs can be an extremely helpful way of adding quality to the outcome of our therapeutic sessions.

REFERENCES

1. Goodman, Stuart B., and Ling Qin. “Inflammation and the Musculoskeletal System.” Journal of Orthopaedic Translation, vol. 10, July 2017, pp. A1–A2, 10.1016/j.jot.2017.07.001. Accessed 24 Aug. 2020.

2. Reveille, John D. “Soft-Tissue Rheumatism: Diagnosis and Treatment.” The American Journal of Medicine, vol. 102, no. 1, Jan. 1997, pp. 23S-29S, 10.1016/s0002-9343(97)00413-0. Accessed 24 Aug. 2020.

3. Zhang, Lijuan, et al. “Synergistic Anti-Inflammatory Effects and Mechanisms of Combined Phytochemicals.” The Journal of Nutritional Biochemistry, vol. 69, July 2019, pp. 19–30, 10.1016/j.jnutbio.2019.03.009. Accessed 24 Aug. 2020.

4. Scheiman, James M. “NSAIDS, GASTROINTESTINAL INJURY, AND CYTOPROTECTION.” Gastroenterology Clinics of North America, vol. 25, no. 2, June 1996, pp. 279–298, 10.1016/s0889-8553(05)70247-8. Accessed 27 Dec. 2019.

5. Brandt, Kenneth D., and Marshall J. Palmoski. “Effects of Salicylates and Other Nonsteroidal Anti-Inflammatory Drugs on Articular Cartilage.” The American Journal of Medicine, vol. 77, no. 1, July 1984, pp. 65–69, 10.1016/s0002-9343(84)80021-2. Accessed 26 Aug. 2020.

6. Chainani-Wu, Nita. “Safety and Anti-Inflammatory Activity of Curcumin: A Component of Tumeric (Curcuma Longa).” The Journal of Alternative and Complementary Medicine, vol. 9, no. 1, Feb. 2003, pp. 161–168, 10.1089/107555303321223035. Accessed 20 June 2019.

7. Patel, Kamal. “Curcumin UPDATE for 2019: Benefits, Dosage, Side Effects.” Examine.Com, Examine.com, 5 Feb. 2015, examine.com/supplements/curcumin/. Accessed 1 Mar. 2019.

8. Siddiqui, MZ. “Boswellia Serrata, A Potential Antiinflammatory Agent: An Overview.” Indian J Pharm Sci, vol. 73, no. 3, 2011, pp. 255–261.

9. Thawani, V, et al. “Open, Randomized, Controlled Clinical Trial of Boswellia Serrata Extract as Compared to Valdecoxib in Osteoarthritis of Knee.” Indian Journal of Pharmacology, vol. 39, no. 1, 2007, p. 27, 10.4103/0253-7613.30759. Accessed 17 Mar. 2020.

10. Riva, A , et al. “A Novel Boswellic Acids Delivery Form (Casperome®) in the Management of Musculoskeletal Disorders: A Review.” European Review for Medical and Pharmacological Sciences, vol. 21, 2017, pp. 5258–5263.

11. McGregor, Gerard, et al. “Devil’s Claw (Harpagophytum Procumbens): An Anti-Inflammatory Herb with Therapeutic Potential.” Phytochemistry Reviews, vol. 4, no. 1, Jan. 2005, pp. 47–53, 10.1007/s11101-004-2374-8. Accessed 2 Sept. 2019.

12. Bartram, Thomas. Encyclopaedia of Herbal Medicine. first ed., Dorset, Grace Publishers, 2007.

13. Fazal, Syed Sufiyan. “Review on the Pharmacognostical & Pharmacological Characterization of Apium Graveolens Linn.” Indo Global Journal of Pharmaceutical Sciences, vol. 2, no. 1, 2012, pp. 36–42.

14. Light, Marylin. “Chemical Constituent of Burdock.” Www.Herballegacy.Com, 2020, www.herballegacy.com/Light_Chemical.html#:~:text=Chemical%20Constituent%20of%20Burdock&text=

15. Maghsoumi-Norouzabad, Leila, et al. “Effects OfArctium LappaL. (Burdock) Root Tea on Inflammatory Status and Oxidative Stress in Patients with Knee Osteoarthritis.” International Journal of Rheumatic Diseases, vol. 19, no. 3, 28 Oct. 2014, pp. 255–261, 10.1111/1756-185x.12477. Accessed 29 June 2020.

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