Evidence-Based Opinions from Multidisciplinary Experts on Use of Naturopathic Herbal Remedies in Pain Management

Abstract

Background

Pharmacological approaches to acute and chronic pain management, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, are respectively associated with adverse reactions (such as gastrointestinal, cardiovascular, and renal effects) that might limit their use in patients with comorbidities and controversy related to inappropriate use. Naturopathic remedies might offer patients alternative and integrative treatments with minimal side effects.

Objective

To explore the regional variation in the acceptance and use of naturopathic remedies in pain management.

Methods

Two expert panel discussions were held by GlaxoSmithKline Consumer Healthcare (now Haleon Pte. Ltd.) over 9 and 12 hours in 2020 and 2021, respectively, and attended by multidisciplinary experts in naturopathy, Ayurvedic medicine, community pharmacy, physiotherapy, clinical pharmacy, Western medicine, academics, and naturopathic pain relief. Experts shared and discussed their experiences of naturopathic treatments and relevant clinical evidence related to different types of pain (including joint and muscle pain, migraine, sleeplessness due to pain, and general pain) and examined barriers to providing support to patients.

Results

Experts agreed on the potential for curcumin (2020, 71.4% [5/7]; 2021, 91.7% [11/12]) and fish oil (2020, 100% [7/7]) for management of osteoarthritic joint pain although these are not uniformly recommended in osteoarthritis treatment guidelines. In treatment of migraines, coenzyme Q10 and magnesium were favored by experts (2021, 90.9% [10/11] and 63.6% [7/11], respectively).

Conclusion

The need was emphasized for more and higher quality clinical studies to support naturopathic remedies, which might not be reflected in the latest treatment guidelines. The expert panel also highlighted missed opportunities for physicians and pharmacists to recommend effective naturopathic treatments.

Keywords:

• herbal remedies
• naturopathy
• osteoarthritis
• migraine
• expert panel discussion

Ethics Approval

Our study is a narrative review/commentary based on a consensus discussion of professionals who gave written consent to participate in the meetings and signed standard agreements, which assigned Haleon full rights to the content generated, including consent for scientific publication. There was no intervention, and no human subjects were involved in the study. On this basis, the study is not subject to the Declaration of Helsinki and exempt from institutional review board ethical review.

Acknowledgments

The authors thank Andrew Jackson of MIMS, Singapore, for providing medical writing support, which was funded by Haleon (formerly GlaxoSmithKline Consumer Healthcare) in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Disclosure

VS is a current employee of Haleon (formerly GSK Consumer Healthcare); AM has consulted for and received honoraria from Haleon. AS-C, FCG, JM, and MG have all received honoraria from Haleon. The authors report no other conflicts of interest in this work.