Relief for Pain

by Lisa Schofield | July 1, 2022

Discomfort and the inflammation that often accompanies it can be addressed through natural products—and summertime tends to bring its share of ouches.

Pain can ruin a moment. Chronic or acute, aching or sharp, pulsing or in waves, physical discomfort is the common experience all humans share. During the summer, most people are more active, increasing the rate of accidents and pulled muscles, and joint flareups, as well as being exposed to sun rays as well as insects and plants that can cause rashes.

According to Anup Krishnnan, CEO, Arjuna Natural Pvt, Ltd, Kerala, India, active people involved in fitness or athletic competition as well as those who have hectic routines often encounter pain in some form due to stresses and rigors of demanding physical movement. “This has an adverse impact on quality of life and wellbeing and in cases even mobility and livelihood,” he said. Commonly, people turn to OTCs (over-the-counter) to reduce the discomfort, however, the good news for natural products retailers is that more consumers are actively seeking alternative more natural solutions. “Until recently, this was not an area where natural safe solutions could enter, as relief is often needed ASAP and not in days,” he added.

“Many consumers are familiar with the occasional sore muscles that accompany a workout or the joint discomfort the comes from a long afternoon walk in the park,” described Vanessa Pavey, ND, education scientist, Life Extension, Florida. “Achy muscles and joints can certainly ruin the rest of the day, so many are looking for fast-acting and effective relief.”

Today’s “natural OTCs” for discomfort are no longer “OTC alternatives” as they hold their own and are increasingly preferred by consumers of all ages who would rather not have to deal with potential side effects caused by pharmaceuticals. Your customers may choose both supplements and topicals for their family first-aid kit at home and on-the-go.

“Working in health food stores for most of my life, the topic of pain and discomfort comes up a lot,” emphasized retailer Tim O’Brien, owner of Wisconsin-based The Healthy Place. “Customers tend to ask for whatever they have heard about in an ad or perhaps from a friend that saw something work for them.”

Ingestibles

Swallowing a capsule, tablet or drops of a liquid to relieve grimace-inducing sensations is a familiar way to provide relief. Supplements are not often thought of by consumers as a way to quicker relief, but here is where you can help customers achieve a customizable fast- and long-term solution.

Life Extension’s Fast Acting Relief formula includes three ingredients that have been clinically studied together to provide quick relief from discomfort, according to Pavey. Turmeric rhizome, boswellia and black sesame seed extracts provide synergistic activity that helps inhibit inflammatory factors to relieve achy muscles and joints. The formula was shown in a human study to help participants feel relief.

On the first day of the seven-day clinical study, participants who received 1,000 mg of this herbal combination reported comfort relief within two and a half hours, and by day seven, there was a 72 percent reduction in total discomfort, Pavey reported. She explained the likely mechanisms of action: Turmeric and boswellia are known to inhibit inflammation in the muscle tissue, joints and ligaments. Turmeric extracts can suppress the activity of pro-inflammatory enzymes cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX), while boswellia also inhibits 5-LOX. Black sesame seeds modulate delta-5 desaturase, an enzyme that regulates inflammation. And, while individually these herbs help inhibit inflammatory factors, they are more effective when combined.

Turmeric (curcumin) and boswellia are a popular combination that customers would recognize. Wisconsin-based Terry Naturally/EuroPharma Inc.’s original formula for pain relief, Curamin, contains BCM-95 curcumin, which combines curcumin with turmeric essential oil for enhanced bioavailability and blood retention, and BOS-10 boswellia, which delivers up to 10 times more acetyl-11-keto-B-boswellic acid (AKBA) than unstandardized forms, according to Cheryl Myers, chief of scientific affairs and education.

Additionally, both Curamin and Curamin Extra Strength formulas contain the amino acid DLPA (dl phenylalanine), as, Myers explained, “it helps prevent the breakdown of one of the brain’s natural pain-killing substances, enkephalins, which are in the same family as endorphins. Each formula also includes nattokinase, an enzyme that increases microcirculation for improved nutrient delivery to the joints.”

EuroPharma’s newest formula for pain relief is CuraMed Acute Pain Relief. It too blends BCM-95 curcumin and BOS-10 boswellia, but in an emulsified matrix of black sesame seed oil that has been clinically shown to help these ingredients provide fast results in a small, easy-to-swallow liquid gel. Black sesame seed oil has been traditionally used in ayurvedic medicine to aid in carrying and dispersing fat-soluble ingredients, plus is an anti-inflammatory which makes it doubly valuable in this formula.

She explained, “The combination of absorption enhancement and anti-inflammatory power attracted researchers to add black sesame seed oil to the already well-established pain-relieving combination of curcumin and boswellia. They chose to use to use black sesame seed oil specifically, because black sesame seeds are higher in beneficial lignans like sesamin and valuable phenolic compounds than white sesame seeds.”

Active Joint & Muscle from Mountain Meadow Herbs, Montana, features turmeric. And, said certified herbalist Megan Lubitz, business development outreach specialist, it is artfully blended with stinging nettle leaves, garlic bulb, horsetail and celery seed. “These herbs also contain many of the vitamins and minerals the body needs for stronger bones. This is a strength building formula, while our Everyday Joint & Muscle formula is an ‘as needed.’ This contains capsaicin from cayenne, which has been shown to help reduce discomfort and muscle spasms. This may partially be due to its ability to block pain receptors, as well as stimulate the cardiovascular system and blood flow.

Methylsulfonylmethane (MSM) is also suitable for longer term support against discomfort and aches. Washington-based Bergstrom Nutrition’s OptiMSM has been shown to improve the inflammatory response following exercise, according to Tim Hammond, vice president of sales & marketing. For example, he provided, one bout of acute exercise (10 sets of 10 repetitions of knee extensions) increased systemic levels of inflammatory cytokines (IL-6) immediately afterward. Not only did 28 days of OptiMSM supplementation before exercise reduce the levels of pro-inflammatory markers (IL-6), it increased anti-inflammatory markers (IL-10),” he reported.

Hammond detailed powerful results of Bergstrom Nutrition’s in-vitro studies demonstrating how the supplement manages inflammatory response. “OptiMSM accomplishes this “through inhibition of the expression of inflammatory markers via the suppression of iNOS and Cox-2 genes, plus the cytokines IL-6 and TNFα, and NF-kB, a nuclear transcription factor that regulates many inflammatory mediators,” he said. “These are all key in producing an inflammatory response to acute injury. MSM blocks the degradation of a key protein, essentially disabling the expression of these inflammatory response mediators.”

In a study examining the effect of MSM on chondrocytes, MSM again demonstrated powerful IL-6 (and IL-8) suppression by deactivating the protein kinase that allows for production of these inflammatory cytokines. Another study evaluating the effect of OptiMSM on knee joint components demonstrated that OptiMSM reduced the expression of inflammatory markers TNF-alpha and IL-1 by 33 percent and 29 percent, respectively, but did not increase the synthesis of proteoglycans or the cartilage matrix in chondrocytes. A recent study also demonstrated MSM to be a selective inhibitor of NLRP3 inflammasome activation, a multi-protein complex operating as a platform for the inflammatory response mediator interleukin (IL)-1β.

Amino Activ, from Tennessee-based VIREO SYSTEMS Inc., features Alpha-GEE, a peptide compound conjugated from various essential and conditionally essential amino acids found in foods, described Mark Faulkner, CEO. Individually, he noted, the amino acids forming the peptide don’t exert inflammation-control properties but “when synthesized and conjugated together in our patent-protected process, they form a compound that expresses beneficial effects on inflammation.”

He noted that studies have shown Amino Activ’s Alpha-GEE has excellent inflammation-management properties and helps reduce activity-induced soreness. “Amino Activ is an efficacious first line alternative to for exercise-induced inflammation. Besides positive clinical outcomes with prostaglandin suppression, Amino Activ’s Alpha-GEE have also been shown to support suppression of systemic inflammation markers like TNF-α, NF-κB, and serum amyloid A.”

Amino Activ was first shown to suppress the release of prostaglandins from cells that had been subjected to stress from over exertion. Another study observed that it could reduce lactic acid production in muscle cells following periods of exercise; accumulation of lactic acid in muscles (hypoxia) is one of the causes of muscle soreness immediately following strenuous activity.

Research on AminoActiv’s mechanism of action, said Faulkner, suggests that its efficacy is related to the stabilization of mitochondrial membranes by increasing oxygen reserves. Stabilized mitochondria are less susceptible to protein leakage, catalyzation of a cytokine reaction, and the chemical cascade of inflammation that ensues. Damage to the mitochondria results in increased levels of prostaglandin production. And recent inflammation research supports the contention among scientists that mitochondrial dysfunction is the central pathway for inflammation. Thus, any supplement that helps stabilize mitochondrial function is key to preventing cellular inflammation,” he explained.

O’Brien recommends Joint Jive by Lively Vitamin Co. “I like how it therapeutically goes after both the inflammation and the lubrication side of pain and discomfort. Folks report feeling like there is just more elasticity, flexibility and mobility, and that their overall pain comes down.”

Topicals

For external relief of muscle and joint discomfort, as well as for scrapes and bites, natural topical formulas synergize well with supplements.

Sovereign Silver First Aid Gel for Topical Healing, from Florida-based Natural Immunogenics Corp., is a multi-action homeopathic medicine that soothes, relieves and heals a wide range of skin problems such as minor cuts, scrapes, burns, bug bites, rashes, sunburn and skin eruptions from acne and eczema, according to Brand Manager Jason Mullins. “Sovereign Silver First Aid Gel for Topical Healing is a natural homeopathic medicine that consists of 99.999 percent pure silver, pharmaceutical-grade water, and a thickening agent commonly used in foods and infants’ syrups for its safety. The homeopathic form of silver in the product has been used for over 2,400 years, long before modern medicine, for a broad range of healing and wellness,” he said.

Instaflex Pain Relief Cream, from Healthy Directions, Maryland, provides menthol in a concentration of 1.25 percent. “When applied, it results in a cooling sensation that can act as a counterirritant to mitigate the sensation of pain,” explained Irfan Qureshi, ND, vice president, product development and quality assurance. “This analgesic effect is the result of the skin being cooled and then heated up, which may interfere with the transmission of pain signals through nerves. Menthol is thought to activate thermoreceptors located on nerve endings in skin tissue. Activation of these thermoreceptors leads to the induction of a cooling sensation in humans and is responsible for the analgesic and pain-relieving effects of menthol.”

Instaflex Pain Relief Cream was shown in a randomized, double-blind clinical study to be about twice as effective as a leading menthol-only rub for relieving pain after seven days of use, Qureshi reported. “Instaflex Pain Relief Cream can be used in combination with other formulations that address additional aspects of joint discomfort and impaired mobility, such as Instaflex Advanced, a dietary supplement that targets additional facets of joint health by providing clinically validated ingredients that work by regulating the body’s inflammatory response and supporting joint comfort.”

EuroPharma’s Traumaplant Comfrey Cream, said Myers, “is perfect for cuts, abrasions, sprains, joint pain, bee stings, minor wounds, insect bites, bruises, sunburn or pain, and burns of any kind.”

The key ingredients in Trauma Comfrey responsible for these actions are allantoin, choline and rosmarinic acid. Allantoin quickly stimulates the rebuilding of cells and regenerates damaged tissue; it can penetrate the skin all the way to tendons, cartilage, and bone. Choline supports quicker recovery of injured blood vessels and nerve endings and improves the pumping of blood through inflamed tissues. Rosmarinic acid may help reduce inflammation, fluid loss from injury and cell damage.

“Traumaplant has shown remarkable abilities for treating blunt sports injuries and bruises, healing open wounds (and in one study reduced pain by 50 percent and reduced the healing time in half), easing muscle pain and improving mobility, and soothing knee and ankle sprains and strains,” Myers said.

In a randomized double-blind, placebo-controlled, multi-center study of 203 individuals experiencing acute ankle sprain and pain, Traumaplant reduced pain by half in just three days.

Another study involved men and women with “contusions and distortions of the knee joint”—bruised and sprained knees—who applied Traumaplant Comfrey Cream 12 hours after getting injured, on average. They were told to rub the ointment into the wounded area at least four to five times a day, a relatively high dose, and then to bandage the wound and wrap it in gauze. The subjects reported that when they applied the cream, there was immediately a pleasant cooling sensation in the wounded area, followed by a distinct and prolonged drop in pain.

Within four days, swelling and pain were markedly lowered. By day seven, none of the patients had pain while resting, 19 were completely pain-free even during movement by day 10 and the last three participants by day 14.

Myers added that the comfrey used in the product is completely safe and non-toxic as typical comfrey roots contain pyrrolizidine alkaloids (PAs) that known to be toxic to the liver. However, “Traumaplant Comfrey Cream features a special cultivar of comfrey called (Symphytum x uplandicum NYMAN), otherwise known as Trauma Comfrey that is specifically cultivated to be completely free of PA content. And only the juice from the aerial parts—leaves, stems and flowers, which are naturally PA-free to begin with—are used, not the roots.”

Natural Path Silver Wings, Tennessee, offers Silver Aloe Vera Gel with Tea Tree Oil containing 200 ppm silver, which, according to Chris Terrell, ND, scientific advisor, helps promote skin healing and helps relieve burns, minor scrapes, cuts and rashes and dry skin. It even soothes insect bites and stings.

Terrell explained, “Silver has been used for generations as a topical skin ointment. Much of its popularity further sprung during the Civil War and WWI, as silver was widely used for battle wound care to help promote healing. This was a vitally important first aid necessity. Aloe vera gel is also renowned for its accelerated wound healing properties. It’s most notable for use on burns and sunburn. Both silver and aloe vera are continually used in burn centers around the world with ongoing success. Tea tree oil is known to help disinfect bacterial and fungal skin conditions, and is used for minor skin cuts, scrapes and promoting healing and soothing skin irritation.”

Arjuna Natural’s Rhuleave-K is clinically shown to provide fast pain relief within three hours, according to Krishnnan. “What differentiates Rhuleave-K is the new SPEEDTECH technology which enables this fast action. Rhuleave-K provides meaningful pain relief in a short time, and effectively targets most types of musculoskeletal pain, that effects head, neck, muscle, joints and general body,” he said. A clinical study published in 2020 of 88 healthy individuals who took either 1,000 mg Rhuleave-K or 1,000 mg acetaminophen daily for seven days post injury showed that the natural product was almost as effective as the OTC. The Rhuleave-K group showed strong response with reduced feelings of pain nearly comparable to the acetaminophen (control) group—66 percent vs. 73 percent respectively.

“My favorite topical to use and to recommend to customers is Wild Theory’s CBD topical,” related O’Brien. “We have sampled it in store for years as I’ve worked with customers at The Healthy Place. After applying it, mid consultation, they would report relief! They would say ‘I am not sure if this is in my head because of how fast its working, but I am pretty sure I am noticing results already.’”

Of course, we cannot forget highlighting homeopathic remedies for pain.

According to Guillaume Lois, Olloïs, California, homeopathic remedies for general pain, inflammation, muscle, joint, headaches and sunburns include Arnica montana, Hypericum perforatum, Ruta graveolens, Bryonia alba, Rhus toxicodendron and Belladonna. Olloïs provides retailers with a First Aid Category dispenser that can be placed in pain-reduction/inflammation section. The First Aid dispenser includes four remedies that help with pain and inflammation. The label on the dispenser mentions the name of the remedy and describes the symptoms it can be used for which helps the customer to easily find the remedy that best suits their needs.

Marketing for Summer

Compared to winter, summer has more potential incidents that can incur pain and discomfort. Emphasizing “summer safety” can motivate your customers to stock up on quick- and longer-term solutions, ingestibles and topicals.

Terrell related that when he served as merchandising/purchasing manager for a health food store, he and his team created endcaps with summer decorations—umbrella, beachball, sunglasses, palm leaves, etc. and include natural sun protection bottles on display and after-sun relief bottles.

He suggested to “print and display a double-sided stack of summer skin tips. Frontside includes pre-sun protection tips and the backside includes post-sun treatment tips. Include perhaps a BOGO discount valid only for pre- and post-sun products. Also include another tips sheet themed around natural insect repellant bottles merchandised the same way.”

Retailer O’Brien said he likes to put all the most powerful more therapeutic pain relief supplements front and center in the pain relief section, so customers are more likely to pick those ones up to analyze. “When working in my The Healthy Place health food stores I really like to simplify things too for my customers. I will ask them what they are looking for. After they communicate that they are looking for pain relief I grab a product or two off the shelf and explain why I believe those products to be the best choice. It takes the overwhelming feelings out of it with a clear path to say yes to!”

Krishnnan noted that while consumers are increasingly looking for products that are safe and provide solutions to discomforts, they are increasingly confused by advertising and lack of information. “There is a consumer perception of OTC solutions being the only one available for meaningful fast pain relief in cases of common muscular pains from exercise.”

With summer making its grand entrance, many individuals are engaged in a variety of outdoor activities and ramping up their exercise routines, Pavey observed. “The resulting muscle and joint inflammation can interfere with continued summer fun,” she said. VR