565
Chin J Integr Med 2012 Aug;18(8):565-570
Pain after injury to the nervous system
(neuropathic pain) is a major chronic pain condition
that remains difficult to treat. Neuropathic pain
associated with peripheral nerve injury is characterized
by sensory abnormalities such as unpleasant and
abnormal sensation (dysesthesia), an increased
response to painful stimuli (hyperalgesia), and pain
in response to a stimulus that does not normally
provoke pain (allodynia). Peripheral neuropathic pain
is frequently observed in patients with long standing
diabetes, cancer, acquired immune deficiency
syndrome (AIDS), leprosy, cervical disc damage and
after laminectomy surgery. An experimental model of
neuropathic pain is induced by chronic constriction
injury to the sciatic nerve and is a widely employed
model in experimental animals.
(1)
It is estimated that
75–150 million people in the United States have a
chronic pain disorder. Neuropathic pain is debilitating
and often has an associated degree of depression
that contributes to decreasing human wellbeing and
productivity. Moreover, the management of chronic
pain is costly to patients and the health care system.
(2)
Conventional analgesics like non-steroidal
antiinflammatory drugs and opioids are ineffective
clinically in attenuating neuropathic pain. Tricyclic
anti-depressants (i.e., amitriptyline, nortriptyline and
imipramine) and anti-convulsants (i.e., phenytoin,
carbamazepine, gabapentin, lamotrigine and topiramate)
have been reported to produce anti-allodynic effects
in neuropathy. However, these drugs are reported to
exhibit a wide spectrum of adverse effects which limits
their full clinical exploitation in the management of
painful neuropathy. The most widely used drugs which
are approved and licensed for neuropathic pain are:
Lyrica (pregabalin), Cymbalta (duloxetine), Neurontin
(gabapentin), Lidoderm (5% lidocaine patch), and
Qutenza (8% capsaicin patch). They are also associated
with a high incidence of side effects.
(3)
Herbal medicines are reported to be beneficial
in the management of painful neuropathy.
(1)
Below
is a list of plants which have the potential to cure
neuropathic pain.
Acorus Calamus
Acorus calamus belongs to the family Araceae.
Traditionally it is used as an ingredient in several
drugs employed for the treatment of headache,
migraine, body ache, and severe inflammatory pain in
the Unani, Ayurveda, and local health care systems
in Indian medicine.
(4)
Phytochemically Acorus species
have shown to possess glycosides, flavanoids,
saponins, tannins, polyphenolic compounds, mucilage,
volatile oil and bitter principles.
(5)
The essential oil of
A. calamus was banned in 1968 in the US due to the
FEATURE ARTICLE
Treatment of Neuropathic Pain with Plant Medicines
Garima Garg and James D. Adams
©The Chinese Journal of Integrated Traditional and Western
Medicine Press and Springer-Verlag Berlin Heidelberg 2012
Department of Pharmacology and Pharmaceutical Sciences,
School of Pharmacy, University of Southern California, 1985
Zonal Avenue, Los Angeles, CA 90089-9121, USA
Correspondence to: Prof. James D. Adams, Tel: 001-323-442-1362,
E-mail: jadams@usc.edu
DOI: 10.1007/s11655-012-1188-6
ABSTRACT Neuropathic pain is a common and very prevalent disorder
affecting the citizens of both developed and developing countries. The approved
and licensed drugs for neuropathic pain are reported to have associated side
effects. Traditional plant treatments have been used throughout the world for the
treatment of neuropathic pain. Among the many medications and other alternative
medicines, several herbs are known to cure and control neuropathic pain with
no side effects. The present paper discusses the plants with neuropathic pain
and related beneficial effects originating from different parts of world that are of
current interest.
KEYWORDS neuropathic pain, peripheral neuropathy, medicinal plants
Prof. James D. Adams