A Natural Approach to Integrative Pain Management

Dr. Tieraona Low Dog

More than 1 in 5 people in the U.S. live with chronic pain frequently resulting in a diminished quality of life. If you’re among those suffering, this one is for you. Read on to learn how you can live a full life, reduce prescription medications, and manage chronic pain with integrative healing modalities and botanicals that are proven safe and effective.

— Tieraona Low Dog, M.D.

Tragically more than 1 in 5 people in the United States live with chronic pain and, as a result, a diminished quality of life. There are plenty of pharmaceutical pain relievers available, but with some contributing to the ongoing opioid crisis, many are seeking natural alternatives. 

Where can you turn when you’ve tried seemingly everything, but nothing touches your pain? Is it possible to live a full life with chronic pain? As an integrative physician, I know it is possible. 

Four Herbs for Pain Relief

I wrote about cannabis in a previous post so now I’m sharing four more of nature’s scientifically-backed pain relievers with you. Over the years I’ve leaned on many herbal allies to help me, my family, and my patients get through painful times, but these four  botanicals—Turmeric, California poppy, corydalis, and peppermint essential oil—each stand out for their ability to ease all types of pain.

Turmeric Rhizome

Derived from underground stems of the plant known as Curcuma longa, turmeric is commonly used in Indian cuisine. The whole rhizome is biologically active, but its powerful anti-inflammatory and antioxidant compounds, collectively referred to as “curcumin,” contribute to much of turmeric’s pain relieving effects. 

In a review of 16 randomized controlled trials evaluating turmeric extracts in patients with knee osteoarthritis (OA), eleven studies compared turmeric extracts to placebo, and five compared them to non-steroidal anti-inflammatories (NSAIDs). The reviewers found that turmeric was equally effective as NSAIDs and significantly better than placebo for reducing knee pain and improving function. They concluded that “turmeric extract is a safe and effective option for the symptomatic management of knee OA, compared to placebo or NSAIDs.” 

My take:  Turmeric can be very effective when used as part of an integrative approach to pain management. I take it myself as a safer long-term alternative to NSAIDs. Choose forms with superior absorption (e.g., bound to phospholipid, containing bioperine or black pepper extract, BMC-95®). The dose is generally 1,500 mg per day of products containing 95% curcumin (curcuminoids). Safety is quite good, however, doses of 20 mg per day of piperine (bioperine) may increase the risk of herb-drug interactions.

California Poppy Herb

This beautiful member of the poppy family is California’s state flower and has a history of use as food and medicine by Native Americans. The young leaves were boiled and eaten as a vegetable, and the whole upper part of the plant was used to relieve tooth pain, headaches, and as a mild sedative.

In 1890, the liquid extract of California poppy (botanical name Eschscholzia californica) was included in Parke Davis catalog as an “excellent soporific and analgesic, above all harmless.” In 1918, California Poppy was entered in the U.S. Formulary as a powerful herb for calming and supporting sleep, and by 2015, the European Medicines Agency Committee on Herbal Medicinal Products concluded, “California poppy can be used for the relief of mild symptoms of mental stress and to aid sleep.” Health Canada now recognizes the traditional use of California poppy as both a sleep aid and analgesic. 

My take:  I’ve used this herb for decades and find it to be highly reliable for folks suffering from chronic pain conditions who are looking for improved sleep. Unlike its cousin, the opium poppy, California poppy is not addictive or dangerous. Gaia Herbs and Herb Pharm both make high quality liquid extracts. Herbs Etc. makes Deep Sleep, a formulation with California poppy and other relaxant herbs. 

Corydalis Rhizome/Root

Corydalis is a flowering herbal plant also in the poppy family. The botanical name is Corydalis yanhusuo and its dried tuberous roots have been used in Traditional Chinese medicine for millennia for their analgesic properties. Beyond pain relieving qualities, corydalis also has antidepressant activity, a comorbidity often seen alongside chronic pain. Interestingly, corydalis is frequently used to treat addiction to opiates and other drugs.

Corydalis contains many active compounds, including roughly twenty alkaloids, which account for its biological effects. One such alkaloid, levo-tetrahydropalmatine (l-THP), is synthetically manufactured and approved for use in China as an analgesic. L-THP, both natural and synthetic, has been used for over 40 years in China as a treatment for chronic pain, back pain, muscle spasms, anxiety, and as an analgesic with sedative/hypnotic properties. 

My take:  I find corydalis, alone or when combined with cannabidiol (CBD), to be very useful for relieving pain, especially nerve pain. I would love to see more research on this plant, as I think its analgesic, antispasmodic, and antidepressant effects could help many people with chronic pain disorders. The dose is generally 1.5–3 grams of the dried rhizome per day, or less when used as an extract. Herb Pharm makes a nice corydalis tincture, Swanson provides corydalis in capsules, and Planetary Herbals Corydalis Minor Pain Relief is a reliable product containing a blend of corydalis, hops, and willow bark extract. Do not use during pregnancy.

Peppermint Leaf

Peppermint, botanical name Mentha x piperita, has a long history of use for relieving pain, indigestion, and respiratory issues. Modern research confirms that the essential oil extracted from fresh peppermint leaves is highly effective for the relief of aches and pain when applied topically, and relaxes gastrointestinal smooth muscles when taken internally, making it effective for the relief of IBS. 

A meta-analysis of 12 randomized clinical trials found that enteric coated peppermint oil supplementation is significantly superior to placebo for global improvement of IBS symptoms and abdominal pain. The enteric coating allows more peppermint oil to reach the intestine. Two clinical trials also show beneficial effects with enteric coated peppermint oil capsules for children with functional gastrointestinal problems.

My take:  The research is solid that enteric coated peppermint oil is highly effective for relieving gastrointestinal cramping and IBS. There are many quality brands to choose from; Pepogest by Nature’s Way provides 0.2 ml of peppermint essential in enteric coated softgels, which is the clinically tested dose. I start with one before the main meal of the day and increase as needed, up to 3 softgels per day. 

Creams and balms containing menthol—peppermint’s active constituent—can be rubbed into skin to ease musculoskeletal aches and pains. In fact, massaging your temples and forehead with peppermint oil may work as well as over-the-counter pain relievers to relieve tension headaches. Do not use peppermint on the face of any child under the age of three.

Interested in making your own headache helper? Try my recipe for Peppermint Headache Oil!


  • 20 drops of peppermint essential oil
  • 4 tablespoons (2 ounces) of carrier oil (almond, grape seed, or sunflower oil)

Directions:  Put the carrier oil into a small bottle and add the peppermint essential oil. Shake well. Gently rub a small amount into temples, forehead, neck, and shoulders, being careful to avoid the eyes.

More Ways to Ease Pain Naturally

In addition to herbs, there are lifestyle tweaks and complementary healing modalities that can also provide natural pain relief. These include:

Reduce inflammation 

Inflammation is inextricably linked to pain (and most other health problems) so finding ways to reduce it is key to pain management. Following an anti-inflammatory eating plan like the Mediterranean diet, and avoiding pro-inflammatory foods such as refined sugar whenever possible could do wonders.

Reduce stress

Science suggests there’s a strong link between chronic stress and chronic pain. Soothing practices such as yoga, mindfulness meditation, and progressive muscle relaxation (PMR) may help relieve stress and pain simultaneously. 

Improve sleep 

Good sleep is crucial for overall health and pain management. In fact, studies show that one of the main predictors for pain intensity is the number of hours slept the night before. Read my blog on how to improve sleep from melatonin and California poppy to CBT-i and guided imagery. 

Massage and acupuncture 

The healing power of touch is an ancient pain remedy. Even current science confirms that hands-on therapies such as massage and acupuncture are effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain, among others.

Hope for Healing from Pain

I’ve treated and suffered many types of pain throughout my life (two hip replacements!). I know the despair that can set in when you can’t find relief no matter what you’ve tried. Relief is possible; it usually takes a combination of things. Be a curious explorer. Most importantly, remember, taking over-the-counter or prescription medications is sometimes necessary, but an integrative approach can often allow you to reduce the amount of medications needed to achieve relief. Wherever you are on your journey, I wish you ease.