Medication in Anthroposophic Pain Therapy

Acute and chronic pain belong to the fundamental experiences of life and accompany numerous illnesses. We treat pain with peripherally effective, non-steroidal anti-inflammatory drugs (NSAIDs) or centrally effective opiates or opioids after diagnostic clarification – usually in accordance with the World Health Organization’s pain ladder. However, analgesics are associated with adverse drug reactions which may restrict their use. In addition, chronic pain patients require integrative therapy, since these drugs alone often do not lead to enough improvement. Anthroposophic Medicine can make a significant therapeutic contribution to pain therapy. 

 Pain is an experience of consciousness in an unphysiological place – a kind of displaced consciousness. The patient’s sensory organization becomes active in a way that leads to different pain qualities such as burning, throbbing or cramp-like pain. The experience of pain reduces the patient’s life forces. Many patients complain of exhaustion and weakness and want therapeutic support for their life organization. Analgesics are designed to minimize or eliminate the experience of pain. However, patients do not just want pain to be “blocked” (symptom treatment), they also wish to address the cause of the pain or the underlying disease. They may also experience pain relief through movement, warmth or external applications and they are looking for therapies that support their inherent health-bringing forces.  

The usual analgesics as well as the medications suggested below are used in anthroposophic pain therapy. Anthroposophic medications help relieve the patient of the disease process that results in pain while also reconnecting his or her soul and spirit with the organism in a way that corresponds to healthy physiological functioning. Pain is caused by the sensory organization (soul body) intervening too deeply in the patient’s life organization and physical body. Treatment of the weakened life organization needs to be  considered as an essential element. For example, it is important to ensure good, regenerative sleep when treating chronic pain. 

Pain qualities

Different qualities of pain may be described, which provides information about possible causes and triggers. They relate to the different types of activity: sharp neuropathic pain has to do with the neurosensory system; inflammatory pain is related to the motor-metabolic system. Colicky pain, in contrast, has a rhythmic pattern. (For more on functional threefolding, see https://www.anthromedics.org/BAS-0349-DE .)  

Neurosensory system: sharp, delineated pain, neuralgic pain, neuropathic pain, convulsive pain
Rhythmic System: colicky pain
Motor-metabolic system: inflammatory pain

Many patients report on the pain-relieving effect of warmth on tension pain in the musculoskeletal system. Warmth returns the sensory organization to a healthier physiological functioning in the organism, allowing the patient’s accustomed mobility to return and convulsive pain in the patient’s musculature to subside. This therapeutic effect of warmth is harnessed in external applications and warmth-enhancing medications. Conversely, inflammatory pain improves through cold and cool external applications. In view of this, we adapt the temperature of an arnica compress, for example, to the type of pain.

Pain triggering and pain intensifying factors in palliative medicine 

Physical factors

• Tumors or metastases exert pressure on tissue and nerves and/or damage them. 
• Muscular tension leads to tension pain. 
• Contractions of smooth or striated muscles lead to spasmodic pain  
• Infections or local inflammatory processes cause throbbing pain.  

Mental and social factors 

• Fears, e.g., of the consequences of a disease, of dying and death, of social or economic losses. 
• Depression and despair regarding one’s life situation and the disease. 
• Experiences of loss, e.g., loss of job, loss of autonomy, loss of social relationships, loss of economic security, loss of physical integrity, etc. 

Spiritual factors 

• Spiritual emptiness 
• Loss of meaning 
• Questions and doubts about one’s life up to now, possibly feelings of guilt 

In addition to medication, the anthroposophic therapeutic concept includes external applications, body-oriented procedures such as rhythmical massage therapy, eurythmy therapy, artistic therapies, and counselling with a doctor, psychotherapist and/or pastoral care. The treatment plan should include aspects relating to the biographical development of the patient. 

Medication in pain therapy

Aconitum napellus (monkshood)

Monkshood belongs to the buttercup family. Its dark blue flowers show a special arrangement and shape. They grow on radially symmetric shoots off the stem. The flowers are closed like helmets and not open to the light. The plant is extremely poisonous. It forms the alkaloid aconitine. 
Aconitum is used for sharp, pulling or burning pain with accompanying anxiety and a cool periphery, i.e., for complaints caused by the soul body affecting the neurosensory system: 

• Aconitum Rh D30 amp. WELEDA, 1x/d 1 amp. in the morning, and as needed
• Aconitum comp. amp. WALA, 1x/d 1 amp. in the morning, and as needed  
• Aconitum D6 pill., 10 pill. 3x/d.
• as an external application: Aconite Nerve Oil WALA (also available as Aconite Pain Oil and Aconit Schmerzöl)
  (see also http://www.pflege-vademecum.de/aconit_schmerzoel.php )

Rhus toxicodendron (Atlantic poison oak)

Rhus toxicodendron is used to treat pulling pain associated with stiffness in the musculoskeletal system which improves through warmth and movement. It is indicated for vesicular, itchy skin rash. 

• Rhus toxicodendron comp. amp. WALA, 1x/d 1 amp. mane and as needed  
• Rhus toxicodendron D6 amp. WELEDA, 1x/d 1 amp. mane and as needed
• Rhus toxicodendron D6 pill. e.g., DHU, 10 pill. 3x/d  

Poison oak is a deeply rooted shrub that forms subterranean rhizomes from which new shoots rise to the surface. Inconspicuous umbels form on the stem where the leaves emerge, i.e., the plant’s generative flowering process penetrates deeply into its vegetative leaf process. Like all sumac species, Rhus toxicodendron forms a milky sap. It contains tannins and highly toxic, skin-irritating phenols. Unlike aconite, contact with it does not lead to pallor and a cool body periphery, but to “inflammatory” skin reactions.

Bryonia alba (white bryony)

Bryonia is used in pain therapy especially for inflammatory processes in serous skin with effusion (e.g., arthritis). The type of pain is an inflammatory, stabbing one that worsens through movement and warmth.

• Bryonia/Aconitum amp. WALA, 1x/d 1 amp. in the morning, and as needed
• Bryonia e radice D4 pillules WALA or Bryonia D6 pill., 10 pill. 3–4x/d until the symptoms subside
• For malignant effusions Bryonia/Stannum amp. WALA, 1 amp. s.c. 1x/d or every other day 

White bryony is a vine with an enormously prominent root. The sweet, spicy smell of the root is striking, as is the smell of the fine tendrils above ground, which seek support on trees and bushes. Small, whitish yellow, star-shaped flowers continue to form on the tendrils even as individual green berries redden. 

Nicotiana tabacum (tobacco)

Nicotiana is used for cramp-like pain to release the sensory organization from its excessively strong and degradative activity in the organism.  

For colicky hollow-organ pain, troubling flatulence and cramp-like upper abdominal pain:

• Nicotiana comp. amp. WALA, 1 amp. in the morning, and as needed 

Nicotiana belongs to the nightshade family (Solanaceae). This annual plant has its origin in the subtropical regions of South and Central America. Strong dark green undivided leaves surround the straight, man-high stem in rhythmic succession. Towards the tip, where the terminal, many-flowered inflorescences appear, they transform into small outer leaves. A strong resinous aromatic aroma surrounds the whole plant. The main ingredient, besides other alkaloids, is the toxic alkaloid nicotine. 

Oxalis acetosella (wood sorrel)

With cases of spasmodic pain, oxalis leads the sensory organization back to healthy physiological functioning.

For hollow-organ pain, colicky pain, bloating, pain in peritoneal carcinosis:

• Oxalis comp. amp. WELEDA, 1 amp. 1x/d in the morning, and as needed

For tumor pain and colic:

• Oxalis Folium Rh D3 amp. WELEDA, 1 amp s.c. 1x/d
• in case this is followed by more colic later, Oxalis D3 dil., 10 drops 3x/d
• Oxalis compresses with oxalis 30% ointment WELEDA.

Oxalis acetosella is a small plant that can be found in shady forested areas. It forms a sturdy rhizome from which small, fleshy, thickened leaves sprout and then rapidly-growing long, stalked leaves in groups of three, and star-shaped flowers. The leaves react sensitively to touch and movement.

Matricaria chamomilla (chamomile)

In cases of convulsive and inflammatory abdominal pain chamomle leads the sensory organizatioin to its physiological activity and strengthens the life organization.

• Chamomilla e radice D6 pill. WALA, 10 pill. 3–4x/d until the symptoms subside
• Chamomile rinses, used externally, serve to promote wound healing. 

This annual plant belongs to the family of composite flowers. Its delicate white-yellow flower heads have an aromatic scent. Chamomile forms a dark blue essential oil, which has an anti-inflammatory effect.

Cuprum metallicum praeparatum (copper)

Copper has a relaxing and warming effect and strengthens the life organization. It is used for spasmodic complaints in the respiratory organization and abdomen and can be combined with the medicinal plants mentioned above:

• Cuprum aceticum comp. amp. WALA, 1 amp. s.c. 1–2x/d in the abdomen, or drink 1 amp.
• Cuprum metallicum praep. amp. D6, D10, D30 WELEDA, 1 amp. 1–2x/d s.c. in the abdomen, or drink 1 amp.  
• Cuprum metallicum praep. trit. D6, D10, D30 WELEDA 
• External applications with Cuprum met. praep 0.1%, 0.4% ointment WELEDA or Cuprum metallicum praeparatum 0.4% oil WELEDA or Red Copper Ointment WALA (also available as Kupfer Salbe rot).

In case of restless legs syndrome, it is often surprisingly effective to take: 

• Cuprum aceticum/Zincum valerianicum dil. WELEDA, WELEDA, 20 drops 3x/d, if needed, also as an ampoule at night. 

Arnica montana (wolf’s bane)

With cases of dull, tearing, pulling pain and muscle tension, this medicinal plant leads the sensory organization back into healthy physiological functioning in the musculosceletal system. It is also used for soft tissue trauma and wound healing.

• For muscular tension pain, use externally as Arnica comp./Cuprum oil WELEDA (also available as Arnica comp./cum Cupro Oleum).

Arnica belongs to the family of composite flowers. As a plant that grows high in the mountains, it prefers light, humid alpine meadows and siliceous subsoil. In spring, a stalk pushes up from a rosette of leaves lying on the ground, taking a single pair of leaves with it. At St. John’s (in June) it unfolds a yellow-orange, spicy fragrant flower with central tubular and surrounding ray florets. The resulting pappi are blown away by the wind. In autumn, the above-ground parts of the plant die off and strong root growth follows, forming runners, from which a new leaf rosette emerges, followed by a flower shoot the following spring.  
Arnica is rich in various ingredients: flavones, choline and phytosterols are found in the flower; tannins, essential oils and finely distributed colloidal silica are found in the whole plant; the rhizome contains inulin, starch, sticky substances and bitter substances.

Viscum album (white-berried mistletoe)

In addition to its effect on tumors, mistletoe has an analgesic effect (1). Through its relationship to warmth and by releasing endorphins, mistletoe detaches the sensory organization from the painful areas of the organism and leads it back to its proper physiological functioning in the organism. Mistletoe therapy thus has a firm place in palliative medicine. Mistletoe preparations must be injected subcutaneously (2, chap. 7).

• AbnobaViscum®
• Helixor®
• Iscador®, Bremistal®
• Iscucin®