Winston D. The use of herbs for treating chronic back pain: a materia medica. J Am Herbalists Guild. 2005;6(1):20-24.

Back pain afflicts more than 65 million Americans every year and results in lost worker productivity and increased medical expenses. Stress, physical injury, disease, poor posture, and other factors can trigger back and neck pain. Standard medical therapy includes physical therapy, steroid interjections, and surgery. Although herbs alone may not cure chronic back and neck pain, they can be an effective adjunct to standard therapy.

Specific herbs used to treat back and neck pain and related conditions include black cohosh (Actaea racemosa syn. Cimicifuga racemosa) root, Solomon's seal (Polygonatum biflorum) rhizome, wood betony (Pedicularis spp.), Saint John's wort (Hypericum perforatum), butterbur (Petasites hybridus) rhizome, Sichuan teasel (Dipsacus asper) root, kava (Piper methysticum) root, skunk cabbage (Symplocarpus foetidus) root, guaiacum (Guaiacum officinale) wood/resin, and Jamaica dogwood (Piscidia piscipula) bark.

Anti-inflammatory herbs including ginger (Zingiber officinale) rhizome, turmeric (Curcuma longa) rhizome, devil's claw (Harpagophytum procumbens) tuber, licorice (Glycyrrhiza glabra) rhizome and European goldenrod (Solidago virgaurea) are useful in treating back and neck pain. Anti-inflammatory herbs are milder than prescription anti-inflammatory medications and have fewer side effects. Analgesic herbs relieve pain, and some can inhibit inflammation. Analgesic herbs include willow (Salix alba, S. purpurea, S. fragilis) bark, meadowsweet (Filipendula ulmaria; syn. Spiraea ulmaria), corydalis (Corydalis spp.) tuber, mulberry (Morus spp.) bark, Jamaica dogwood bark, and wintergreen (Gaultheria procumbens). Herbal antispasmodics relieve muscle spasms and pain, and many are also sedatives. Antispasmodic herbs include black cohosh root, butterbur root, skunk cabbage root, valerian (Valeriana officinalis), kava root, and California poppy (Eschscholzia californica) root. Herbal nervines and sedatives are used to reduce stress and decrease muscle tension. These include motherwort (Leonurus cardiaca), lavender (Lavandula angustifolia) flower, lemon balm (Melissa officinalis), and California poppy root.

Some herbs are used topically to treat back and neck pain including: arnica flowers, distilled witch hazel (Hamamelis virginiana) bark/leaf, ginger rhizome, balsam poplar (Populus basalmifera) buds, chaparral (Larrea tridentata), medicine sage (Artemisia ludoviciana), Saint John's wort oil, lobelia (Lobelia inflata) seed, and capsaicin from cayenne pepper (Capsicum annuum).

Herbs used to treat sciatica include sweetclover (Melilotus spp.), bai zhu atractylodes (Atractylodes macrocephala) root, southern prickly ash (Zanthoxylum clava-herculis) bark, horse chestnut (Aesculus hippocastanum) seed, and Saint John's wort flowering tops. Specific herbs indicated for neck pain and whiplash are: kudzu (Pueraria sp.) root, lungwort (Lobaria pulmonaria) lichen, achyranthes (Achyranthes bidentata) root, butterbur, passionflower (Passiflora incarnata), corydalis (Corydalis yanhusuo) tuber, Saint John's wort flowering tops, arnica (Arnica montana) flowers, rue (Ruta graveolens), and kava root.

In Traditional Chinese Medicine, kidney yin and/or yang tonics are often used to treat low back pain and sciatica. Essential oils with topical analgesic activity, including wintergreen essential oil, lavender essential oil, and juniper (Juniperus communis) essential oil, can be added to massage oils to help relieve pain. The author states that 50% of all back pain is stress-related and concludes, "If stress is a causative factor for chronic back and neck pain, then nervines, sedatives, herbal antidepressants, and adaptogens should also be considered."