You are in pain and lifestyle guide vitamins supplements.

Supplements to help manage chronic pain? For answers, WebMD turned to the experts in integrative medicine.

"I believe that supplements can be the cornerstone of pain management well," said David C. Leopold, MD, director of medical education at Scripps Center for Integrative Medicine Integrative, San Diego. "People are looking for even more supplements. They have less tolerance for the side effects of conventional drugs against pain. They want something different."

An overview of chronic pain supplements our experts considered the most important.

Anti-inflammatory herbs and plants. Chronic inflammation contributes to many painful conditions, including osteoarthritis and back pain. Anti-inflammatory drugs such as aspirin, ibuprofen and naproxen work well because they block the enzymes that cause both swelling and pain.

"There are natural alternatives to NSAIDs have a similar mechanism," says Leopold. They include turmeric, green tea, ginger, rosemary, cat's claw, devil's claw and willow bark.

Completing the pain is better? Leopold and other experts on individual turmeric. "It works very well," says Tanya Edwards, MD, medical director of the Center for Integrative Medicine at the Cleveland Clinic. "I had arthritis patients starting with turmeric and are able to go beyond NSAIDs at all." Look standardized turmeric capsules.

Because they work in the same way as NSAIDs, pain supplements do not have some of the same risks, such as bleeding and stomach. However, the side effects tend to be less severe. Leopold always suggest that people who take anticoagulant medication consult a doctor before using any of these supplements pain.

Fish oil. "Fish oil supplements beat is clean," says David P. Rakel, MD, founder and director of the Integrative Medicine University of Wisconsin in Madison. There is strong evidence that helps many conditions ranging from cardiovascular disease to depression to asthma.

Fish oil can also relieve the pain and inflammation caused by many chronic diseases. The dose used in the study the most convincing is 2 to 4 grams of EPA + DHA per day (read the labels!). Although benefits of omega-3 are available from other sources, experts say that fish oil has the best proof.

"Council omega-3 for all, including people with chronic pain," says Leopold. Says help headaches, back pain, nerves, pain, and autoimmune conditions such as rheumatoid arthritis.

"The pain that you get from fish oil alone is not huge," says Rakel. You can increase the analgesic effects of supplements of fish oil that combines with other analgesics, such as turmeric and ginger, Rakel said. But first, check with your doctor to be sure that these combinations are safe for you.

Vitamin D. A number of studies have linked low levels of vitamin D with increased levels of chronic pain.

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A 2009 study examined the vitamin D levels of people with chronic pain with opioid analgesics. Those who were deficient in vitamin D dose required almost two times higher than medication to control the pain.

Edwards now controls the levels of vitamin D in many of his patients suffering from chronic pain. If you are below 50-70 nanograms / milliliter, can you recommend a supplement to relieve physical pain.

"Personally, I have seen miracles," he said. "I found that this can be a huge advantage in the symptoms of fibromyalgia sufferers." He noted that it is useful for other types such as chronic pain, such as bone and joint pain.

Capsaicin. Capsaicin comes from hot peppers and can relieve pain when applied to the skin. "Topical capsaicin appears to be useful for all types of pain," said Edwards. Studies have shown that it can help relieve the pain of rheumatoid arthritis, osteoarthritis, psoriasis, shingles, and diabetic neuropathy. It can also offer natural relief for back pain, fibromyalgia pain, headache. Warning:. your pain may worsen for a few days before improving when using capsaicin and there is the risk of skin irritation. Wash hands after application of capsaicin. Do not touch your eyes or other sensitive areas when there are traces of capsaicin on your hands.

Glucosamine sulfate. "When it comes to joint pain, I think that glucosamine supplements are among the best data out there," says Leopold. He feels pain particularly strong this supplement can help relieve osteoarthritis pain of the knee. Glucosamine is often combined with chondroitin, which may have a further advantage.

Leopold said that studies suggest that glucosamine not only relieves pain, but also slows the progression of osteoarthritis.

SAMe. There is good evidence that the same provides natural pain relief for people with osteoarthritis. Some studies have shown that it is almost as effective as painkillers like Celebrex. But there is a catch to this pain supplement: cost.

"SAMe can run $ 80 - $ 120 per month," said Edwards, "so do not tend to use a lot I can usually get results that are just as well with less expensive treatments.».

Magnesium. The evidence is mixed. But some studies have shown that magnesium supplements can help with the pain caused by conditions such as headaches, muscle spasms and fibromyalgia. Some experts believe that magnesium deficiency may be a widespread problem.

"It 's really easy to be deficient in magnesium," said Edwards, who recommend magnesium supplements for their patients with chronic pain. "Foods that are high in magnesium are things like sunflower seeds and pumpkin seeds. Most of us simply do not eat them very often." Regular consumption of alcohol can also deplete magnesium levels.

Acetyl L-carnitine. Several studies have shown that the nutrient acetyl-L-carnitine can alleviate neuropathic pain from diabetes. This pain supplement seems to regenerate damaged nerves and, over time, to restore sensitivity.

Alpha lipoic acid. As acetyl-L-carnitine, alpha lipoic acid appears to help diabetic neuropathy. "The preliminary data show promise, but that will not only reduce pain, but also seems to slow the progression of nerve damage," says Rakel tells WebMD. "It can help protect nerves from further damage."

Alpha-lipoic acid may also improve insulin sensitivity - another plus for people with diabetes. There is evidence that this supplement can help with nerve damage pain caused by cancer treatments, too.

Bromelain. Bromelain, an enzyme derived from the pineapple plant, appears to reduce inflammation and pain. Some studies have found useful in osteoarthritis and knee pain. There is some uncertainty as to how it is absorbed in digestion, as it can be neutralized by stomach acid. More research needs to be done.

Riboflavin (vitamin B2). "There have been some promising research showing that riboflavin can help reduce the frequency of migraines," says Rakel, but a recent study does not support the request. Rakel still think it is safe to try a maximum of eight weeks, because of its high security clearance. There is evidence that extracts of CoQ10 and standardized butterbur (Petasites) can also help prevent migraine headaches.

MSM (methylsulfonylmethane). It is a compound that occurs naturally in certain plants and animals, which has been shown in preliminary research to reduce pain osteoarthritis. Further studies are needed to clarify its safety and efficacy.

Supplements chronic pain: a combination of approaches

Effective as physical pain can be, Leopold urges people to keep an open mind on traditional approaches, too. "NSAIDs such as ibuprofen and naproxen work very well," said Leopold, "and they are incredibly cheap. The price tag of some supplements can be considerable."

Natural pain relief and traditional medicine do not need to be in opposition. Leopold patients using a daily pain as turmeric supplement for pain. Then, during exacerbations, in addition to an NSAID.

That said, no one should be mix painkillers and supplements without seeing a doctor. Could be risky. So make sure that your health care provider knows all the medications and supplements you use.