Kava & St John's Wort for CPPS?
Posted: Fri May 30, 2003 8:59 pm
Hello all. I've had prostatitis / chronic prostatitis / chronic pelvic pain syndrome since '99, but this is my first post at this forum.
Two of the compelling theories of chronic prostatitis / chronic pelvic pain syndrome etiology are those of muscular spasm and neurogenic inflammation. Detailed info is presented at http://www.chronicprosatitis.com The following serves as a brief synopsis....
* Muscular spasm. Inflammation (perhaps caused by a sustained and disordered immune reaction to a transient infection, perhaps neurogenic) "sensitises" nerves in the region, making the muscles of the pelvic floor more susceptible to painful spasm. Many CPPS-sufferers find that certain exercises (e.g. sit-ups, stair-climbing) lead to a very sudden "flare up" of pain, suggesting a neuromuscular component of the condition.
* Neurogenic inflammation. Nerve injury leads to the development of "perverted" (remodelled) pain pathways. Frequently, the nerves comprising such pathways are lacking in opiate receptors, making the pain intractable to both opiate medications (e.g. codeine, morphine) and the body's own endorphins. Chronic activation of NMDA receptors plays a role. Additionally, the release of substance P from nerve endings causes mast cells to release histamine and other pro-inflammatory substances. A "vicious cycle" ensues and the pain and inflammation are perpetuated. Further info on this darkly fascinating topic can be found at http://www.spineuniverse.com/displayart ... le391.html and at http://www.hosppract.com/issues/2000/07/brook.htm
Interestingly, opioid-resistant pain is often responsive to treatment with tricyclic antidepressants (TCAs), such as amitriptyline. TCAs work at neuron synapses, inhibiting the re-uptake of serotonin and norepinephrine (noradrenalin). The analgesic effect of the TCAs is thought to be attributable to serotonin, which appears to inhibit the release of the "pain chemical" substance P. The action of norepinephrine at alpha-2-adrenergic receptors may also have a pain-killing effect. http://www.spineuniverse.com/displayart ... le391.html
The herbal antidepressant St John's Wort is thought to exert an effect similar to that of prescription antidepressants (i.e. it is thought to increase levels of serotonin and norepinephrine (and possibly also dopamine) at synapses). Consequently, St John's Wort has been used with some success in the management of chronic pain. Three to four weeks of daily dosage are required before an effect is noticed. (From 'The Healing Power of Vitamins, Minerals and Herbs', published by Reader's Digest). Links....
http://www.vitastand.com/information/stjohnswort.htm and
http://www.i-nutraceutical.com/herbal.html
The other herb of interest is one called kava (or "kava kava"). Generations of island-dwellers in the south Pacific have used the herb (in the form of a beverage) for more than three thousand years. It has all the salubrious effects of alcohol, but none of the intoxicating side-effects. Its primary effect is that of an anxiolytic (calmative). Like benzodiazepines (e.g. Valium) and barbiturates, it is thought to function at the GABA (gamma-amino butyric acid) receptors. However, kava lacks the side-effects of the pharmaceutical sedatives.....the kava-user does not develop a tolerance that necessitates ever-increasing doses, and kava does not impair mental acuity. The mild calmative action of kava is certainly appealing, but the other properties may be of special interest to CPPS-sufferers.... Kavalactones (the active ingredient of the herb) have also been shown to have a "blockade" effect at NMDA receptors, making kava useful in the management of chronic pain. It also has anti-spasmodic and myorelaxant (muscle relaxing) effects, making it especially useful in the treatment of painful muscle spasm. (from 'The Healing Power of Vitamins, Minerals and Herbs', published by Reader's Digest)
Links:
http://www.i-nutraceutical.com/herbal.html and
http://www.healthwwweb.com/herbmed/piper.html
Some (if not all) cases of chronic prostatitis / chronic pelvic pain syndrome are characterised by neuropathic pain and muscle spasm. The properties of St John's Wort and kava would seem to suggest that these two herbs may be of value in the treatment of CPPS.
Two of the compelling theories of chronic prostatitis / chronic pelvic pain syndrome etiology are those of muscular spasm and neurogenic inflammation. Detailed info is presented at http://www.chronicprosatitis.com The following serves as a brief synopsis....
* Muscular spasm. Inflammation (perhaps caused by a sustained and disordered immune reaction to a transient infection, perhaps neurogenic) "sensitises" nerves in the region, making the muscles of the pelvic floor more susceptible to painful spasm. Many CPPS-sufferers find that certain exercises (e.g. sit-ups, stair-climbing) lead to a very sudden "flare up" of pain, suggesting a neuromuscular component of the condition.
* Neurogenic inflammation. Nerve injury leads to the development of "perverted" (remodelled) pain pathways. Frequently, the nerves comprising such pathways are lacking in opiate receptors, making the pain intractable to both opiate medications (e.g. codeine, morphine) and the body's own endorphins. Chronic activation of NMDA receptors plays a role. Additionally, the release of substance P from nerve endings causes mast cells to release histamine and other pro-inflammatory substances. A "vicious cycle" ensues and the pain and inflammation are perpetuated. Further info on this darkly fascinating topic can be found at http://www.spineuniverse.com/displayart ... le391.html and at http://www.hosppract.com/issues/2000/07/brook.htm
Interestingly, opioid-resistant pain is often responsive to treatment with tricyclic antidepressants (TCAs), such as amitriptyline. TCAs work at neuron synapses, inhibiting the re-uptake of serotonin and norepinephrine (noradrenalin). The analgesic effect of the TCAs is thought to be attributable to serotonin, which appears to inhibit the release of the "pain chemical" substance P. The action of norepinephrine at alpha-2-adrenergic receptors may also have a pain-killing effect. http://www.spineuniverse.com/displayart ... le391.html
The herbal antidepressant St John's Wort is thought to exert an effect similar to that of prescription antidepressants (i.e. it is thought to increase levels of serotonin and norepinephrine (and possibly also dopamine) at synapses). Consequently, St John's Wort has been used with some success in the management of chronic pain. Three to four weeks of daily dosage are required before an effect is noticed. (From 'The Healing Power of Vitamins, Minerals and Herbs', published by Reader's Digest). Links....
http://www.vitastand.com/information/stjohnswort.htm and
http://www.i-nutraceutical.com/herbal.html
The other herb of interest is one called kava (or "kava kava"). Generations of island-dwellers in the south Pacific have used the herb (in the form of a beverage) for more than three thousand years. It has all the salubrious effects of alcohol, but none of the intoxicating side-effects. Its primary effect is that of an anxiolytic (calmative). Like benzodiazepines (e.g. Valium) and barbiturates, it is thought to function at the GABA (gamma-amino butyric acid) receptors. However, kava lacks the side-effects of the pharmaceutical sedatives.....the kava-user does not develop a tolerance that necessitates ever-increasing doses, and kava does not impair mental acuity. The mild calmative action of kava is certainly appealing, but the other properties may be of special interest to CPPS-sufferers.... Kavalactones (the active ingredient of the herb) have also been shown to have a "blockade" effect at NMDA receptors, making kava useful in the management of chronic pain. It also has anti-spasmodic and myorelaxant (muscle relaxing) effects, making it especially useful in the treatment of painful muscle spasm. (from 'The Healing Power of Vitamins, Minerals and Herbs', published by Reader's Digest)
Links:
http://www.i-nutraceutical.com/herbal.html and
http://www.healthwwweb.com/herbmed/piper.html
Some (if not all) cases of chronic prostatitis / chronic pelvic pain syndrome are characterised by neuropathic pain and muscle spasm. The properties of St John's Wort and kava would seem to suggest that these two herbs may be of value in the treatment of CPPS.