Herbal ANG™

TCM herbal analgesic formula for acute and chronic pain — potent analgesic; strong anti-inflammatory; invigorates blood circulation; relieves pain of skeletal and smooth muscles; may be used alone or as an adjunct to another formula

⚠️ Discontinue one week prior to surgery. Contraindicated during pregnancy and nursing. Designed for short-term symptomatic treatment — not recommended for long-term use. For chronic pain, identify and treat the underlying cause. Contains Dang Gui (Radix Angelicae Sinensis), which invigorates blood circulation — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all due to higher risk of bleeding and bruising.

CLINICAL APPLICATIONS

* Pain: acute or chronic

* Pain: dull, sharp, stabbing, numbing, burning, and fixed, moving, or radiating

* Pain of skeletal and smooth muscles

Background: Pain is the most common reason for physician consultation in the United States. Acute pain is a beneficial and necessary warning signal for survival — it alerts the individual to withdraw from harmful situations, protect a damaged body part while it heals, and avoid similar experiences in the future. Chronic pain, however, may persist after the stimulus has been removed or after the body has healed, significantly interfering with quality of life and general functioning — causing anxiety, stress, depression, anger, fatigue, sleep disturbance, immune suppression, and many others. Because chronic pain affects both body and mind, effective treatment requires addressing both psychological and physical aspects. In TCM, the fundamental principle is: "Where there is pain, there is stagnation. When stagnation is cleared, so will the pain." Proper treatment requires careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnation), and location (upper body, lower body, extremities, or internal organs).

Key herb-level clinical data:

— Yan Hu Suo (Rhizoma Corydalis / Corydalis): the strongest and most potent herb in the entire Chinese herbal pharmacopoeia for pain relief; enters both xue (blood) and qi (energy) levels to invigorate blood circulation, regulate qi, and relieve pain in the chest, abdomen, and limbs; effective for visceral organ and musculoskeletal pain; inhibits histamine and pro-inflammatory mediators — effective in both acute and chronic phases of inflammation; analgesic potency comparable to morphine — used with satisfactory anesthetic effect in 98 of 105 patients (93.4%) undergoing surgery; analgesic effect significantly increased with concurrent electro-acupuncture vs. electro-acupuncture alone; safer than morphine — significantly fewer side effects, less risk of tolerance, and no evidence of physical dependence even with long-term use; drug screen study (Rhode Island Clinical Research Center): 6 capsules of Corydalin (AC) — both subjects completely negative on 7-drug panel (opiates, benzodiazepines, barbiturates, etc.)

— Ru Xiang (Gummi Olibanum / Frankincense / Boswellia): analgesic and anti-inflammatory — treats acute trauma and injuries; antiarthritic — reduces edema and arthritic scores in adjuvant-induced arthritis via suppression of TNF-α and IL-1β; facilitates wound healing by stimulating maturation and differentiation of white blood cells; clinically: trauma and external injuries, chest pain, colicky or sharp pain, acute sprain of lower back and legs

— Mo Yao (Myrrha / Myrrh / Commiphora): analgesic and anti-inflammatory — treats acute trauma and injuries; antiarthritic — reduces edema and arthritic scores in adjuvant-induced arthritis via suppression of TNF-α and IL-1β; facilitates wound healing by stimulating maturation and differentiation of white blood cells; clinically: trauma and external injuries, chest pain, colicky or sharp pain, acute sprain of lower back and legs (used synergistically with Ru Xiang for a wide range of pain from qi or blood stagnation, trauma, or arthritic syndrome)

— Dang Gui (Radix Angelicae Sinensis / Angelica Sinensis): tonifies and moves blood; analgesic and anti-inflammatory — inhibits nitric oxide and prostaglandin E2 in peritoneal macrophages; anti-inflammatory effect approximately 1.1× stronger than aspirin (acetylsalicylic acid); analgesic effect approximately 1.7× stronger than aspirin; clinically: menstrual pain (112 patients), migraine headache (35 patients), different types of headache (36 patients), general pain (105 patients)

— Sheng Ma (Rhizoma Cimicifugae / Cimicifuga): channel-guiding herb — moves upward and outward with a dispersing nature; breaks up stagnation and relieves pain; reaches the far ends of the body including the extremities; enhances the overall effect of all herbs in the formula; mild anti-inflammatory and analgesic

WESTERN THERAPEUTIC ACTIONS

* Potent analgesic — Yan Hu Suo (morphine-comparable, 93.4% surgical anesthesia success); Dang Gui (1.7× aspirin potency); Ru Xiang + Mo Yao (trauma, sprain, arthritic pain); Sheng Ma (mild, guiding)

* Strong anti-inflammatory — Yan Hu Suo (histamine↓, pro-inflammatory mediators↓); Dang Gui (NO↓, PGE2↓, 1.1× aspirin); Ru Xiang + Mo Yao (TNF-α↓, IL-1β↓, edema↓); Sheng Ma (mild)

* Antiarthritic — Ru Xiang + Mo Yao (adjuvant-induced arthritis, arthritic scores↓)

* Wound healing — Ru Xiang + Mo Yao (WBC maturation and differentiation↑)

* Synergistic with acupuncture — Yan Hu Suo + electro-acupuncture significantly increases analgesic effect

CHINESE THERAPEUTIC ACTIONS

* Invigorates blood circulation; relieves blood and qi stagnation (Yan Hu Suo, Dang Gui, Ru Xiang, Mo Yao)

* Relieves pain of visceral organs and musculoskeletal system (Yan Hu Suo)

* Guides herbs to extremities and far reaches of the body (Sheng Ma)

DOSAGE

Alone: 3–4 capsules three times daily as needed. For severe pain: 7–8 capsules every 4–6 hours as needed. As adjunct with other formulas: 2–3 capsules in addition to the regular dose of the base formula. Take on an empty stomach with two tall glasses of warm water. Discontinue when desired effects are achieved. Begins to show effectiveness within 30 minutes. Can be used in conjunction with acupuncture for a synergistic analgesic effect.

Clinical notes: Herbal ANG is excellent for both internal and external injuries leading to pain of the body and extremities — the TCM diagnosis for such conditions is typically qi and blood stagnation. If pain is located in the trunk (chest or abdominal regions), additional examination is necessary to diagnose the underlying cause — Herbal ANG will relieve pain but will not address the underlying illness (e.g., kidney stones, gallstones) and may delay treatment. Cancer pain is often severe and may not be relieved effectively by herbs — under these circumstances, opioid drugs should be used for pain management if necessary; CA Support and C/R Support may be used as adjunct treatments.

Supplementary formulas: Headache — add Corydalin (AC) or Corydalin (CR). Neck and shoulder pain — add Neck & Shoulder (AC) or Neck & Shoulder (CR). Arm pain (shoulder, elbow, wrist) — add Arm Support. Lower back pain — add Back Support (AC) or Back Support (CR). Herniated disk — add Back Support (HD). Knee pain — add Knee & Ankle (AC) or Knee & Ankle (CR). Gout — add Flex (GT). Chronic musculoskeletal disorder with damaged soft tissues — add Flex (MLT). Arthritic syndrome or fibromyalgia from coldness — add Flex (CD). Arthritic syndrome or fibromyalgia from heat — add Flex (Heat). Spasms and cramps — add Flex (SC). Neuropathy — add Flex (NP). Bone spurs — add Flex (SPR). Dysmenorrhea — add Mense-Ease. Gallstone pain — use with Dissolve (GS). Kidney stone pain — use with Dissolve (KS). External or trauma injuries — use with Flex (TMX). Post-surgical care — add Flex (TMX) for blood circulation and pain, Herbal ABX to prevent infection. Gastric pain — add GI Care. IBS pain or bloating — add GI Harmony. Food poisoning or traveler's diarrhea — add GI Care II. Ulcerative colitis pain — add GI Care (UC). Hemorrhoids — add GI Care (HMR). Endometriosis, uterine fibroids, ovarian cysts — add Resolve (Lower). Fibrocystic breast disorder — add Resolve (Upper). Unknown pain with blood stagnation — add Circulation (SJ). Bell's Palsy or TMJ pain — add Symmetry.

Nutrition: Cold-type pain: avoid cold or raw foods (vegetables, salads, watermelon, pear), cold drinks, and exposure to cold weather; avoid cold showers or swimming in cold water; warm/hot natured foods such as lamb, pepper, onions, and scallions are recommended. Heat-type pain: avoid spicy food; increase cold-natured vegetables and fruits such as watermelon and cucumber. Damp-type pain: avoid greasy, fatty, or fried foods; dairy products not recommended. Increase calcium and magnesium — they calm the nerves and reduce sensitivity to pain.

Lifestyle: Proper diet and exercise are extremely important in preventing recurrent pain syndrome — chronic pain is often the result of occupations requiring repetitive use of the same joints or repeated injuries to the same area; strong efforts should be made to eliminate or improve such working conditions. Exercise keeps qi and blood circulating properly. Other effective therapies include massage, relaxation techniques, deep breathing, and heat/cold therapy.

CASE STUDIES

— 25-year-old female (R.B.): Severe head and neck pain; tension headaches in frontal and occipital area; pain 7/10, decreased mobility, increased heart rate; infection and meningitis ruled out; also in yoga and psychotherapy; occipital neuralgia (Western). Herbal ANG + Neck & Shoulder (AC) + acupuncture 2x/week + dietary changes. Result: slow, steady improvement to healthier lifestyle; tendons and ligaments getting stronger from enhanced blood flow; very happy with results.

— 63-year-old female (Y.J.): Arthritis and gout pain throughout feet, fingers, wrists, and arms; joint inflammation, redness, inability to extend joints; sharp burning pain; BP 132/61, HR 73; qi and blood stagnation. Flex (GT) + Herbal ANG + acupuncture. Result: pain reduced from 9 to 5; range of motion improved; less stiffness.

— 42-year-old female nurse: Chronic pain throughout body, especially neck and shoulders; Liver qi and blood stagnation with Spleen and Heart deficiency. Herbal ANG + Neck & Shoulder (CR) + acupuncture 2x/week for 1 month. Result: improved more than with physiotherapy and anti-inflammatory drugs previously tried; range of motion increased by 50%; muscles softened.

— 27-year-old male electrician (L.S.): Severe back spasms — unable to stand up straight for 2 days after bending over at work; Liver yin deficiency. Back Support (AC) + Herbal ANG 4 capsules 3x/day. Result: complete recovery in 1 week; pain intensity decreased throughout treatment.

— 41-year-old female (N.T.): Neck pain, spasms, unable to turn head left, waking with morning pain; severe pain and discomfort; Liver blood deficiency. Neck & Shoulder (AC) + Herbal ANG. Result after 2 days: neck pain decreased; range of motion greatly improved.

— 65-year-old female (D.S.): Fluctuating discomfort in neck, shoulder, and lower back from desk job; limited range of motion, positive rotator muscle palpation; damp-cold bi zheng (painful obstruction syndrome); fibromyalgia (Western). Herbal ANG + Arm Support (+ Back Support (CR) for lower back pain as needed). Result: anti-inflammatories and prescription drugs reduced by 70%; overall pain decreased by 50%; patient continues herbs for more relief.

— 44-year-old female: Chronic migraines (30-year history) — tight sharp pain; neck and arm pain; tight SCM, trapezius, biceps, and deltoid on palpation; Liver qi stagnation with qi and blood stagnation; repetitive muscle syndrome (Western). Corydalin (CR) + Herbal ANG as needed. Result over 6 months: got off all medications; better results than anti-inflammatories.

— 58-year-old female (L.K.): Left knee pain; limited ROM, pain with movement, limping; pain 7/10, only slightly alleviated with elevation or rest; qi and blood stagnation with Liver and Kidney yin deficiencies. Knee & Ankle (CR) + Herbal ANG + acupuncture. Result: greater ROM; pain level reduced.

— 83-year-old female (J.B.): Upper right shoulder and low back pain; qi and blood stagnation in Urinary Bladder and Small Intestine channels. Back Support (CR) + Herbal ANG. Result: decreased pain; improved quality of life.

Related Reading

Also see: Corydalin (AC) – for acute headache | Corydalin (CR) – for chronic headache | Neck & Shoulder (AC) – for acute neck and shoulder pain | Neck & Shoulder (CR) – for chronic neck and shoulder pain | Back Support (AC) – for acute lower back pain | Back Support (CR) – for chronic lower back pain | Back Support (HD) – for herniated disk | Knee & Ankle (AC) – for acute knee pain | Flex (GT) – for gout | Flex (SC) – for spasms and cramps | Flex (NP) – for neuropathy | Flex (TMX) – for trauma and external injuries | Mense-Ease – for dysmenorrhea | Dissolve (GS) – for gallstone pain | Dissolve (KS) – for kidney stone pain | Circulation (SJ) – for blood stagnation pain | Symmetry – for Bell's Palsy or TMJ pain | Pain Relief & Musculoskeletal Support Collection.