Throughout the world’s earliest cultures, healers turned to the natural world as their source of medicine. Historical traditions such as Ayurveda in India, Unani (Hikmat) medicine in the Middle East, and early European herbal practices crafted advanced therapeutic methods centered around flora and natural substances, many of which remain clinically significant today.
Take turmeric, for instance. Historically simmered in milk or mixed into a paste, it was utilized for its healing and anti-inflammatory attributes. Currently, biomedical studies are examining curcumin, its active ingredient, for its potential in chronic pain and arthritis management. Similarly, consider willow bark, which ancient Greek practitioners brewed in tea to alleviate fever and body discomfort. It contains salicin, a natural precursor to what would later be known as aspirin. Another notable illustration from Unani medicine is Colchicum autumnale (Suranjan Talkh), historically employed to address gout and joint pain. Its primary component led to the development of colchicine, a medication still utilized today for gout attacks, pericarditis, and familial Mediterranean fever. These instances highlight that nature has historically provided the foundation for some of our most groundbreaking therapies.
What makes contemporary medicine so intriguing is that we have progressed beyond solely using the whole plant or relying on trial and error. Thanks to modern science, ranging from molecular biology to computational modeling, we can now focus on identifying the exact molecules that produce therapeutic benefits. We can isolate them, examine how they interact with our receptors, and even modify their structures to minimize side effects or enhance efficacy. This is the bridge we are constructing: from the ancient fields where turmeric, willow bark, and Colchicum autumnale were collected, to today’s laboratories where their active ingredients are fine-tuned into targeted, evidence-based therapies. We are not replacing age-old wisdom; we are building upon it, employing contemporary tools to uncover nature’s designs in completely novel ways.
During my pain medicine rotation as a fourth-year medical student, I was amazed by the difficulties in treating patients suffering from severe, chronic pain, particularly given the risks of addiction and side effects associated with opioids. That was when I discovered Prialt (ziconotide). Prialt is sourced from the venom of a small marine creature, the cone snail. These snails utilize their venom to incapacitate prey, but researchers found that a component of the venom can block specific calcium channels in human nerves, effectively interrupting pain signals without engaging opioids. It offers a treatment option primarily for patients with intense, challenging pain, especially after they have explored alternatives like physical therapy, acupuncture, back injections, nerve ablation procedures, and medications such as gabapentin, Lyrica, or Cymbalta.
Equally captivating is capsaicin, the active substance that provides chili peppers their spiciness. While it initially elicits a burning sensation, researchers discovered it can desensitize nerve fibers linked to pain. Nowadays, high-concentration capsaicin patches serve as a robust, non-opioid solution for specific nerve pain types, like post-herpetic neuralgia. This is one of numerous instances where scientists have converted an unexpected natural effect into a tool for contemporary, precise pain management.
Chronic pain is seldom a straightforward or singular issue. It often arises from various interrelated processes: acute and chronic inflammation involving cytokines, prostaglandins, and immune cells; neuropathic pain resulting from nerve injury or dysfunction; oxidative stress, which disrupts the equilibrium between free radicals and antioxidants, leading to cell damage; and central sensitization, in which the nervous system becomes overly responsive to stimuli that typically wouldn’t induce pain.
Grasping this complexity underscores why there is no universal remedy—and why both ancient healing practices and modern science contribute significantly. Each method tackles different aspects of the issue, whether it’s attacking inflammation with plant-based substances, moderating nerve function with venom-derived treatments, or employing natural irritants like capsaicin to desensitize pain pathways.
Investigating these therapies reminded me that some of the most groundbreaking medical advancements do not always originate in laboratories; they frequently stem from nature. As I prepare to enter a field like anesthesiology, where pain management is both an art and a science, I find it encouraging that we can merge traditional knowledge with modern accuracy. It instills in me the hope that we are not merely alleviating pain; we are transforming our understanding of it.
I wish to extend my gratitude to Dr. Zulfiqar Ahmed, who assisted me in developing the concept and writing this article.
Varun Mangal is a medical student.