Most people have experienced feelings of loneliness. It often occurs during life transitions such as changing schools, moving to a new city or country or when an elderly person outlives their spouse and friends.

Loneliness is often stigmatised, trivialised or ignored but when loneliness becomes a chronic condition, the impact can be far more serious than many people realise. Loneliness is emerging as a public health issue and the UK now has a designated loneliness minister to tackle the issue.

Elderly people are especially vulnerable to loneliness. According to Age U.K., more than 2 million people in England over the age of 75 live alone. 1.4 million elderly people saying they feel lonely with more than one million elderly people say they go for over a month without speaking to a friend, family member or neighbour.  Covid-19 and the national lockdowns exacerbated loneliness and social isolation (7).

Loneliness is not the same as social isolation. Social isolation is the lack of social contacts and having few people to interact with. A person can live alone and not feel lonely or isolated. Loneliness is an individuals personal, subjective sense of lacking desired affection, closeness, and social interaction with others (8). A person may be surrounded by other people but still feel lonely. This is common with elderly people in care homes or hospitals who are surrounded by others yet still experience chronic loneliness (9).

To truly overcome loneliness requires a sense of belonging which is only achieved through reciprocal connections. Lonely people need to feel they are contributing towards the connection to create a sense of belonging not just being the recipient of help (9).

Studies on Blue Zones, areas around the world where people routinely live to 100 in good health, have found one of the important factors for their longevity and good health is ‘belonging’. These Blue Zones place great emphasis on family, on community connections or being part of a faith-based group. As a result, the elderly in these communities have a feeling of purpose in life, a reason for waking up each morning as the feel loved and needed (6).

Humans have thrived as a species through connection with others. As hunter-gatherers people needed each other to stay alive. Loneliness doesn’t just make people feel unhappy, it makes people feel unsafe both mentally and physically. Evolutionary instincts brought prehistoric people together to work together for food, shelter, and protection.

The mental distress people experience when feeling lonely or isolated is a warning to re-engage or face danger. Short term loneliness can be beneficial as it highlights the need for social connection, but chronic loneliness is harmful to all areas of health and wellbeing.

Just as physical pain serves to protect the body, loneliness protects the social body. It lets us know that social connections are diminishing. According to psychologist John Cacioppo, the brain goes on high alert for social threats and can produce a hyper-reactivity response to perceived negative behaviours in other people. This induces feelings that interactions are unpleasant which can result in self-preservation behaviour of retreating further from people which increases loneliness (9).

Loneliness is linked to worse cardiovascular health, lower quality of life, decreased cognitive function, higher depression rates, mental health issues and decreased life span (2). A 2017 a meta-analysis of forty systemic reviews of mainly observational studies, identified a significant association between loneliness and increased all-cause mortality (1).

Until recently the cellular mechanisms by which loneliness caused declining health were not well understood. A research team lead by psychologist John Cacioppo carried out studies that identified that loneliness creates inflammation and a less effective immune response though over expression of genes involved in inflammation and decreased expression of genes involved in antiviral responses (3). The team called this phenomenon “conserved transcriptional responses to adversity” or CTRA (4).

The team then studied gene expression in leukocyte immune cells (white blood cells), that are involved in protecting the body from bacteria and viruses. The study didn’t just focus on humans but also included the highly social primate species, rhesus macaques (3).

The leukocyte cells from the lonely monkey’s and humans showed as expected CTRA, increased inflammation and decreased antiviral immune responses.  New information was also revealed about a reciprocal relationship between loneliness and leukocyte gene expression suggesting each can help propagate the other over time (3). Loneliness predicted future CTRA gene expression measured a year or more later and CTRA gene expression also predicted loneliness. These results were specific to loneliness and could not be explained by depression, stress, or social support (4).

The team then investigated social experiences and CTRA gene expression in rhesus macaques. The lonely monkeys also had higher CTRA gene expression as well as higher levels of the stress hormone norepinephrine.  Norepinephrine can stimulate blood stem cells in bone marrow to make more immature monocyte immune cells (a type of Leukocyte) that have high levels of inflammatory gene expression and low levels of antiviral gene expression which finally explained CTRA gene expression in white blood cells (4).

Loneliness results in flight-or flight stress signalling, which increases the production of immature monocytes which up regulates inflammation genes and impaired viral response. The danger signals activated in the brain by loneliness affect the production of white blood cells, the shift in monocytes output may propagate loneliness and contribute to its health risks (3).

One potential intervention in helping to reduce loneliness in the elderly is social prescribing. Social prescribing, also known as community referral, enables health professionals to refer people to a link worker (community connector or navigator). Link workers take time to get to know the individuals needs finding out what matters to them and then connect them to a range of local, non-clinical services.

Social prescribing recognises that people’s health and wellbeing are determined by a range of social, economic, and environmental factors. It seeks to address people’s needs in a holistic way and to support individuals to take greater control of their own health (5).

Social prescribing is designed to support people with a wide range of social, practical, or emotional needs usually provided for by voluntary or community organisations connected to link workers through social activities and social groups such as gardening, singing, crafting, learning, befriending, technology lessons or men’s sheds. This initiative is supplemented by investment in community projects such as cafes, art spaces or gardens that can become a social point for social prescribing (5).

Social prescribing is supported by a growing body of evidence that shows it can lead to a range of positive health and wellbeing outcomes.

Studies have pointed to improvements in quality of life, emotional and mental wellbeing and reduced levels of anxiety and depression. However, there are weaknesses as many of the studies are small scale, do not have control groups, focus on progress rather than outcomes or relate to individual interventions rather than the social prescribing model (5).

Social prescribing has generally not had the primary aim of addressing loneliness. To address this gap the British Red Cross in collaboration and funded by the Co-op partnership, delivered a national prescribing service for lonely people (10).

The social prescribing service consisted of paid link workers and volunteers who developed supportive relationships with the lonely service users, assessing their needs and providing individualised care. These three components were considered critical in loneliness interventions. Support was provided for 12 weeks and concentrated on building lonely people’s confidence so that they were then able to use the community activities and services such as crafting groups, adult learning, and leisure facilities (10).

The social prescribing service helped to reduce service users’ loneliness and provide other benefits such as improved wellbeing and confidence. The results are interesting as it was the service users under 50 years old that were more likely to experience improvements in loneliness. This is due to younger people’s loneliness being related to lack of social connections while elderly people’s loneliness is often entrenched (due to self-preservation mode), arises from the death of friends and spouses, or from a loss of functional ability to engage in activities (10).

A key finding was that 60% of service users reported a worsening of their loneliness after finishing the 12 weeks service. One reason was that service users were unable to continue attending community activities because they were reliant on link workers/volunteers for transport (10).

Social prescribing could be a very effective tool in helping to reduce chronic loneliness in the elderly provided there are enough link workers and transport is available to help the less mobile elderly. Consideration needs to be taken about including behaviour interventions to change how lonely elderly people think about other people, helping them to understand that they are in a self-preservation mode and how to come out of it so that they can happily engage in community activities.

Ultimately we all want connection with each other and our community. Nothing can replace a feeling of belonging, sharing and laughing with each other. Unfortunately in our society the elderly do not have as much access as they should to these human needs, but social prescribing can be an antidote to that. There are even social prescribing projects which involve gardening- a wonderful way to connect both with nature and other people.

1. N. Leigh-Hunt, D. Bagguley, K. Bash, V. Turner, S. Turnbull, N. Valtorta, W. Caan, An overview of systematic reviews on the public health consequences of social isolation and loneliness,Public Health, volume 152, 2017,Pages 157-171.
2. Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Health & Social Care in the Community. 2015;25(3):799-812. doi:10.1111/hsc.12311
3. Allen S. Loneliness triggers cellular changes that can cause illness, study shows. University of Chicago News. https://news.uchicago.edu/story/loneliness-triggers-cellular-changes-can-cause-illness-study-shows. Published 2015. Accessed August 6, 2022.
4. Loneliness triggers cellular changes that can cause illness, study shows. Science Daily. https://www.sciencedaily.com/releases/2015/11/151123201925.htm. Published 2015. Accessed August 7, 2022.
5. Ewbank L. What is social prescribing?. KingsFund. https://www.kingsfund.org.uk/publications/social-prescribing. Published 2020. Accessed August 7, 2022.
6. Buettner D. Power 9® – Blue Zones. Blue Zones. https://www.bluezones.com/2016/11/power-9/. Accessed August 9, 2022.
7. Loneliness in older people. nhs.uk. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/loneliness-in-older-people/. Published 2021. Accessed August 8, 2022.
8. Rossall P, Iparraguirre J, Davidson S. Loneliness at local and neighbourhood level. Age UK. https://www.ageuk.org.uk. Published 2015. Accessed August 7, 2022.
9. Adams T. John Cacioppo: ‘Loneliness is like an iceberg – it goes deeper than we can see’. The Guardian. https://www.theguardian.com/science/2016/feb/28/loneliness-is-like-an-iceberg-john-cacioppo-social-neuroscience-interview. Published 2016. Accessed August 7, 2022.
10. Foster A, Thompson J, Holding E et al. Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme. Health & Social Care in the Community. 2020;29(5):1439-1449. doi:10.1111/hsc.13200

First up is a true medicinal powerhouse, calendula (Calendula officinalis). Calendula is by far one of the easiest herbs to grow, it displays beautiful orange blooms all summer long and the insects go absolutely bonkers for it. For these reasons, calendula will always take centre stage in my herb garden.

The vibrant tangerine flowers are jammed packed with antioxidant, anti-inflammatory, antiviral and anti-fungal compounds. Traditionally calendula flowers abundant in resin are infused with olive oil as a base for a skin soothing which is why calendula is so popular in many cosmetics products today.

When infused into oil, it becomes what herbalist call liquid gold that will make your skin glow. A simple way to prepare calendula is to make a tea from the dried flower heads. Calendula tea is said promotes the health of the skin, respiratory, lymphatic and digestive systems.

Gardeners will already know calendula to be a great source of pollen which makes for a very useful companion flower that will attract beneficial insects who assist with pollination and the control of pests. It’s pretty much a magnet for attracting biodiversity to the garden and comes in a whole host of colours. One of my favourite variates is the ‘Art Shades’ mix a popular strain with large blooms in unusual shades including tangerine, peach and apricot, it sounds more like a fruit salad than a flower bloom.

Growing tips

Sow Calendula undercover 2 weeks before the last frost and plant out once all risk from frost has gone. I like to cover young seedlings with horticultural fleece or netting during the plants early stage to prevent attack from slugs and birds. A quick tip to keep the plant in continuous bloom, remove the spent flower heads sometimes called deadheading remembering to keep them aside to dry and store for future use in teas and ointments.

Second on my list of flowers with holistic powers is Cornflower (Centaurea Cyanus). A lightly fragrant annual flower that produces brilliant colourful displays of white, blue, pink, red and purple. These old fashioned wild flowers are super easy to grow, they’re not fussy on soil type and are super drought resistant.

One of my favourite things about cornflowers is they grow nice and tall. Some varieties can even reach heights of 2.5ft plus. The long, narrow hairy stems with fringed flowers make cornflower an excellent choice for freshly cut flowers bouquets.

The most popular and famous of the Centaurea Cyanus is the vivid sapphire blue variety. This year I’ve interplanted blue cornflower with a striking orange Indian Prince calendula. The contrast of blue and orange looks visually stunning along my border of the garden and the bees and butterflies can’t keep away.

Cornflowers have a long history of being used in the medical and cosmetic industries. It’s primarily the dried flowerhead that have been used medicinally for its anti-inflammatory properties. I personally use the dried petals to brew herbal tea as I’m a big fan of its lightly floral flavour with a hint of spice.

Cornflower tea is thought to aid in soothing stomach ulcers, while using the tea as rinse or wash is used to speed the healing of bleeding gums. Cornflower tea can also be good for improving digestion as the herbs high antioxidant content aids in detoxing the liver.

Growing tips

Cornflower can be sown directly on the surface of freshly raked compost or soil. Scattering seeds on the surface mixed with other seeds like poppies, borage and chamomile is a great way to create a mini wildflower meadow. Taller varieties of cornflower can benefit from being stacked with a bamboo support to help them from toppling over.

Next up is a vigours vine like bushy plant that grow low to the ground. The leaves are a round and sometimes almost heart-like shaped, the flowers come in bright shades of oranges, apricots, yellows and creams with long spurs protruding out from behind them. It’s one of our favourites- nasturtium.

Beauty aside, one of the main reasons why I love to grow nasturtium is I’ve found it to be one of the most effect cabbage white caterpillar trap I’ve come across. Veggie growers will know that if you don’t cover your brassicas you’ll be spending all summer picking cabbage white caterpillar of your kales, broccolis and cabbages.

So how do nasturtiums help? Well… the peppery leaves of nasturtium are a delicacy for cabbage white caterpillars, growing them in or next to your brassica’s is a great form of natural pest control. The humble cabbage white get’s a lot of flack and growing some decoy plants is the perfect way to give them a safe place to breed.

It’s worth noting that I advise growing dwarf compact varieties of nasturtiums in the veg patch as the trailing varieties will have vigorous growth and can literally swallow a whole veg bed in just a few weeks.

In the kitchen nasturtium blossoms are great for bringing bursts of colour to the plate. The flowers contain as much vitamin C as parsley, and more lutein than tomatoes which is great for eye health. Even if all you do is toss them into a salad, nasturtium blossoms are good for you. I like to collect the newly open flowers early in the morning so they’re extra sweet and full of nectar.

For me, what makes nasturtium the complete plant for the garden is it has strong antiseptic properties found in its leaves that can be used on wounds to help fight infections. The seeds which are the size of large peas can be ground into pastes to fight fungal infections in toenails. It doesn’t stop there, when you chew nasturtium leaves pungent vapours are released which are said to help ease the effects of bronchitis and other infections in the lungs.

Growing tips

Nasturtium sometimes doesn’t respond well to being repotted so it’s a good idea to direct sow seeds in their final planting position. Dib a hole slightly bigger than the seed and around 5cm deep. I like to sow two seeds per hole for an extra bushy and abundant bloom.

Coming in at number 4 is Nepeta Grandiflora, also known as catnip (also known as cat mint), yes that’s the stuff your fluffy kitty goes silly for! Despite being famous for its effects on felines, cats aren’t the only ones who can enjoy catmint. The leaves and flowers can be steeped to make a soothing herbal tea with a cool minty taste and a sweet floral fragrance. Some people enjoy eating young cat mints leaves.

I think they have a delicate fresh minty flavour, making them a great aromatic salad topper. Older leaves can be used as a potherb in cooked dishes. Catmint tea is said to relieve tension and improve sleep quality. Much like many herbal teas, cat mint can aid digestive problems such as upset stomach and nausea. It is also particularly useful for treating fevers.  

One of the many benefits of growing Nepeta is that it has a long flowering season and its aromatic leaves and flowers are loved by bees and other pollinators. It’s an easy to grow perennial which will come up and flower reliably every year. Nepeta is notorious for sprawling, especially as the summer goes on it can almost develop a bald spot in the middle. A good way to avoid this is give the old Chelsea chop.

A pruning method which allows you to limit the size of plants and control the flowering season of many herbaceous plants. It gets its name The Chelsea Chop because it is usually carried out at the end of May, coinciding with the RHS Chelsea Flower Show.  The Chelsea chop has several functions. Firstly it makes the plant compact, while delaying flowering.  It is useful to use on plants that love to sprawl such as Nepeta. 

Growing tips

A plant best grown from cutting so you’re better off buying pot plants at any time of the year, although spring and autumn are ideal times to plant in the garden. Once growth dies back in autumn, cut back to the ground before spring.

The fifth and final flower with holistic powers that I will be writing about today (and I must say I personally feel we have saved the best ’til last!) is none other than the humble marigold or tagetes erecta.

Mexican marigolds are my favourite flower to grow in the veg garden for so many reasons, but please note that tagetes erecta and calendula officinalis are two different species that both share the common name marigold so be sure to check the Latin name before you buy any seeds.

Dwarf marigolds are my go-to companion flower, particularly for lettuce and tomatoes. Marigold roots release pheromones which deter cutworm, interplanting marigolds with lettuce is a great way to deter those pesky pests from nibbling away at the base of your lettuce plants. Alongside tomatoes marigolds act as a double-edged sword. Deterring pests like aphids and black fly with their strong odour they emit from their leaves and flowers.

They also attract beneficial insects who can assist with pollination of your tomato crop and control pests. Ants farming aphids on your tomatoes can be a real pain, lucky enough marigolds are great for attracting lady bugs and guess what a ladybugs favourite meal is? That’s right aphids.

Now the reason why I love the dwarf varieties so much is they can easily be planted on the corners of your beds without losing too much cropping space. Dwarf varieties also fit perfectly under cucumbers and tomatoes growing up string or canes.

Pest control aside, marigolds are incredibly useful in the medicine cabinet. Marigold flowers support skin healing, their petals contain natural antiseptic, anti-inflammatory and hydrating properties. The flowers are generally used in herbal medicine, fresh or dried. The flowers are often used to prepare ointments, oils and gels. Its relaxing and soothing qualities help promote wound healing for sunburns, scratches, eczema and dermatitis. 

Growing tips

Growing from seed is super easy. Sow 2 weeks before the last frost date and plant out after the risk of frost has completely gone. When the plant reaches 4 branches high pinch out the stem to encourage the plant to become more compact and bushy, resulting in more blooms.

• Short on space? Try growing these flowers in baskets, pots or containers, you’ll be surprised at how well the grow with limited space.
• Try growing in raised beds to ease the burden of bending down, alternatively a foam kneeling mat is a great way to make long periods kneeling more comfortable.
• There are lots of lightweight tool options available from plastic wheelbarrows to spades and watering cans.
• Wild flower meadows like the cornflower mentioned are not only beautiful, but they require less maintenance and bring the benefits of nesting habitat for wildlife for ladybirds to butterflies, hedgehogs and birds.

Happy growing!

The temperature and humidity of the climate fluctuates from season to season, day to day and during the day night cycle. It is also markedly different according to which geographical region we live in. Despite all of these fluctuations, the body must maintain its own balance between extremes of heat and cold on the one hand and dampness and dryness on the other. Temperature and fluid balance profoundly affects flow.

Temperature: Heat and cold

Did you know that you can hear the difference between hot and cold water? Try it out, in a blind test, have a friend pour hot water into a cup and cold water into a cup and ask you which is which, ten times out of ten you will give the right answer. This is something that we know but we don’t know we know!

It is a knowing we aren’t necessarily aware we have. But why do they sound different? They sound different because temperature affects the viscosity or ‘thickness’ of the water. At low temperatures, water is more viscous and flows slower and less freely. At higher temperatures it is less viscous and flows faster and more freely. This is easier to see in a thicker substance like honey.

Our blood is a fluid and it obeys these same principles. If our body fails to maintain a warm enough temperature, the Chinese observed that ‘flow’ or circulation of fluids start to ‘congeal’ and flow less smoothly. If the solution to inflammation is promotion of flow, then restoring this flow is key. If the fluids of the body are cold, then quite simply, we need to warm them up.

One of the first herbs we will go to when blood is not flowing due to cold is Cinnamon. Cinnamon is spicy sweet and warm. It also has an amazing ability to promote flow out towards the limbs and extremities. The spiciness invigorates the flow of blood and the sweet flavour harmonises.

If there is chronic stagnation of flow in the blood from cold over a period time, this can lead to a more entrenched stagnation. One might think of how a river can start to get silted up and blocked over time. When the water stands still, it stagnates. In this kind of situation, we need something not only to warm the flow and invigorate the blood, but also to go a little deeper and stir up the metaphorical silt sitting at the bottom.

And now we get to solve ‘the turmeric paradox’. Turmeric is spicy and warm, but it is also bitter. The warmth and spiciness, like Cinnamon, warms and invigorates the blood. However, the bitterness drives the effect deeper and has a ‘dredging’ effect. In the Chinese materia medica it is said to have the ability to disperse clumping in the circulation.

So, turmeric powerfully restores flow and through this helps reduce inflammation. In the right circumstances, it does this in the best way. Instead of suppressing the natural inflammatory healing response, it assists it and makes it more efficient.

Chronic blood stagnation is one of the most common effects of ageing. As we age, our constitutions weaken and so does our circulation. Over time, the circulation of blood stagnates, so much so that it can be visible to the eye, for example with varicose veins. This makes turmeric an ideal tea for the elderly.

Turmeric actually came later on to the Chinese pharmacopeia, with its origins in Central Asia and long being used by Ayurveda and Middle-Eastern medicine traditions. However, when it arrived, brought to China along the Silk Road, the Chinese embraced it, classified it and it quickly became a frequently used herb within the medicine.

Too much heat in the blood can also affect circulation. Heat can cause the blood to move ‘recklessly’ and to flow outside of the vessels. It can also dry the body out and cause dehydration. For this reason, Chinese medicine also uses cooling herbs to treat flow. However, we are warm-blooded mammals with a necessity to keep our body temperature elevated against the forces of nature.

Consequently, we must always be careful not to cool the body down too much and lose the root of our energy. For this reason, Chinese medical practitioners prescribe herbal formulae and balance the temperature by combining both warming and cooling herbs.

Fluid balance: Dampness and dryness

We probably all know someone who had terrible chronic aches and pains in the body and then they went on holiday and they all disappeared. The UK has a damp climate. Excessive dampness obstructs flow. If someone suffers from pain caused by excessive dampness and they go to a hot dry country, perhaps to a desert environment, the climate becomes the cure.

In Chinese medicine, there are countless different ways we can deal with damp in the body: we can give herbs to transform it; to dry it; to leach it out through the urine; to take it out through the bowel; to disperse it; or even in some cases, to sweat it out. By getting diagnosed from a well-trained practitioner, they can make a nuanced decision in choosing the correct strategy to deal with the damp in the body.

Even though there are many different herbs and strategies to deal with damp, there is one which is used in everyday cooking in China that is very safe, very effective and has a wide variety of applications. Its Chinese name is Yi Yi Ren and it is variously called Job’s Tears, Coix seed or Chinese pearl barley in English. It has a bland taste.

Bland foods sometimes have the ability to ‘leach’ damp out through the urination. You can cook with it and put it in your food or you can boil it in water and drink it as a tea. The Chinese consider it particularly effective in treating damp that lodges in the joints.

One of its great benefits is that it not only drains damp, but also clears stagnant heat while at the same time having a nourishing quality. This gives it a very balanced effect. It is a medicinal which is very often found in damp type pain conditions.

Dryness causes the blood flow to stagnate, just as water lacks the power to flow when there is insufficient amounts. For dryness, we can use the sweet flavour to moisten and the sour flavour to astringe and help retain the fluid we have. A classic Chinese medicine combination for pain is to bring together the sweetness of licorice root with the sour, bitter, cool but nourishing quality of white peony root. These two herbs combined are one of the most famous two herb combinations for pain, particularly when the cause is lack of fluids.

Just getting started… This is a brief introduction to Chinese medicine thinking on how herbs influence flow but there are so many more factors that Chinese medicine practitioners consider.

The Chinese understood that the body has a mechanism to open and close towards the exterior. If its cold the pores will close down and warmth and fluids will flow more interiorly to protect the internal organs. If it is hot the pores open and warmth and fluids flow to the exterior to help the body cool down.

If this opening and closing of ‘the exterior’ of the body becomes unregulated it can also profoundly affect the quality of flow in the body and the temperature and fluid balance. Chinese medicine has innumerable tomes just dedicated to this question and how to address these imbalances with different herbs and formulae.

Opening, exterior releasing, sweat promoting herbs tend to be spicy like ginger and cinnamon. Closing, exterior consolidating herbs tend to be sour like white peony root. When you pair these herbs together they balance opening and closing and regulate the exterior. Now you know why ginger, lemon and honey is so good for colds!

You can use this spaImagine for a moment, something that makes you really angry, properly furious. Now become aware of your physical body. You may be aware that you are clenching muscles up and down the body, your heart rate may have gone up, you may feel hot, flushed and red in the face, mind racing.

Emotions have a tangible and profound effect on flow in the body and effect everything from our internal organs to the blood circulation. If emotions are unregulated, either over-expressed or repressed, they constantly through our physiological balance out. Many Chinese herbs have profound effects on our emotions through re-establishing flow.

Many of these herbs have powerful aromas that harmonise the mind but also move our qi. When our qi moves, our blood moves. Examples of these would include mint, rose or jasmine.

Many diseases and ailments also cause inflammation, pain or discomfort. Constipation can cause heat, dryness and stagnation in the body. Diabetes can cause peripheral neuropathy, numbness in the extremities. The after effects of severe colds and flus can lead to chronic pain as is being seen worldwide in the now common presentation of ‘Long Covid’. The skilled diagnosis and intervention of a Chinese herbalist can at the least ameliorate the symptoms of these internal conditions but in many cases get right to the root of them and restore the whole body back to balance.

So far we have only talked about taking herbs internally. However, herbs are just as often used as externally applied oils, creams and pastes especially when treating pain. They are most commonly added to a base of Camphor and Menthol.

Camphor is very warming and Menthol is very cooling. Which creates a powerful dynamic. They are both also very aromatic. Aromatic herbs ‘penetrate’ deeply into the tissues and they also powerfully move stagnated fluids. Different herbs are added to this base to create different effects; some more warming, some more cooling; some more draining and drying, some more nourishing.

Please note: Camphor and Menthol are powerful ingredients and should only be prepared by professionals. Camphor is only suitable for external use and should not be taken internally.

The number of Chinese herbs in active use is enormous, each with their own character and specific uses. When combined together into different formulas, they can be tailored to have highly specific effects particular to individual patients’ needs. The Register of Chinese Herbal Medicine (RCHM) requires high quality degree-level qualifications for membership assuring the public that the practitioner can provide a skilled, professional and safe service. RCHM practitioners also use herbs from approved suppliers that are checked for safety and quality on the one hand and ethical sourcing. No animal products or endangered species are used.

Chinese herbal medicine has successfully been used to treat pain conditions, from the mild to the severe, from the acute to the chronic for thousands of years. It is our hope that we can raise awareness of the great depth of practice that it has to offer.

If you would like to find out more about herbal medicine in the UK or find a practitioner, you can visit the Register of Chinese Herbal Medicine at www.rchm.co.uk. You can also follow us on Facebook at https://www.facebook.com/RegisterofChineseHerbalMedicine.

1. Zeng L, Yu G, Hao W, Yang K, Chen H. The efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis: a systematic review and meta-analysis. Biosci Rep. 2021;41(6). doi:10.1042/bsr20210817
2. P.817 Tortora, G.J., Derrickson, B., 2006. Principles of anatomy and physiology. John Wiley & Sons, Hoboken, NJ.

The Ayurvedic cannon details very specific treatments for bone and joint diseases. The earliest texts of Charaka Samhita (150BCE-100CE) and Sushruta Samhita (50-500CE) detail various symptoms associated with joint pain as part of other diseases involving fever (jwara) and neurological vata disorders (vatavyadhi).

Vaghabata in his Ashtanga Hridaya Samhita (600CE) mentions a disease named vatashonita meaning ‘vata in the blood’ which is associated with intense joint pain and has symptoms similar to gout. Madhava Nidana (c650-950) in his classic on pathology is the first to mention amavata as a disease in its own right. Amavata literally means ‘toxic vata’ and is commonly associated with Rheumatoid Arthritis.

Ama is a term used to describe all unmetabolised wastes that have cold, heavy, wet and sticky qualities infamous for obstructing the channels and causing degeneration of health. Vata relates to the functional principle in the body associated with all movement and is associated with the qualities of cold, dry, lightness and irregularity. Vata is also associated with the experience of pain so commonly felt in bone and joint diseases.

• Low digestive fire leading to creating of toxins (mandagni, ama)
• Vata aggravating diet and lifestyle (vatakara ahara vihara)
• Malnutrition including nutrient deficiency and wasting of the tissues (dhatu kshaya)
• Incompatible foods; milk and fruit, milk and fish, meat and dairy
• Inappropriate diet: stale foods, cold foods, constitutionally inappropriate foods, processed foods, fermented foods.
• Excessive exercise (Ati vyayama)
• Deficient exercise (Kashaya vyayama)
• Injury
• Hormonal disorders
• Hereditary causes (sahaja vikritis)

The basic pathogenesis of bone related diseases is due to the intimate connection between vata and the bones. There is an inherent link between the main site of vata in the colon and the bones. The colon is responsible for the uptake of many types of minerals that nourish the bones. This is the link to their natural qualitative relationship as both vata dosha and the bones are high in the air element.

This means that a healthy vata directly nourishes the bones. The other association is that from the colon excess ‘wind’ and ‘toxic gases’ can be expelled, whilst important minerals are absorbed, ensuring that an excessive accumulation of vata does not occur.

If the digestive fire is low then vata will be aggravated in the colon. This will lead to a dual problem. Firstly, there will be reduced assimilation of these precious mineral nutrients intended to nourish the bones, hence leading to a deficiency. Secondly there will be an increased accumulation of toxic wastes (ama) leading to an excess. These toxins will be carried by vata to the connective tissue, joints and bones where the ensuing congestion will lead to the multiferous forms of ‘arthritic’ diseases.

These ama toxins have a watery, sticky and mucoid like nature and hence have an affinity for similar kapha-like tissues in the body; hence the attraction to the protective linings of the connective tissue and synovial fluid covering the joints. Vata is the mover and ama is the obscurer. The joints then become involved which can result in pain and deformity.

Whilst the main dosha involved with bone and joint disorders is usually vata the other doshas may also be involved. Some general signs and symptoms of bone and joint diseases are:

• Vata: Thin body and bones, fragile, bones breaking easily, rough and dry skin, cavities, rough, severe pain, migrating pain, loose joints
• Pitta: Inflammation, red hot joints, sharp pain, fever, infective disorders
• Kapha: Excess and large bones/teeth/hair, stiffness, itching, pitting oedema over joint, less pain, thickening skin, osteo-tumours, heaviness, hirsutism

It is said that when one dosha is involved the disease is curable, if two dosha are involved the disease can be managed and if all three dosha are involved then it is incurable.

Ayurveda has a time tested ability to differentiate the causative factors, the pathogenesis and the diversification of the different forms of every disease. This allows for remarkably precise and accurate treatments that are individualised to suit every patient, which is why we recommend seeing a herbalist rather than simply buying an over-the-counter product.

Rheumatoid arthritis is a chronic condition involving loss of mobility and enduring pain of the joints with some swelling of the synovial joints. It has similarities to many arthritic diseases with specific clinical features associated with Rheumatoid Arthritis (RA).

Arthritis is the generic name for a number of diseases involving inflammation of the tissue surrounding one or any number of joints with pain, redness, warmth, pain and restricted motion. Such conditions may include rheumatoid, osteo, psoriatic, gout, ankylosing spondylitis and tuberculosis.

RA is a chronic inflammatory disease which typically affects the synovial membrane involving the peripheral joints of the joints of the fingers, wrists, feet and ankles and later the hips, knees and shoulders. The symptoms manifest between exacerbation and remission and are three times more likely to occur in women than in men. RA is diagnosed by a blood test indicating the presence of rheumatoid factor. It is also diagnosed by X-rays revealing rheumatoid erosions around the joints. The exact causative factors of RA are not known by are thought to involve some form of autoimmune condition or some infective pathogen. It affects 1-3% of the population and peaks between 30-50 years of age.

Arthritic diseases are usually treated with pharmaceutical medication that may have associated side-effects; Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), steroidal anti-inflammatories (corticosteroids), immunosuppressive drugs (methotrexate, cyclosporine) and remittive drugs (penacillamine). Whilst these drugs may offer symptomatic relief they have been associated with hepatotoxicity, kidney damage and immunodeficiency.

Whilst there are obvious similarities, amavata cannot be directly linked with arthritis as it has a distinct pathology and treatment strategy with different objectives to those sought by allopathic mediciation. It involves the diagnosis of the three dosha and the treatment of them along with the tissues, channels and digestive fire. The objective is to treat the root causative factor as well as the symptoms.

Weak digestive fire, sedentary lifestyle, heavy oily food, no exercise or exercising directly after eating heavy food can all make people more susceptible to the onset of arthritis.

People of a vata/kapha constitution become susceptible to this condition due to the extreme opposites of qualities. This constitutional combination can be like two people living in one body, always contradicting oneself…I should, shouldn’t etc.

The seasonal change that takes place moving from the heat of summer to the coolness of Autumn can aggravate chronic conditions that may have remained dormant during the summer months where heat and dryness kept them under control.

Arthritis is a condition that often manifests in the autumn season as it is aggravated primarily by an excess of vata that builds up in this season.

Toxins are produced from the causative activities associated with vata and are carried quickly to seats of kapha (joints) and fill the channels with a waxy toxic material (ama) which has similar qualities to kapha. Joints are a primary site of kapha. This produces weakness of body, heaviness of heart, affects the joints (comprising of synovial fluid) of waist, neck and shoulder, stiffness and is itself a cause of many diseases.

Low grade fever, reduced appetite, increased thirst, lethargy, alternate feelings of heaviness and hollowness (kapha/vata). Symptoms can be reversed at this early stage by correcting digestion and with simple Ayurvedic treatments such as steaming and oil massage.

• Stiffness
• Pain
• Inflammation
• Excess saliva
• Coated tongue
• Lack of enthusiasm
• Thirst
• Bloating
• Insomnia
• Fainting and constipation. At this stage stronger treatment such as cleansing the system and herbs are required.

Ayurvedic treatment methods for arthritis:

• Support digestion
• Remove toxic ama
• Rejuvenate the whole system and repar damage

The first line of treatment should be ‘lightening’ therapy involving strengthening the digestion whilst initiating cleansing treatments. Enkindle digestion with spices such as ginger, asafoetida and trikatu. Once digestion is working well and toxins (ama) have been removed through appropriate diet and herbs you move to a rejuvenation treatment to restore vitality (ojas).

Diet should be light and warming with lots of digestive spices. Including some high quality essential fatty acids and oils is important. It is worth avoiding foods with the same sticky-clogging-inflammatory nature of amavata; dairy, gluten, flour, sugar, greasy foods and rich meats such as pork.

Some people benefit from avoid members of the Solanaceae family (potatoes, aubergines, peppers) as well as other potential irritants such as peanuts, soya and corn.

Recommended herbs are guggul, ginger, celery seed, castor oil, haritaki, boswellia, gotu kola, turmeric, ashwagandha and sariva. Triphala powder at night to clear ama from the colon is also beneficial. Warming and invigorating oils, such as mahanaryan oil and castor oil packs, help to remove congestion and gentle exercise and yoga are recommended but avoid strenuous exercise such as jogging or weights.