Herbal support for broken bones

I was sitting on Snow Hill station two weeks ago trying to tell Chris my train was on time when a text came into my mobile phone.

“My friend has a broken bone which won’t heal,” I read. “Can you recommend any herbs for her?”

The train was just pulling in and my texting abilities are not great, so I simply replied, “Comfrey and plantain.”

I hate giving single herb answers when asked a question. It falls into the “Take aspirin if you have a headache” mentality of allopathic medicine which does not allow any opportunity to think “What’s happening here?”, “What part of the body needs supporting?” and “Which herbs might be suitable for this situation and why?” So this is a more considered response to the original query.

Fractured bones are serious conditions. If you fracture a long bone and it isn’t dealt with in time, you can die. I first came across this during a Medical Services Committee hearing when a GP failed to diagnose a fractured neck of femur in an elderly lady who fell out of bed. The doctor on the Committee which was there to decide whether or not the GP was in breach of his terms and conditions of service to the NHS was not impressed.

“You do realised this lady could have died?” he said. “You were lucky her husband rang for an ambulance after you left the house.”

It was a sobering thought and one I had cause to remember a few years later when a woman with mental health problems slipped off the fourth floor windowsill of her locked ward onto an inaccessible concrete triangle between three buildings. It took the firemen an hour to reach her and none of the hospital staff would touch her until the ambulance men arrived. She didn’t die from the fall, but from breaking all her long bones. She lost so much fluid her blood pressure fell to a point of no return.

So what actually happens when you break a bone? A really good tutorial of the physical components can be found here. In a nutshell, the blood forms a clot and the bone is stimulated to form new collagen to hold the bone together which is gradually ossified, healing the break.

What really surprised me was the length of time it takes for a break to heal even at the most normal rate. We are talking about 3-4 weeks for the bony callous to form and a further three to four months for the bone to bind together with remodelling inside the bone taking place for several months after that.

This means anyone who breaks a bone needs to be thinking of supporting that part of the body for a good six months afterwards. Nothing is going to mend within a couple of weeks.

So how can a bone fracture be best supported from a herbal perspective? The most useful discussion I found was begun by Persimmon on the Herbwifery Forum back in 2007. She had been involved in an accident which resulted in a badly damaged ankle. She was using her inherent herbal knowledge to inform her own treatment and asked for any further suggestions to her protocol.

I thought the way she set things out was really useful, which is why I am repeating it here.

(i) Bone healing is an inflammatory process, so don’t take any medication which is anti-inflammatory. This means you don’t take ‘ibu-profen’ or ‘nurofen’ for the pain because these are both “non-steroidal anti-inflammatory drugs” (NSAIDs). Persimmon also recommends not taking any supplements which are targeted at inflammation.

You don’t need to take the same precautions with anti-inflammatory herbs. Calendula is a great anti-inflammatory, but is actually recommended for healing fractures by Henriette Kress.

(ii) You need adequate mineral intake, preferably through food. Persimmon recommends calcium in particular but also magnesium and trace minerals. If someone won’t change their diet, chewable calcium carbonate (CaCO3) can be taken.

So where do we get the minerals? It’s back to nettles and oatstraw, possibly with red clover thrown in for good measure. These can be made into long infusion teas as per Susun Weed’s method (2 ozs dried herb covered with 16 fl.ozs (2US pints) boiling water in a large jar/jug left covered overnight and the resulting strained infusion drunk hot or cold throughout the following day).

If it’s spring/summer/autumn, I’d also do a fresh herb maceration overnight with cold water. (Gather as many herbs as you like, cover with cold water in a clean plastic bowl, leave overnight in a cool place, strain and drink the following morning.)

Minerals are best extracted in cider vinegar, so you could also take 2tsp herb infused vinegar (nettle, motherwort, mugwort) in cold water or with 2 tsp honey in a mug of boiling water several times a day.

You also need to eat lots and lots of green leafy vegetables (cabbage, sprouts, kale and other brassicas) unless you have an underactive thyroid, in which case you need to think carefully about your greens!

Susun Weed has a good mineral rich soup recipe here.

(iii) You also need adequate protein intake for making new collagen. Bone broth is really useful made with marrow bones. Jim Macdonald has a nice recipe and method here, I have one here. (You'll need to scroll down to the very bottom of the article for the recipe.)

Vegetarians and Vegans may be surprised if they suddenly get cravings for steak at this time. I’ve had vegetarian friends tell me about this phenomenon. It usually happens when the body is anaemic and needs an easily digested and absorbed protein source.

(iv) You will need to increase your fibre and water intake, especially if you have been taking a narcotic based pain killer (morphine, codeine & derivatives and dia-morphine). These medications cause serious constipation. If this happens you may not feel like eating. If you do become constipated, you need to not become reliant on senna or other commercial products because they will lessen the ability of the lower bowel to constrict. Lots of fibre, marshmallow, yellow dock, psyllium husks etc are all useful herbal allies.

You might be wondering where comfrey and plantain come into the equation. Comfrey has a long history of helping to heal bones. Matthew Wood has cautioned about not using comfrey too early, especially not before the fracture has been set or this may result in new bone growth and the bone having to be rebroken because it has healed in the wrong position.

You need to be aware of the discussions around comfrey and hepatoxic PSAs before you decide to use it, so you can make an informed decision. One thing to remember is that comfrey’s historical use has mainly been external, not internal, so it needs to be applied either as a poultice (bruise the leaves and apply to the skin, changing every three hours or so), a fomentation (mash the herb with water and apply as a hot poultice, replacing once cold) or an infused oil.

The dilemma is often lack of access to the site of the break once a cast has been put on. Some people have reverted to pushing comfrey leaves inside the cast when they can or waiting until the cast is removed and then applying liberal amounts of comfrey infused oil to the skin.

Plantain can be used in exactly the same way as comfrey, with the added advantage of being taken internally at the same time as externally either as a tea or tincture.

It is interesting that Dr Christopher’s classic Tissue and Bone Formula, has now replaced comfrey with plantain. The original recipe was comprised from oak bark, comfrey leaves, marshmallow root, mullein herb, walnut bark (or leaves), gravel root, wormwood, lobelia and skullcap. The current formula now includes white oak bark, lungwort, slippery elm bark, marshmallow root, mullein leaf, black walnut leaf, gravel root, wormwood herb, plantain leaf, skullcap herb, lobelia herb and aloe vera gel powder.

If you are thinking about making up your own formula, you need to be aware that lobelia is classified as a Class 3 herb in the UK which means it is only supposed to be dispensed by qualified herbalists. It is also a powerful emetic if you take too much, so miniscule drop doses only and preferably talk to someone who uses lobelia regularly before you experiment!

There are other herbs which are useful in the treatment of broken bones. Susun Weed recommends using St John's Wort tincture for infection free healing and preventing nerve damage for broken bones. The dose is 25-30 drops 1-2x day. Henriette Kress says that SJW oil used externally is good for swelling associated with broken bones.

Kiva Rose and Jim MacDonald recommend using a mallow, mullein and comfrey poultice for painful, swollen broken bones. They also recommend using a small dose of horsetail tincture in with other herbs when the break is fresh, or as a single dose (1-5 drops three times a day) if an old break won’t heal. Kiva writes about her experience here.

It has been a fascinating process putting this article together. Now, instead of a gut response of two major herbs, if someone asks me about broken bones again, I can help them understand what the process of bone healing is and which herbs and foods can be helpful to support the broken bone in the best possible way.