Comfrey - Symphytum officinale

Common Names: Comfrey, common comfrey, true comfrey, boneset, slippery-root, knitbone, ass ear, knitback, healing herb, consound, consoude, salsify, wallwort, gum plant, consuelda, blackwort, bruisewort, black root, Symphytum officinale, kostihoj, medicinal comfrey, black comfrey, European comfrey

Latin Name: Symphytum officinale

Origin: Asia, Europe, North America

Short Introduction

Comfrey can be easily cultivated from seeds in most temperate regions. Simply sow seeds in a warm frame for several days in early spring, then transplant the seedling into a container under favorable conditions before moving the young plant to its final spot in the garden after four weeks. Comfrey prefers a sunny to mildly shaded location with moist, humus-rich, and nutrient-dense soil. The plant needs consistent watering throughout its growth. It blooms from May through August, which is the best time to harvest parts of the plant for medicinal purposes. Comfrey can also be propagated by root division or root cuttings.

Detailed Description

Comfrey: A traditional remedy for joint, muscle, and tendon discomfort.

Botanical Information

Comfrey (Symphytum officinale) is a perennial, robust herb reaching up to 130 cm tall. Its upright stem is hairy and branched in the upper parts. The whitish rhizome transitions seamlessly into a branched root system. The leaves are oblong, alternate, egg-shaped to lanceolate, veined beneath, hairy on the surface, and taper towards the petiole. Its bell-shaped flowers are arranged in paired clusters, with colors ranging from reddish to purple, blooming from May to July. The fruit is a four-parted nutlet containing a four-chambered ovary with four seeds.

Origin and Distribution

Comfrey thrives in the temperate zones of Europe and into central Asia, with the greatest range in mid-elevation regions (it does not naturally occur in northernmost or southern Europe), and has been introduced secondarily to North America. In the Czech Republic, comfrey grows both in lowlands and in mountainous areas. In general, it prefers moist habitats along riverbanks, streams, damp meadows, fields, and forests. It flourishes in rich, slightly acidic to slightly alkaline, clay or clay-loam soils.

Usage / Dosage

The use of comfrey root and leaf in herbal medicine dates back to the 12th century, with numerous historical publications attesting to its therapeutic properties. In the 17th century, Nicholas Culpeper praised comfrey in 'The English Physitian' for its powerful effects against inflammation, pain in joints, muscles, tendons, and as a remedy for rheumatism and gout. Modern clinical research continues to confirm these traditional uses. The root and leaf are harvested for medicinal purposes.

Externally, comfrey leaf extract has been evaluated in three different topical forms (gel, solution, emulsion) for wound healing, using both qualitative and quantitative histological analyses in animal studies. These studies observed significantly enhanced healing, attributed to increased collagen deposition and greater control over tissue inflammation.

Rosmarinic acid, found in comfrey root, appears to have the most significant pharmacodynamic effect, offering anti-inflammatory and analgesic action. Other compounds support tissue granulation and regeneration as well as callus formation. Comfrey’s constituents have also demonstrated the ability to inhibit platelet formation, prostaglandin synthesis, and erythrocyte aggregation. In vivo studies noted prostaglandin and arachidonic acid inhibition and a comfrey root extract reduced edema in animal models.

Clinical studies show that comfrey root extract accelerates and enhances wound size reduction compared to standard treatments. Similar effectiveness has been shown in trials for myalgia of the upper and lower back, as well as for acute ankle sprains, where 10% comfrey root extract preparations significantly reduced pain compared to placebo. Comfrey ointment has also been beneficial in contusions, knee sprains, and supraspinatus tendinitis, improving swelling and both active and passive pain.

In another study, 40 patients experienced improvement in symptoms of acute contusions and traumatic injuries of the knee after applying comfrey preparations. Effects included objectively assessed pain reduction, less restricted mobility due to pain, and reduced swelling. The overall treatment lasted eight days, with improvement seen in more than 85% of patients. In musculoskeletal rheumatism (like epicondylitis and periarthritis), topical comfrey applications showed significant improvements in pain sensations both at rest and during exercise, as well as reduced tension at the site of inflammation compared to placebo.

The analgesic effect and relief for osteoarthritis in patients using comfrey extract topically for 12 weeks is documented. Two weeks of topical ointment improved mobility, reduced pain, and diminished sensitivity and swelling of sprained joints, with results comparable to diclofenac (a strong non-steroidal anti-inflammatory drug). Studies have shown comfrey to have at least equal efficacy to diclofenac, sometimes greater, with no evidence of comfrey being inferior.

A post-marketing publication from 2008 covering 163 patients showed local application of comfrey for bruises, joint pain, sprains, and muscle pain at a dose of 2-3 times daily for 11-12 days, reducing morning stiffness and the need for painkillers. Physicians observed improvement in the majority (93.25%) of cases.

Additional studies and case reports suggest non-traditional uses for comfrey ointments, including for insect bites, mastitis, skin inflammations (including dermatitis), sweat gland abscesses, gangrenous growths, ulcers, bedsores, and varicose ulcers.

Traditional Medicine

Comfrey root is traditionally used in poultices or ointments for bone fractures, vein inflammations, and bruises. In Balkan folk medicine, comfrey is taken internally for gastrointestinal issues, and externally for rheumatism and gout. Across Europe and Asia, comfrey in various forms is used for muscle and joint pain relief. After its introduction to America, it was also embraced in Native American folk medicine.

Homeopathy

In homeopathy, Symphytum is used to support bone healing after injuries or fractures, relieving periosteal pain during recovery, alleviating bruises, and easing pain in tendon and bone inflammations. Symphytum may also help with certain superficial eye injuries.

Active Compounds

Comfrey contains varying amounts of tannins, essential oils, alkaloids, and mucilaginous substances. The root is rich in allantoin (0.5-5.0%), mucilaginous polysaccharides (about 30%), phenolic acids (rosmarinic, chlorogenic, hydroxycaffeic, and caffeic acids), glycopeptides, tannins, amino acids, and triterpene saponins (including monodesmosidic and bidesmosidic glycosides with hederagenin, such as symphytoxide A), oleanolic and lithospermic acids. Comfrey also contains pyrrolizidine alkaloids (0.013-1.2%) with unsaturated structures (e.g., acetylintermedine, acellycopsamine, lycopsamine, and symphytine).

Traditional Dosage

There is no universally agreed optimal dosage for comfrey. Clinical studies generally recommend products containing comfrey extract be used 2-3 times per day, in keeping with traditional practice. German sources set a maximum daily alkaloid dosage at 100 mcg/day, equating to several grams of comfrey extract per day.