Can a comfrey (Symphytum officianale) root extraction help ease aching joints and muscles? Many of those following the folk use of comfrey up to present-day think so. Additionally, there is scientific research demonstrating comfrey’s effectiveness at soothing muscle and joint pain, some of which are highlighted in this post.


The warm weather has a way of encouraging us to get outside and move our bodies more. Whether you’ve been hiking, biking, playing, or enjoying water sports, comfrey cream can be a wonderful ally in supporting achy muscles that result from physical, summertime activities. For that reason, I’ve also included my go-to comfrey cream recipe for achy joints and muscles! 

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What is Comfrey?

The comfrey plant, Symphytum officinale, gets its name from the Latin confervere, meaning to grow together. When the root is boiled in water, it forms a sticky, glue-like paste. This is memorable if you have worked with it, and some use this quality to remember comfrey’s centuries-long use—applying comfrey over bones, bruises, sprains, and minor wounds with the intention to support mending!


A member of the borage family, comfrey root, leaves, and stems have an obvious coat of bristly hair. This perennial can grow up to 4-feet tall. Its long, lance-shaped leaves can be up to 1 foot in length closer to the bottom of the stem and are shorter higher up the stem. Comfrey flowers are bell-shaped and purple, pink, or pale yellow in color, and it has a dark taproot.

The leaves and stems of comfrey contain pyrrolizidine alkaloids that can cause toxic damage if ingested in excess (Ulbricht, 2010). Thus, it is not advised to ingest herbal preparations of comfrey unless guided by an expert pharmacologist and physician. Learn more in The Comfrey Controversy: Can and Should One Use Comfrey Internally?


Topical preparations of comfrey are generally safe provided they are not applied excessively or to an open wound. This is because only a small amount of the pyrrolizidine alkaloids are absorbed through the skin (Jedlinszki et al., 2017). When buying commercial brands, seek those that have had the pyrrolizidine alkaloids removed, if possible.

Research on the Topical Use of Comfrey


Topically, comfrey root and leaf extracts have been traditionally used for bruises, sore muscles and joints, sprains, mild wounds, and gout (Natural Medicines, 2020). Some recent human studies have demonstrated that extracts may help with ankle sprains, knee pain and stiffness, backaches, and mild skin abrasions.

For Ankle Distortions

An ankle sprain can come out of nowhere and cause a lot of pain, limitations, and regret until it is healed.  At least three human studies found that the topical use of a cream containing comfrey root extract may safely help with pain, swelling, and mobility symptoms associated with an ankle sprain.


   In a randomized, controlled, double-blind study with 203 patients, applications

      of a 10% comfrey cream were well tolerated, reduced swelling and pain, and  

      improved mobility (Kucera et al., 2004).


   In a multicenter, randomized, double-blind, placebo-controlled study with 142

      ankle sprain participants, a comfrey root extract applied 4x/day for 8 days

      improved pain, swelling, and mobility without any adverse reactions (Koll et al.,



   In a randomized multicenter study with 164 ankle sprain patients, swelling and

      pain were improved more successfully using a comfrey root extract compared to

      a diclofenac gel (Predel et al., 2005). 


While larger and more studies are needed to fully determine safety and effectiveness, short term topical application of comfrey may give you peace of mind, relief, and support while you rest and heal, following any additional advice from your physician.

For Knee Pain and Stiffness

Knee pain and stiffness can be a stubborn concern that keeps many from doing activities they enjoy. Two interesting studies found that a topical application of a product containing comfrey root extract helped with knee pain and stiffness. For one of these studies, the average time participants had experienced knee pain and stiffness leading up to the study was six and a half years! 


   In a randomized, placebo-controlled, double-blind, multi-clinical trial, 43

      volunteers with osteoarthritis used either a topical cream containing comfrey,

      tannic acid, and eucalyptus or a placebo cream 3x/ day for 6 weeks. The herbal

      topical cream was prepared at two different strengths, as an additional measure

      of efficacy. The groups using the herbal preparations reported a significantly

      greater reduction in pain and stiffness associated with osteoarthritis of the knee

      without serious adverse reactions (Smith & Jacobson, 2011).


   In a randomized, double-blind, placebo-controlled trial, 220 patients with knee

      osteoarthritis used either a commercial topical comfrey root extract or a placebo. 

      A significant reduction in pain was observed in the groups using the comfrey

      product. As an additional measure of efficacy, groups instructed to use the

      comfrey preparation for the longest period of time experienced the most

      improvement. (Grube et al., 2007). 


Of course, more research is needed to validate efficacy and safety. However, people with knee pain may be glad to try a topical preparation that could help in addition to any other recommendations made by their physician.

For Back Pain

As a Licensed Massage Therapist for fifteen years, I have noticed that back pain can be caused by a variety of reasons and can be very debilitating. Sometimes, massaging on topical ointments can help reduce pain and inflammation.


Three clinical studies have provided evidence that ointments containing comfrey root have helped reduce back pain. While there can be a variety of causes for back pain, these small studies offer hopeful results that comfrey root may offer potential analgesic and anti-inflammatory benefits. More research is needed.


   In a double-blind, randomized, placebo-controlled study involving 120 patients

      with acute back pain, symptoms were quickly reduced in the group using 4

      grams of an ointment containing 35% comfrey root extract 3x/day for 5 days

      (Giannetti et al., 2010).


   In a small study with 30 subjects, lower back pain from exercise was reduced

      with an ointment containing comfrey. The cream was applied to the local lumbar

      area 4x during the day of the exercise, with the first application being pre-

      exercise (Jurcau & Jurcau, 2013).


   A multi-center, randomized, double-blind, controlled clinical trial was conducted

      with 161 patients having acute lower back pain. An ointment containing comfrey

      helped reduce lower back pain (Stam et al., 2001).

For Superficial Bruising


Comfrey has long been used in folk traditions for bruising and abrasions. Although it has historically been used on open wounds, it is now not advised related to the toxic pyrrolizidine alkaloids that can absorb more readily into the body through an open wound. Additionally, use on a deep cut may encourage healing of the outer skin the preparation comes in direct contact with faster than the deeper tissue, leading to abscess. Comfrey is avoided on cuts or puncture wounds for this reason.


   In a study of 712 children with superficial wounds, applying a 25% comfrey

      cream for one week or up to two weeks (2-4x day) offered a strong benefit to

      risk ratio (Kucera et al., 2018).


   In a randomized double-blind study of 278 patients with fresh abrasions, a

      topical preparation containing a 10% comfrey leaf extraction applied for 2-3

      days reduced wound healing time of adults and children without side effects

      (Barna et al., 2012).

Topical Use Safety

When harvesting comfrey or buying from a non-commercial supplier, note that there is variety within the species. Hybrids and other species may have a similar appearance but could have significantly different amounts of the toxic pyrrolizidine alkaloids (Kucera et al., 2018). Make sure to always buy comfrey (Symphytum officianale) root and leaf from a trusted source.


Avoid using comfrey extracts on broken skin or open wounds. Also, avoid use for more than two weeks or excessive concentrations containing more than 100 mcg of pyrrolizidine alkaloids (Wichtl, 2004 & Ulbricht, 2010).


Do not use comfrey with very young children or during pregnancy or lactation. Avoid comfrey with certain medical conditions, such as liver disease. Avoid with medications that induce CYP3A4 or are hepatotoxic (Natural Medicines, 2020). Contact your doctor or pharmacist if you have any questions before use. Like any new treatment, discontinue use if any irritation occurs. In some cases, ointments with comfrey have caused redness, itching, and a rash (Smith, 2011).

Comfrey Cream Recipe for Muscle and Joint Comfort


This comfrey cream recipe works great for local areas that have mild bruising or soft tissue pain. Apply a small amount (not to exceed a teaspoon) topically 2-3x/day for up to 2 weeks. Understand comfrey’s contraindications before using it.


To make this recipe, first, you must prepare the comfrey root tincture. This is done by soaking the root in at least 50% alcohol for a minimum of two weeks. Be sure to use comfrey root from a reputable source that has properly identified the species. Choose organically grown comfrey when possible. After the tincture is made, then you can whip up the fabulous joint and muscle cream! Be sure to choose organic carrier oils and essential oils when possible. Yield: Approximately 5 cups of whipped lotion.




Comfrey tincture

1 ounce dried organic comfrey (Symphytum officinale) root

1 pint of 50% alcohol

1 pint-sized glass canning jar, with lid


Comfrey cream

½ cup organic sunflower oil

¼ cup organic safflower oil

2 ½ cups organic, unrefined coconut oil

½ cup organic, unrefined cocoa butter

1/8 cup comfrey tincture (Symphytum officinale), store bought or via recipe, above.

12 drops peppermint (Mentha piperita) essential oil

12 drops juniper berry (Juniperus communis) essential oil

12 drops black pepper (Piper nigrum) essential oil

Double boiler

Electric bowl mixer (like a KitchenAid) or a blender

Glass bowl with a lid

Small glass jars with lids for sharing (optional)




   First, make the comfrey root tincture by combining the dried comfrey root and

      alcohol in a sterilized, dry, glass pint jar. Seal with a lid and then label with the

      ingredients and date. Set on a sunny windowsill and shake once a day for 2-4



   After 2-4 weeks have passed, strain the root from the alcohol using a coffee

      filter inserted in a wire mesh strainer or similar setup. Save the remaining liquid

      alcohol portion. This is the tincture. Set aside ⅛ cup for the cream recipe and

      store the rest in a glass jar. Label with the ingredients and date made.


   To make the cream, combine sunflower oil, safflower oil, coconut oil, and cocoa

      butter in a double-boiler over low heat until completely melted. Remove from

      heat. Cover, but leave a small air opening.


 Allow the oil mixture to cool until it reaches room temperature, which could take

      8-12 hours. It’s ready when the mixture has solidified somewhat and has a

      cloudy, creamy, and slightly runny consistency.


   Transfer the cooled oil and butter mixture to a standing electric mixer or



   Add ⅛ cup of the comfrey tincture and all essential oils to the cooled oil/butter



   Begin mixing on low. After the consistency begins to thicken, turn the mixer up

      a little bit. As the consistency thickens some more, turn the mixer up a little bit

      more. Mix for about 10 minutes, until nice and whipped


   Scoop the finished comfrey cream into sanitized glass jars. Cap, then label the

      jars with the date made and ingredients.


The recipe makes about 5 cups of whipped creamy lotion. Without overexposure to air or heat—and without cross-contamination—the recipe should last as long as the expiration date of the carrier oils used.


To Use. Healthy adults: massage about 1 teaspoon of cream into a local area up to 4x/day for up to 2 weeks. Please read the Topical Use Safety section of this article (above) before using.


This recipe is contraindicated for small children and those with certain medical conditions. Skin patch test before use, especially if you have sensitive skin, and never use on a deep wound. Ask your doctor if you have any questions.


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