How to Use Tart Cherries for Pain Relief

Using tart cherries for pain relief is well documented.

They are best known for preventing attacks of gout, and as a “folk remedy” for other forms of arthritis. In recent years, they’ve been the subject of laboratory research, animal research, and human clinical trials.

Studies suggest they have the pain-killing ability of NSAIDs, for any kind of pain, but also the potential for long-term benefits.

A 2011 review article in Critical Reviews in Food Science and Nutrition1Cherries and Health: A Review
L. M. McCune, C. Kubota, N. R. Stendell-Hollis, C. A. Thomson
Critical Reviews in Food Science and Nutrition 2011 Jan; 51(1):1-12
PMID: 21229414
(Abstract only is free.)
summarized that there are “potential preventive health benefits of cherry intake in relation to cancer, cardiovascular disease, diabetes, inflammatory diseases, and Alzheimer’s disease. Mechanistically, cherries exhibit relatively high antioxidant activity, low glycemic response, COX 1 and 2 enzyme inhibition, and other anti-carcinogenic effects in vitro and in animal experiments.”

Tart cherries have also been shown to prevent muscle pain and loss of strength, and to restore muscle function after exercise. To me this suggests a muscle-building quality similar to whey! Perhaps tart cherries can also fight pain by building muscle and increasing strength.​

Three Kinds of Cherries

There are three kinds of cherries. Tart cherries are considered superior, but all three have similar health benefits.

Sweet cherries (Prunus avium): Varieties include Bing cherries

Tart cherries, also called sour cherries (Prunus cerasus): Varieties include Montmorency, Balaton

Black cherries (Prunus serotina): Grow in the wild

Tart cherries and black cherries are typically available only dried, freeze dried, or as juice.

Sweet cherries are also available fresh and canned.

Anthocyanins

Anthocyanins are believed to give cherries their unique benefits. They are a group of antioxidant phytochemicals (“plant chemicals”) of the kind called flavonoids.

Two of the anthocyanins, called anthocyanin 1 and anthocyanin 2, are believed to work together for pain-killing, anti-inflammatory, and antioxidant properties.

The only fruits that contain both anthocyanin 1 and anthocyanin 2 are cherries and raspberries.

Tart cherries typically contain far more anthocyanins than sweet cherries. However, sweet cherries have also been studied in clinical trials.

Tart Cherries for Pain

Amazingly, tart cherries act like NSAID painkillers without the drawbacks.

Both tart and sweet cherries have been shown to be COX-2 inhibitors, the mechanism used by NSAIDs and related painkillers.

Studies have demonstrated equivalence to NSAIDs in the laboratory (to ibuprofen [Advil] and naproxen [Aleve], in a study published in Phytomedicine in 20012Cyclooxygenase Inhibitory and Antioxidant Cyanidin Glycosides in Cherries and Berries
N. P. Seeram, R. A. Momin, M. G. Nair, L. D. Bourquin
Phytomedicine 2001 Sep; 8(5):362-9
PMID: 11695879
(Abstract only is free.)) and in animal studies (to indomemacin [Indocin] in a study published in 2004 in Behavioural Brain Research3Tart Cherry Anthocyanins Suppress Inflammation-Induced Pain Behavior in Rat
J. M. Tall, N. P. Seeram, C. Zhao, M. G. Nair, R. A. Meyer, S. N. Raja
Behavioural Brain Research 2004 Aug 12; 153(1):181-8
PMID: 15219719
(Abstract only is free.)
).

A 2012 article in Medicine and Sport Science4Cherry Juice Targets Antioxidant Potential and Pain Relief
K. S. Kuehl
Medicine & Sport Science 2012; 59:86-93
PMID: 23075558
(Abstract only is free.) summarized that “tart cherries appear to possess similar effectiveness” as NSAIDs “in treating the inflammatory reaction seen in both acute and chronic pain syndromes encountered among athletes and non-athletes with chronic inflammatory disease.”

Gout

Tart cherries have long been associated with improving gout.

In 1950, Dr. Ludwig Blau published a paper in Texas Reports on Biology and Medicine5Cherry Diet Control for Gout and Arthritis
Ludwig W. Blau
Texas Reports on Biology and Medicine 1950; 8(3):309-11
PMID: 14776685
(no abstract), recommending eating 1/2 pound of fresh or canned cherries per day to prevent gout attacks.

A study published in Arthritis & Rheumatism in 20126Cherry Consumption and the Risk of Recurrent Gout Attacks
Yuqing Zhang, Tuhina Neogi, Clara Chen, Christine Chaisson, David Hunter, and Hyon K. Choi
Arthritis & Rheumatism 2012 Dec; 64(12):4004-4011
PMID: 23023818
PMCID: PMC3510330 collected information from a large group of gout patients during the course of a year and did a sophisticated statistical analysis.

It found a “35% lower risk of recurrent gout attack” when patients were eating at least one serving (1/2 cup or 10-12 cherries) over a two-day period, whether they also took anti-gout medications or not. If a patient both ate cherries and took allopurinal, the risk of gout attacks was 75% lower.

The researchers believed that the benefits peaked at three servings (1.5 cups or 30-36 fresh cherries) over a two-day period.

In that study, most who consumed cherries were eating fresh cherries—therefore, they ate sweet cherries and not tart cherries. And, there is a natural limit on how many fresh cherries someone can eat! Would the results have been even better if patients had larger amounts of tart cherries in the form of juice? Nevertheless, this study was good evidence that cherries really do prevent gout attacks.

In the Journal of Arthritis7Pilot Studies of Cherry Juice Concentrate for Gout Flare Prophylaxis
Naomi Schlesinger, Ruth Rabinowitz, and Michael Schlesinger
Journal of Arthritis 2012 1:1, a 2012 article reported work with tart cherry juice concentrate.

In a pilot randomized controlled trial, tart cherry juice was compared to pomegranate juice. For four months, patients took either 2 tablespoons of tart cherry juice concentrate (the equivalent of 90-120 cherries) every day or the same amount of pomegranate juice concentrate. The number of gout attacks per month were decreased in the patients who took tart cherry juice, but not in the patients who took pomegranate juice. Of the cherry juice patients, 55% were attack-free for four months and stopped taking NSAIDs after two months. Only 20% of the pomegranate juice patients were attack-free and none stopped any medication.

The researchers’ retrospective analysis of nearly five years of clinic patients came up with about the same results: 50% of patients who took tart cherry juice for at least four months became attack-free.

The researchers did not find that tart cherry juice reduced uric acid levels in the patients, so they concluded that cherry juice works against gout in some other way. This was evidence for the theory that gout crystals cause white blood cells to release a substance known as interleukin 1-beta (IL-1β), which ultimately causes the pain of gout. Their laboratory experiments did show that tart cherry, and not pomegranate, inhibits IL-1β.

Arthritis

Because of the studies on tart cherries and its long history as a home treatment for arthritis, it would seem to be worthwhile to try for any kind of arthritis, joint, or muscle pain.

The one study on osteoarthritis with clear results seems to be unpublished. It used Montmorency tart cherries concentrated in capsules for patients with knee osteoarthritis. According to the news release8Can Cherries Relieve the Pain of Osteoarthritis?
Baylor Scott and White Health Online Newsroom, “More than half of the patients enrolled in a 2007 pilot study at the Baylor Research Institute experienced a significant improvement in pain and function after taking the cherry pills for eight weeks.”

Protecting muscles

There’s evidence that tart cherries protect muscles and increase strength.

A number of studies have investigated what they call “exercise induced muscle damage” in resistance training and marathon running.

A 2011 article in Medicine & Science in Sports & Exercise9Montmorency Cherry Juice Reduces Muscle Damage Caused by Intensive Strength Exercise
J. L. Bowtell, D. P. Sumners, A. Dyer, P. Fox, K. N. Mileva
Medicine & Science in Sports & Exercise 2011 Aug; 43(8):1544-51
PMID: 21233776
(Abstract only is free.) concluded, “Montmorency cherry juice consumption improved the recovery of isometric muscle strength after intensive exercise.”

A 2006 article in the British Journal of Sports Medicine10Efficacy of a Tart Cherry Juice Blend in Preventing the Symptoms of Muscle Damage
D. A. J. Connolly, M. P. McHugh, O. I. Padilla-Zakour
British Journal of Sports Medicine 2006; 40:679-683
PMID: 16790484
PMCID: PMC2579450 studied a type of one-armed weight lifting exercise in college-age men who had not recently participated in strength training. The subjects drank two 12 oz. bottles of juice or placebo every day for 8 days, with the exercise on the fourth day. The cherry juice was a tart cherry / apple blend that had the equivalent of 50-60 cherries per bottle. The placebo was Kool-Aid. Each subject did this once with juice and once with placebo.

While drinking Kool-Aid, the subjects found that their pain peaked 48 hours after the exercise. At 24 hours later, they had lost 30% of their muscle strength, and at 96 hours later they still had 12% strength loss.

While drinking tart cherry juice, they found pain declining after 24 hours. Their loss of strength was only 12% at 24 hours, and at 96 hours they had actually gained strength to 6% more than before the exercise.

Anti-inflammatory and Antioxidant

An article in The Journal of Nutrition in 201311Sweet Bing Cherries Lower Circulating Concentrations of Markers for Chronic Inflammatory Diseases in Healthy Humans
Darshan S. Kelley, Yuriko Adkins, Aurosis Reddy, Leslie R. Woodhouse, Bruce E. Mackey, and Kent L. Erickson
The Journal of Nutrition 2013; 143:340-344
PMID: 23343675 stated, “Limited data indicate that both sweet and tart cherries decrease oxidative stress and inflammation in humans.”

Here are a few interesting studies:

A randomized controlled trial was published in 2010 in the FASEB Journal12100% Tart Cherry Juice Reduces Pro-Inflammatory Biomarkers in Overweight and Obese Subjects
Keith R. Martin and Lacey Burrell
The FASEB Journal 2010 Apr; 24(1) Supplement 724.15
(Abstract only). Subjects drank 8 oz. of tart cherry juice daily for four weeks. Markers of inflammation were reduced, including the “sed rate” (ESR).

When mice were given tart cherry juice, in a 2009 study in Plant Foods for Human Nutrition13Improved Antioxidant and Anti-Inflammatory Potential in Mice Consuming Sour Cherry Juice (Prunus Cerasus cv. Maraska)
A. Saric, S. Sobocanec, T. Balog, B. Kusic, V. Sverko, V. Dragovic-Uzelac, B. Levaj, Z. Cosic, Z. Macak Safranko, T. Marotti
Plant Foods for Human Nutrition 2009 Dec; 64(4):231-7
PMID: 19763832
(Abstract only is free.), the mice had increased levels of important antioxidant enzymes:

• Increased superoxide dismutase (see discussion in Wheatgrass Juice)
• Increased glutathione peroxidase (see discussion in Whey Protein)

A 2009 study published in The Journal of Nutrition14Tart Cherry Juice Decreases Oxidative Stress in Healthy Older Men and Women
Tinna Traustadottir, Sean S. Davies, Anthoney A. Stock, Yali Su, Christopher B. Heward, L. Jackson Roberts II, and S. Mitchell Harman
The Journal of Nutrition 2009; 139:1896-1900
PMID: 19692530
PMCID: PMC3151016 designed an experiment to evoke the way older adults aren’t as able to withstand surgery and other serious stresses as well as younger people. The subjects drank about 8 oz. of either a tart cherry / apple blend or Kool-Aid every day for two weeks. Then the test involved squeezing their arms with a blood pressure cuff for half an hour while making measurements of oxidative stress. The study concluded that drinking cherry juice improves older adults’ “capacity to constrain an oxidative challenge.”

Action Steps

Tart cherries have the pain-killing ability of NSAIDs, but unlike NSAIDs, they have long-term health benefits. They’ve been shown in clinical trials to prevent gout attacks and to restore muscle function after exercise.

Trial

For a trial of tart cherries to fight pain, be sure to

• Take a large enough amount
• Be consistent
• Extend the trial for at least four months, if possible

Clinical trials used the equivalent of 90-120 tart cherries daily; or, follow the label instructions on bottles of capsules.

You may want to also consume as many kinds of cherries as possible in as many forms as possible.

Types of cherries

Sweet cherries (Prunus avium): Varieties include Bing cherries

Tart cherries, also called sour cherries (Prunus cerasus): Varieties include Montmorency, Balaton

Black cherries (Prunus serotina): Grow in the wild

While there should be some benefit from any type of cherry, tart cherries generally contain more anthocyanins and are more powerful.

Examine the label for the scientific name to be sure what kind of cherry you are getting. Some product names are misleading.

Look for products without added sugar. Added sugar may increase your pain and / or increase your blood sugar.

What was used in the clinical trials?

The successful clinical trials in the Journal of Arthritis (for gout, 201215Pilot Studies of Cherry Juice Concentrate for Gout Flare Prophylaxis
Naomi Schlesinger, Ruth Rabinowitz, and Michael Schlesinger
Journal of Arthritis 2012 1:1) and in the British Journal of Sports Medicine (for exercise induced muscle damage, 200616Efficacy of a Tart Cherry Juice Blend in Preventing the Symptoms of Muscle Damage
D. A. J. Connolly, M. P. McHugh, O. I. Padilla-Zakour
British Journal of Sports Medicine 2006; 40:679-683
PMID: 16790484
PMCID: PMC2579450) used the equivalent of 45-60 tart cherries twice a day (= 90-120 cherries per day) in the form of tart cherry juice concentrate.

Juice concentrate is a thick liquid meant to be diluted with water for a beverage or taken a spoon at time. Check the label for its serving size, equivalent number of cherries, and for a recommended amount of liquid for diluting the concentrate.​

The amount used in the clinical trials is generally 1 tablespoon (or 1/2 ounce) twice a day.

Brands used in clinical trials

The clinical trials that identified the source of the tart cherries used the products of Brownwood Acres.

FruitFast tart cherry juice concentrate from Brownwood Acres
1 oz. = 2 tbsp = 70-100 cherries

CherryFlex capsules from Brownwood Acres
Used in the 2007 Baylor Research Institute pilot study

Brownwood Acres products are not organic.​

Organic brands (examples)

Organic brands of tart cherry juice concentrate:

• Dynamic Health
• Eden Foods​
• Lakewood Juices

Organic brands of tart cherry juice:

• Eden Foods
• Lakewood Juices​
• Smart Juice

Other forms of tart cherries

A 2012 article in the Journal of Food Science17Processed Tart Cherry Products–Comparative Phytochemical Content, In Vitro Antioxidant Capacity and In Vitro Anti-Inflammatory Activity
B. Ou, K. N. Bosak, P. R. Brickner, D. G. Lezzoni, E. M. Seymour
Journal of Food Science 2012 May; 77(5):H105-12
PMID: 23163942
(Abstract only is free.)
 compared different forms of tart cherry products.

“All processed tart cherry products possessed antioxidant and anti-inflammatory activity,” it concluded, but they contained different proportions of the various phytochemicals. “On a per serving basis, juice concentrate was superior to other tart cherry products.”

They considered: ​

• Tart cherry juice concentrate
• Individually quick-frozen cherries
• Canned cherries
• Dried cherries​

Dried and freeze-dried

See Dried Fruit Resources for sources of dried fruit online.
​

Capsules (examples)

• CherryFlex capsules from Brownwood Acres

• Life Extension Tart Cherry Extract

There are others!​

Recipes

Recipes can help you eat as many sweet, tart, and black cherries as possible:

• Tart cherry recipes from the Cherry Marketing Institute​
• The Kitchn has hundreds of recipes using cherries

References

Articles

Anti-Inflammatory Properties of Tart Cherry
Michael Downey
Life Extension Magazine, June 2013

The Red Report: The Science Behind Tart Cherries (PDF)
Cherry Marketing Institute, 2012

The Cherry Nutrition Report (PDF)
Cherry Marketing Institute

Tart Cherries: Summary of Current Scientific Literature (PDF)

Medical Journal Articles

Every link leads to free full text, except as noted. In some cases, to get to the full text, you’ll need to find and click an additional PDF or full text link .

PMID is the ID number in the free PubMed medical literature index. PMCID is the ID number in the free PubMed Central full-text archive.

General

Cherries and Health: A Review
L. M. McCune, C. Kubota, N. R. Stendell-Hollis, C. A. Thomson
Critical Reviews in Food Science and Nutrition 2011 Jan; 51(1):1-12
PMID: 21229414
(Abstract only is free.)

Antioxidant Capacity and Anthocyanin Profile of Sour Cherry (Prunus cerasus L.) Juice
Irem Damar and Aziz Eksi
Food Chemistry 2012; 135:2910-2914
PMID: 22980889
(Abstract only is free.)

100% Tart Cherry Juice Reduces Pro-Inflammatory Biomarkers in Overweight and Obese Subjects
Keith R. Martin and Lacey Burrell
The FASEB Journal 2010 Apr; 24(1) Supplement 724.15
(Abstract only)

Anthocyanins Induce the Activation of Phase II Enzymes Through the Antioxidant Response Element Pathway Against Oxidative Stress-Induced Apoptosis
P. H. Shih, C. T. Yeh, G. C. Yen
Journal of Agricultural and Food Chemistry 2007 Nov 14; 55(23):9427-35
PMID: 17935293
(Abstract only is free.)

Anthocyanin Content, Lipid Peroxidation and Cyclooxygenase Enzyme Inhibitory Activities of Sweet and Sour Cherries
V. Mulabagal, G. A. Lang, D. L. DeWitt, S. S. Dalavoy, M. G. Nair
Journal of Agricultural and Food Chemistry 2009 Feb 25; 57(4):1239-46
PMID: 19199585
(Abstract only is free.)

Anthocyanins and Human Health: An In Vitro Investigative Approach
Mary Ann Lila
Journal of Biomedicine and Biotechnology 2004:5 (2004) 306-313
PMID: 15577194
PMCID: PMC 1082894

Processed Tart Cherry Products–Comparative Phytochemical Content, In Vitro Antioxidant Capacity and In Vitro Anti-Inflammatory Activity
B. Ou, K. N. Bosak, P. R. Brickner, D. G. Lezzoni, E. M. Seymour
Journal of Food Science 2012 May; 77(5):H105-12
PMID: 23163942
(Abstract only is free.)

Tart Cherry Juice Decreases Oxidative Stress in Healthy Older Men and Women
Tinna Traustadottir, Sean S. Davies, Anthoney A. Stock, Yali Su, Christopher B. Heward, L. Jackson Roberts II, and S. Mitchell Harman
The Journal of Nutrition 2009; 139:1896-1900
PMID: 19692530
PMCID: PMC3151016

Sweet Bing Cherries Lower Circulating Concentrations of Markers for Chronic Inflammatory Diseases in Healthy Humans
Darshan S. Kelley, Yuriko Adkins, Aurosis Reddy, Leslie R. Woodhouse, Bruce E. Mackey, and Kent L. Erickson
The Journal of Nutrition 2013; 143:340-344
PMID: 23343675

Cherry Antioxidants: From Farm to Table
Gianna Ferretti, Tiziana Bacchetti, Alberto Belleggia, and Davide Neri
Molecules 2010; 15:6993-7005
PMID: 20944519

Cyclooxygenase Inhibitory and Antioxidant Cyanidin Glycosides in Cherries and Berries
N. P. Seeram, R. A. Momin, M. G. Nair, L. D. Bourquin
Phytomedicine 2001 Sep; 8(5):362-9
PMID: 11695879
(Abstract only is free.)

Gout

If Life Serves up a Bowl of Cherries, and Gout Attacks are “the Pits”: Implications for Therapy
Allan C. Gelber and Daniel H. Solomon
Arthritis & Rheumatism 2012 Dec; 64(12):3827-3830
PMID: 23023794

Cherry Consumption and the Risk of Recurrent Gout Attacks
Yuqing Zhang, Tuhina Neogi, Clara Chen, Christine Chaisson, David Hunter, and Hyon K. Choi
Arthritis & Rheumatism 2012 Dec; 64(12):4004-4011
PMID: 23023818
PMCID: PMC3510330

Previously Reported Prior Studies of Cherry Juice Concentrate for Gout Flare Prophylaxis: Comment on the article by Zhang et al
Naomi Schlesinger and Michael Schlesinger
Arthritis & Rheumatism 2013 Apr; 65(4):1135-6
PMID: 23334899

Pilot Studies of Cherry Juice Concentrate for Gout Flare Prophylaxis
Naomi Schlesinger, Ruth Rabinowitz, and Michael Schlesinger
Journal of Arthritis 2012 1:1

Cherry Diet Control for Gout and Arthritis
Ludwig W. Blau
Texas Reports on Biology and Medicine 1950; 8(3):309-11
PMID: 14776685
(no abstract)

Osteoarthritis

Can Cherries Relieve the Pain of Osteoarthritis?
Baylor Scott and White Health Online Newsroom

Efficacy of Tart Cherry Juice to Reduce Inflammation Biomarkers among Women with Inflammatory Osteoarthritis (OA)
Kerry S. Kuehl, Diane L. Elliot, Adriana E. Sleigh, Jennifer L. Smith
Journal of Food Studies 2012; 1(1):14

Randomized Double-Blind Crossover Study of the Efficacy of a Tart Cherry Juice Blend in Treatment of Osteoarthritis (OA) of the Knee
H. R. Schumacher, S. Pullman-Mooar, S. R. Gupta, J. E. Dinnella, R. Kim
Osteoarthritis and Cartilage 2103 Aug; 21:1035-1041
PMID: 23727631

Muscle Pain

Tart Cherry Anthocyanins Suppress Inflammation-Induced Pain Behavior in Rat
J. M. Tall, N. P. Seeram, C. Zhao, M. G. Nair, R. A. Meyer, S. N. Raja
Behavioural Brain Research 2004 Aug 12; 153(1):181-8
PMID: 15219719
(Abstract only is free.)

Efficacy of a Tart Cherry Juice Blend in Preventing the Symptoms of Muscle Damage
D. A. J. Connolly, M. P.  McHugh, O. I. Padilla-Zakour
British Journal of Sports Medicine 2006; 40:679-683
PMID: 16790484
PMCID: PMC2579450

Efficacy of Tart Cherry Juice in Reducing Muscle Pain During Running: A Randomized Controlled Trial
Kerry S. Kuehl, Erica T. Perrier, Diane L. Elliot, and James C. Chesnutt
Journal of the International Society of Sports Nutrition 2010; 7:17
PMID: 20459662
PMCID: PMC2874510

Montmorency Cherry Juice Reduces Muscle Damage Caused by Intensive Strength Exercise
J. L. Bowtell, D. P. Sumners, A. Dyer, P. Fox, K. N. Mileva
Medicine & Science in Sports & Exercise 2011 Aug; 43(8):1544-51
PMID: 21233776
(Abstract only is free.)

Cherry Juice Targets Antioxidant Potential and Pain Relief
K. S. Kuehl
Medicine & Sport Science 2012; 59:86-93
PMID: 23075558
(Abstract only is free.)

Improved Antioxidant and Anti-Inflammatory Potential in Mice Consuming Sour Cherry Juice (Prunus Cerasus cv. Maraska)
A. Saric, S. Sobocanec, T. Balog, B. Kusic, V. Sverko, V. Dragovic-Uzelac, B. Levaj, Z. Cosic, Z. Macak Safranko, T. Marotti
Plant Foods for Human Nutrition 2009 Dec; 64(4):231-7
PMID: 19763832
(Abstract only is free.)

Influence of Tart Cherry Juice on Indices of Recovery Following Marathon Running
G. Howatson, M. P. McHugh, J. A. Hill, J. Brouner, A. P. Jewell, K. A. van Someren, R. E. Shave, S. A. Howatson
Scandanavian Journal of Medicine & Science in Sports 2010 Dec; 20(6):843-52
PMID: 19883392
(Abstract only is free.)