Pain is considered the third most common healthcare problem disabling more individuals than heart disease and cancer together. Although pharmacological pain management offers a significant relief in several pain-related diseases, many patients turn to its supplementation with complementary and alternative medicine. Botanicals used in pain therapy can contribute to restoring the quality of life to a patient and may effect and enhance conventional pain management. Herbal analgesic use in several pain-related diseases such as rheumatologic diseases, back pain, cancer, diabetic peripheral neuropathy and migraine will be discussed. In addition, this review describes botanicals with known analgesic activity for which randomized, placebo-controlled, double-blind trials assessing their efficacy in different pain-related diseases have been published and which have been recently evaluated in many systematic reviews with well-described methodology.