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Loren Fishman, MD


Complementary Osteoarthritis Treatment: What Works, What Doesn't

Posted: 05/04/11 09:41 AM ET

There are many types of arthritis, but osteoarthritis -- the wear-and-tear-condition that affects us all to one degree or another as we grow older -- is mainly a problem with the cartilage within joints. When a joint works properly, bones, bathed in lubricating synovial fluid, slide along each other smoothly. But arthritis (also called degenerative joint disease) can cause damage to the cartilage on one side, which soon produces disrepair on the other side. The top layer of cartilage becomes worn irregularly or even disappears, allowing bones to rub against each other. That friction causes inflammation, loss of range of motion and eventually deformities.

Both standard medical practice and complementary therapies can do a lot for those who have osteoarthritis.

Non-steroidal anti-inflammatories like Advil (but not Tylenol or aspirin), and some non-steroidals of prescription strength, can alleviate pain but also reduce the inflammation inside the joint that is causing the pain in the first place. They are important in the treatment of osteoarthritis, as are lifestyle choices. Exercise and a healthy weight and a good diet are essential. Physical therapy can help with range of motion issues. Most surgical knee and hip replacements are done because of osteoarthritis, and they can be very effective.

Alternative therapies can also bring a great deal of relief. Here are a few worth looking into:

Yoga And Tai Chi
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Good circulation of synovial fluid is crucial to keeping joints healthy. The beauty of yoga is that the poses move joints into extreme but safe positions, allowing all the corners and crevices of the joint to be bathed by this lubricating and life-sustaining fluid. Obviously, yoga helps with range of motion. Also, importantly, PGC1Alpha -- a natural anti-inflammatory produced in the body -- is released by muscles during yoga, and possibly during the practice of Tai Chi as well. Tai Chi, though it doesn't stretch the muscles. It does promote coordination, though, which relieves excess pressure on the joints.
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For those who have osteoarthritis, the future may bring major advances in drug therapy. But I think we will also see progress on the frontiers of complementary and alternative therapies, including vitamins and other supplements, such as Devils Claw. Examples of work currently being done abound, and here's just one: a study in Denmark has completed implanting tiny gold beads around osteoarthritic knees!

Arthritis is a chronic and inevitable condition -- a process of what they call wear-and-tear. Non-steroidal medications, yoga and chondroitin sulfate represent an effort to find an even stronger process to resist arthritis. I'm confident that there will be further breakthroughs in the not-too-distant future.