Complementary Osteoarthritis Treatment: What Works, What Doesn't

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:

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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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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.

 

Comments

[Nancy Al-Bader]

10:06 PM on 05/21/2011

I have had OA since I was 40. I am now 49 and up until recently I was only using Sam-e to manage the pain and it did wonders to alleviate almost all of it. I have been taking one 400mg pill in the morning and one at night. Buy it from Swanson the mail order company because it is the cheapest and is just as effective as the more expensive stuff. However, in the past three months I have undergone tremendous stress lately and my arthritis has become much worse. I have had increase Sam-e to three per day and have started on a niacinamide and n-acetyl cysteine regimen. I don't know if it will work but it's worth trying. Besides niacinamide has so many other great benefits...like improved mood,increased brain function, prevents diabetes and helps with sleep, depression and anxiety. It is a difficult program to follow because I have to take the niacinamide 250mg six times a day, three hours apart. I just set my phone to beep every three hours starting at 7 am to 10 pm. It is suppose to help rebuild cartilage, not just mask the pain, so it's worth it. However if one stops the niacinamide the arthritis will come back. Apparently the niacinamide blocks the body from attacking itself, so if you stop taking it the body will resume the attack. Google Kaufman's arthritis research using niacinamide.

[kkdc]

10:34 AM on 05/20/2011

Chiropractic care is missing in this commentary. Proper alignment of vertebral and extremity articulations, means better ability to move and stay fit, but also that alignment helps prevent further joint deterioration...because proper movement of joint surfaces allows circulation critical to joint health. Joints need "food" and replentishment and when fixated, the fluids and circulation that come in are slowed down, and debris within joint capsules, which is part of normal joint physiology, is not removed at the same rate. Joints need nutrients too, such as the long chain molecules of glucosamine etc. Get chiropractic on board for a healthier and better functioning nervous system. Your body organs need the right nerve signaling from the brain through the spinal cord in order to function well and information from the periphery needs to be fed to the brain in the other direction in order for it to make the right decisions. It's only natural. One of the safest, oldest, hands-on forms of health care...back to the time of Hipocrates or before. Don't forget that body needs overall good nutrition too, including fish oil, lean protein, phytochemicals from fruits and vegetables to keep inflammation down.

[suzirotc]

10:06 PM on 05/12/2011

I have osteoarthritis everywhere - hands, feet, back and knees. Doctor prescribed Mobic which helps and I take Gluecosomine/Chondroitin once a day in the morning. The G/C helps me a lot. Last month, I ran out of it and after only one week, I felt the difference. Many pharmacies offer "buy 1, get 1 free" and that's what I do. There are also coupons in our paper for it. There are mornings when I can hardly get out of bed but I push even with the pain and once I get moving and keep moving, I feel much better.

The best medicine is exercise - just keep moving. It really works.

Sue B

[EvolveorPerish]

12:16 AM on 05/08/2011

SAM e is the best- if you are an undermethylator. It significantly relieved my joint pain, allergies, and improved my mood. When I exercise I use joint muscle plus by Global health Trax- it's awesome. CLO reduces inflammation as well.

Some people benefit from avoiding grains, especially wheat, and the night-shade family (tom's, white potatoes)- Check out the Paleo Diet- it works.

[Sayer Ji]

12:15 AM on 05/06/2011

There is a solid base of scientific support for the use of Curcumin, Boswellia, Glucosamine, and SAMe to name but a few natural substances of value in osteoarthritis. http://www.greenmedinfo.com/disease/osteoarthritis

[jojoforeman]

12:31 PM on 05/05/2011

After playing soccer for over 30 years and a few tweeks to my knee, I had severe arthritis and was told the only answer was a knee replacement. I just didn't feel I was ready for that and found PRP (platelet rich plasma) therapy. I had three treatments and while the pain isn't 100% gone, the difference is remarkable and I'm playing soccer again. The downside is insurance doesn't cover it, but the cost was not much more than all of my co-pays and drug costs would have been. I expect I will have to have the replacement someday, but at least I was able to delay it.

[Carol Ardman]

08:56 AM on 05/05/2011

Here's a link to an excellent blog, published today -- an interview with Dr. Fishman that sheds even more light on this important topic. http://family.lifegoesstrong.com/got-arthritis-do-yoga

[merlinspinoza]

12:35 AM on 05/05/2011

http://ayurveda-ayurvedic.net/osteoporosis.html

backgrounder:http://www.globalgoodnews.com/health-news-a.html?art=130454900250067498

some aspects of this qualify for CME credit http://www.clinical-ayurveda.org/ :

"AMA PRA Category 1 CME credit. For a description of each program, including CME credit details, please click on the link for each:

-Clinical Ayurveda for Improved Diagnosis and Treatment: A Webinar Series for Health Professionals
-Training Program in Ayurvedic Medicine: Co-Sponsored by Scripps Center for Integrated Medicine - Live program
-Online Distance Education Program in Ayurvedic Medicine..."

[Anastasia]

09:18 PM on 05/04/2011

Alas, foods from the nightshade family (potatoes, tomatoes, eggplant, et al) do seem to aggravate arthritis. They supposedly cause inflammation and even damage to the joints.

I've found that it does help quite a bit, not to eat those foods.

[Loren Fishman, MD]

09:01 AM on 05/05/2011

Hi Anastasia, I have heard from some of my patients that nightshades can make arthritis worse, and I'm glad your pain is relieved by not eating those foods. However, I have not seen research evidence that eliminating nightshades from one's diet helps arthritis.

[Anastasia]

01:48 PM on 05/05/2011

You might find this study interesting.

There is no harm in suggesting that people eliminate a particular food from their diet to see if it helps.

http://www.noarthritis.com/research.htm

[RMankovitz]

09:15 PM on 05/04/2011

The author states “Arthritis is a chronic and inevitable condition -- a process of what they call wear-and-tear.”

In my opinion, that is an incorrect statement, unsupported by the evidence. We are not machines, and we are capable of self-repair, assuming a lifestyle in alignment with nature. I know of several folks in their 80s and early 90s with no aches, no pains, no drugs, and no signs of arthritis on their x-rays.

For those who chose a lifestyle in alignment with our current social norms, I agree that pain in many forms is a likely result. For those unfortunates, I have the following suggestions.

An eating plan that eliminates the top nine allergenic foods worldwide, which are: dairy, wheat, eggs, peanuts, soy, tree nuts, fish, shellfish, and seeds might be helpful.

Regarding the use of supplements to alleviate arthritis pain, a fascinating and inexpensive approach, known as the Kaufman protocol, is the use of niacinamide (not niacin), a vitamin. Here is some background info on it:

http://www.arthritistrust.org/Articles/JWrightInterviewsWilliamKaufman.pdf

You might look into naltrexone (LDN) therapy. Naltrexone is an FDA approved medication that, in low doses, exhibits remarkable properties to boost immune system response and to normalize autoimmune disorders. It is inexpensive, relatively non-toxic, and widely available in generic form. See:

http://www.lowdosenaltrexone.org/

Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization

[Nalini Chilkov]

02:16 PM on 05/04/2011

Your information about acupuncture is not correct. Acupuncture DOES reduce inflammation. A PubMed search reveals pages of studies demonstrating that acupuncture reduces inflammatory cytokines and TNFa and NFkB. Furthermore, only licensed acupuncturists practice in the US. In California, where I have practiced for 30 years the same board that licenses physicians also licenses acupuncturists. Most acupuncturists practicing in the US today use sterile disposable needles. Many pain and arthritis clinics have acupuncturists on staff. Please do not mislead readers to think that acupuncturists are second class health care providers who cannot be trusted. Please do your homework and look at the research before you make statements about acupuncture and why and how it works.

[StThomas]

04:29 PM on 05/04/2011

Citing the particular studies you have found on Pubmed to prove your point, would be more convincing than asking someone else to find them!

[Loren Fishman, MD]

11:13 PM on 05/04/2011

I agree that acupuncture does reduce cytokines, and tumor necrosis factor, at least, but while these are factors in inflammation, they are also factors in scores of other processes. They may be used as markers for inflammation, but they are not the same as inflammation. To take another example, there are medications that reduce elevated liver enzymes, but do not have much effect on liver disease itself. Though I admit it's possible that acupuncture actually does reduce specific inflammatory conditions, and you may have had that experience many times, my patients to date have not.

I did not mean to suggest that acupuncturists are second class health providers, or that they cannot be trusted. I have two acupuncturists in my office, and find that in general, acupuncturists run the same gamut of quality that I see in doctors, nurses and just about everybody else. To me alternative medicine is not either-or, it's Why not both?

[RMankovitz]

01:27 PM on 05/04/2011

The author states “Arthritis is a chronic and inevitable condition -- a process of what they call wear-and-tear.”

In my opinion, that is an outrageous statement, unsupported by the evidence. You are not a machine, and are capable of self-repair, assuming you follow a lifestyle in alignment with nature. Some people still remember nature – she evolved us. I know several folks in their 80s and early 90s with no aches, no pains, no drugs, and no signs of arthritis on their x-rays.

For those who chose a lifestyle in alignment with our social mores, I agree that pain in many forms is a likely result. For those unfortunates, I have the following suggestions.

An eating plan that eliminates the top nine allergenic foods worldwide, which are: dairy, wheat, eggs, peanuts, soy, tree nuts, fish, shellfish, and seeds might be helpful.

Regarding the use of supplements to alleviate arthritis pain, a fascinating and inexpensive approach, known as the Kaufman protocol, is the use of niacinamide (not niacin), a cheap vitamin. Here is some background info on it:

http://www.arthritistrust.org/Articles/JWrightInterviewsWilliamKaufman.pdf

You might want to try low dose naltrexone (LDN) therapy. Naltrexone is an FDA approved medication that, in low doses, exhibits remarkable properties to boost immune system response and to normalize autoimmune disorders. It is inexpensive, relatively non-toxic, and widely available in generic form. See:

http://www.lowdosenaltrexone.org/

Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization

[No death panels]

10:04 PM on 05/04/2011

But since OA is not due to immune system problems or allergies, why would any of those recommendations help?

[Nancy Al-Bader]

10:17 PM on 05/21/2011

Actually I developed allergies when I was 40 and within six months I also developed arthritis. Arthritis can be caused by allergies, because it is an auto immune disorder, which means the body attacks itself and can destroy cartilage. Arthritis is not just from wear and tear. Stress brought on the allergies and whenever I undergo tremendous stress my arthritis gets much worse. The stress has to be severe, not just everyday stuff.

[Pod-gers]

12:40 PM on 05/04/2011

Tart Cherry Juice.

[M4dwoman]

12:15 PM on 05/04/2011

Unfortunately, the joints affected in me prevent me from trying many of the bending and stretching alternatives, although I have tried. Lack of funds and crappy insurance also play a part.
By the end of the day, I am either in severe pain or total agony, depending on the activities I have participated in. I have had to give up many of the things that provide me with distractions, like painting, sports, and playing an instrument.
I'm willing to try anything to improve my quality of life, and I know it could be much worse, but in the end, I'm afraid I will give in to the despair.

[Loren Fishman, MD]

11:32 PM on 05/05/2011

I take it this is arthritis. Have you tried the different sorts and
applications of non-steroidal anti-inflammatory medicines? Gentle,
mindful, self-caring movements and postures will free up natural
inflammatory substances in your own body, and there are new medicines
on the horizon.

Take up some hope, that's all any of us have anyway,

Loren

[emerywood]

11:15 AM on 05/04/2011

Most if not all young people have no idea what osteoarthritis is for it doesn't affect them. But, it is most annoying and hard to tolerate for older folks when constant pain and loss of agility due to joint and bone
changes occur. And it affects almost all older folks. There is as yet no effective medication for this condition.
NSAID is helpful but one always worries about side effects like gastrointestinal bleeding while strong pain
killers may affect one's mind. It is a little perplexing why big pharma don't work on new medications for this condition as it would definitely be a hot seller as all older folks would use it if it really works.

[RuthieBabe]

02:30 PM on 05/04/2011

You are right about the pain. I suffered from it for years and became almost a invalid due to the extreme pain. Just standing in a short line for a few minutes would bring me to tears. Shopping at the grocery store was the worst and I dreaded having to go at any time (mid-night was a good time). I sometimes suspected that people thought I was being lazy becuase I could do some thing naturally but they didn't fully understand the kind o pain I carried around each day. I finally had a knee replacement in 2009. The difference was incredible. I didn't need the pain meds in the hospital because the pain I experienced was SO much less than what I had endured before. I never knew why OA and RA was not better researched for alternatives. There's a huge market out there.

[Nancy Al-Bader]

12:07 PM on 05/23/2011

You really should take Sam-e. It works so much better than NSAIDs. NSAIDs can even make arthritis worse by irritating the cartilage. My doctor told me this and I have also read about it online.