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:
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.
Though quite a bit of research has been done, there is disagreement about how well this ancient Chinese technique works for easing the pain of osteoarthritis. In 2003, the government looked at many clinical trials and concluded that acupuncture may not be effective. But the next year a landmark study showed that acupuncture does help with function and pain relief for people who have osteoarthritis of the knee. Many of my patients feel that acupuncture is beneficial, but I always advise them to check the credentials of the person giving the treatments and to be sure needles are sterilized to prevent the spread of disease. In my experience, acupuncture has indeed reduced arthritic pain, but it has not alleviated the underlying inflammation the way the medicines and yoga do.
Glucosamine is a naturally-produced human amino sugar that gets distributed in cartilage and other connective tissue; chondroitin sulfate is a complex carbohydrate that helps cartilage retain water. Many studies have shown that a combination of glucosomine sulfate (the sulfate is important) and chondroitin may reduce the pain and inflammation of osteoarthritis and may even slow disease progression. Some people with moderate-to-severe pain who participated in a large clinical trial conducted by the government did experience significant pain relief when taking these supplements together. About 79 percent of these patients had a 20 percent or greater reduction in pain. Research on these supplements is continuing. At this point studies suggest that these nutrients actually do help rebuild cartilage.
Many of my patients have enthusiastically endorsed both these treatments for reducing the pain and disability of osteoarthritis. The Feldenkrais method of improving movement is gentle and promotes self-awareness. Alexander Technique is postural. Both can be done in groups or privately.
While I have seen reports that ginger can be taken in pill form and used in compresses, I have not seen evidence that it is effective for reducing the pain or disability of osteoarthritis. More research is needed.
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.