Arthritis
Arthritis is an inflammation of the joints and cartilage that can affect any part of the body.
Osteoarthritis
The most common form of arthritis is osteoarthritis, the main symptoms being pain and stiffness; they are generally relieved by resting the affected joint.
With osteoarthritis, the joints themselves - especially those in the fingers - sometimes swell and become deformed. There is less inflammation associated with osteoarthritis than with rheumatoid arthritis.
One distinguishing characteristic of this type of arthritis is that the affected joint is cool and hard to the touch rather than warm and spongy as in rheumatoid arthritis. Destruction of the cartilage that surrounds the ends of the bones is common in osteoarthritis. Small bone spurs then grow from the surface of the bone into the joint. These spurs decrease the mobility of the joint.
Osteoarthritis also tends to run in families. If you have a family history of this disorder, keeping your weight at an optimal level has been shown to decrease your risk of developing it in knee joints.
Rheumatoid arthritis
Rheumatoid arthritis is an inflammatory disease that affects people of all ages and is thought to be an auto-immune disorder that causes the body to attack its own tissues. The primary symptom being painful, stiff joints that become swollen, tender, and deformed. Fatigue, a low-grade fever, and depression may accompany rheumatoid arthritis.
Ankylosing spondylitis
This is yet another type of arthritis. It typically affects the spinal column, causing pain and stiffness in the back.
Arthritis can also be associated with inflammatory bowel syndrome. This type of arthritis can usually be controlled by focusing on controlling the intestinal inflammation.
There is no known cure for arthritis. Doctors prescribe drugs to reduce pain and inflammation in the joints and to prevent further joint damage and deformities. For osteoarthritis, paracetamol may help, while anti-inflammatory drugs are typically used for rheumatoid arthritis. You'll notice that some pain drugs also reduce inflammation, but paracetamol isn't one of them.
SUPPLEMENTS TO HELP RELIEVE ARTHRITIS
The following nutrients can help keep your joints flexible and pain-free.
- B vitamins. Improvements have been noted by taking 6.4 milligrams of folic acid per day and 20 micrograms
of vitamin B12 per day. Niacin (vitamin Bs) may also provide some relief.
- Vitamins C and D. These been shown to help osteoarthritis. Vitamin
C is essential to the body for making collagen, an important component
of joints. Two hundred milligrams of C per day is probably enough;
try 500 IU (international units) of vitamin D.
- Vitamin E. May help relieve some pain of arthritis.
Typical dosage: 400 to 600 IU daily.
- Boron. The rate of arthritis is higher with 1 milligram
or less of boron per day. A recommended
dose is 3 milligrams per day.
- Calcium. Being an important component of bone, it
decreases the amount of bone loss that occurs from long-term
steroid use.
Typical dosage: 1,000 milligrams per day.
- Glucosamine sulphate. This
compound makes up the main component of cartilage in joints.
Although there is some scepticism, many well designed, short-term
studies have shown that glucosamine can decrease osteoarthritis
symptoms. Glucosamine is not a pain reliever, however, and it takes
four to eight weeks before you feel results.
Typical dosage: 500 to 1,500 milligrams daily.
Caution: glucosamine can cause mild digestive problems and should not be used by people with heart disease or diabetes. - Bromelain For rheumatoid arthritis, take 400mg of bromelain between meals, three times a day, to help reduce joint swelling
HERBAL REMEDIES
Cayenne and Other Peppers (Capsicum spp.)
Peppers contain a strong analgesic and anti-inflammatory agent known as capsaicin. This compound blocks a chemical in the body that acts as a pain signal. You can find capsaicin in many commercial creams and ointments for arthritis pain.
Typical dosage: a cream containing 0.25 per cent to 0.75 per cent capsaicin applied daily.
Caution: Some people experience a slight burning of the skin with capsaicin use. If you do, try a cream with a lower percentage of capsaicin.
Evening Primrose (Oenothera biennis)
The seed from this plant contains the essential fatty acid gammalinolenic acid (GLA), which has an effect on inflammation. For this reason, the seed oil may significantly help arthritis pain, especially in cases of rheumatoid arthritis. One study showed that patients taking 12 capsules per day of evening primrose oil or 540 milligrams of GLA were able to reduce the amount of non-steroidal anti-inflammatory drugs they were taking. (Evening primrose oil is expensive, but other good sources of GLA are available; see 'Keeping Joints from Creaking'.)
Typical dosage: up to 12 capsules per day; or 1/2 teaspoon of oil per day.
Flax (Linum usitatissimum)
The linoleic acid found in flaxseed oil may also be beneficial for arthritis
because it alters how the body breaks down prostaglandins, chemicals involved
in inflammation.
Typical dosage: 2 tablespoons of oil per day in
food (use on top of cereal or as a salad dressing).
Stinging Nettle (Urtica dioica)
This plant is used by some in a process called urtication, according to Dr James A. Duke, author of The Green Pharmacy. This rather painful procedure involves swatting the aching joint with the whole plant so the nettles scratch the skin. Such a treatment probably works both by distracting the patient - or victim, depending on how you look at it - and by injecting anti-inflammatory chemicals from the plant. There's a much less painful way to take advantage of nettles: steaming or drying the leaves removes their sting. Nettles are high in boron, a mineral recommended for arthritis.
Typical dosage: up to six 435-milligram capsules per day; or 1 cup of tea per day, divided into two or three doses (steep 1 teaspoon of dried herb in 1/4 litre of hot water for 10 minutes).
Ginger (Zingiber officinale)
Traditionally used in India to treat arthritis. Components of ginger such as gingerol can inhibit the production of prostaglandins possibly more effectively than the arthritis drug indometacin.
Typical dosage: up to eight 500- to 600-milligram capsules per day; or 1/2 to 1 teaspoon fresh ground root per day; or 10 to 20 drops of tincture in water three times per day.
Caution: doses of ginger higher than these should not be used by people with diabetes, heart problems or bleeding problems.
Devil's Claw (Harpagophytum procumbens)
This herb from Africa has traditionally been used for most types of arthritis. The tubers contain a group of chemicals called iridoids that have anti-inflammatory activity. One clinical study showed patients with arthritis improved when taking one 500-milligram tablet of devil's claw three times per day. Other studies conclude, however, that devil's claw provides no relief for arthritis. It may be best to find out for yourself.
Typical dosage: up to six 400- or 500-milligram capsules per day; or 30 drops of tincture three times per day. Caution: do not take if you have peptic ulcers.
Green Tea (Camellia sinensis)
Most of the Eastern world has been drinking green tea for centuries, but only recently has it become the darling of medical research. Scientists now know that green tea contains compounds called polyphenols that may help relieve the symptoms of rheumatoid arthritis. A study from Case Western Reserve University in Cleveland, Ohio, showed that mice given polyphenols isolated from green tea were protected from developing a disease similar to rheumatoid arthritis. Although this experiment was conducted on mice, similar results might be found in humans. Black tea may also be beneficial.
Typical dosage: several cups of green tea per day are safe (follow manufacturer's instructions for tea bags). Because green tea extracts vary widely in concentration, follow manufacturer's recommendations on dosage of extracts.
Feverfew (Chrysanthemum parthenium)
Feverfew has been used for arthritis. In some laboratory studies extracts of feverfew were able to stop certain processes involved in rheumatoid arthritis.
Typical dosage: up to three 300- or 400-milligram capsules per day; or two average-sized fresh leaves per day; or 15 to 30 drops of tincture per day.
Caution: Not to be taken if you are pregnant.
Turmeric (Curcuma longa)
Turmeric has also been used as a treatment for arthritis. Its active ingredient, curcumin, inhibits the production of prostaglandins. This anti-inflammatory property has been confirmed in animal studies. Turmeric can be taken in food, or applied topically to the joint as a poultice to relieve pain.
Typical dosage: 250 to 500 milligrams of standardised capsules up to three times daily; or up to 1 teaspoon per day in food; or 10 to 30 drops of tincture up to three times per day.
Yucca (Yucca brevifolia)
Traditionally been used as an arthritis remedy, studies have confirmed its effectiveness. An extract of yucca reduces the swelling, pain and stiffness of arthritis, though studies were controversial. Yucca can be used either internally or externally on the joint.
Typical dosage: up to four 490-milligram capsules per day.
Willow (Salix alba and other Salix spp.)
Willow is probably the oldest herb known to treat pain and inflammation. The inner bark of this plant contains salicin, which is changed to salicylic acid in the body. The compound in aspirin, acetylsalicylic acid, is derived from salicylic acid.
Typical dosage: up to six 400-milligram capsules per day.
Boswellia (Boswellia serrata)
This gum resin is an Ayurvedic remedy for arthritis. Studies in India have documented its usefulness and products containing boswellia are marketed there. Boswellia is sometimes mixed with turmeric and another Ayurvedic remedy, ashwaganda. Typical dosage: up to three 400-milligram capsules per day.
Pineapple (Ananas comosus)
The fresh fruit contains bromelain, a compound with anti-inflammatory properties that many people find useful for arthritic conditions.
Typical dosage: three to four 40-milligram capsules per day; or simply enjoy eating more pineapple in your regular diet.
Other Recommendations
Aromatherapy pain relief
A hot bath-with eucalyptus and rosemary essential oils helps ease painful, stiff joints. Add five drops of each to a bathtub of hot water and soak for 15 minutes.
Relieve inflammation with healthful fats
To relieve inflammation, avoid saturated animal fats and eliminate polyunsaturated, hydrogenated, and partially hydrogenated oils from your diet Beneficial fats that alleviate inflammation include extra-virgin olive oil and omega-3 fatty acids, found in cold-water fish, such as salmon, sardines, or herring, and walnuts and flaxseeds. Use olive oil as your primary source of fat and eat one to two servings daily of foods rich in omega-3 fats.
Keeping Joints From Creaking
Consuming the following oils are good substitutes for costly evening primrose oil because of their high levels of either gamma-linolenic acid (GLA) or the chemicals your body uses to make GLA.
- Borage seed oil
- Blackcurrant seed oil
- Fish oils
- Flaxseed oil
- Nut oils
- Safflower oil
Avoid dietary allergens
People with rheumatoid arthritis often have food allergies and may benefit from consulting with a health practitioner for guidance. Eliminating the most common food allergens (wheat corn, beef, and dairy products) is a good place to begin. Avoiding foods from the nightshade family (tomato, potato, aubergine, and cayenne pepper) is also helpful.
Lifestyle changes can make a difference in controlling arthritis symptoms:
Keep exercising for mobility
Gentle exercise, such as walking, tai chi, yoga, and swimming, improves circulation to the joints, slows down cartilage loss, and improves range of motion. Aim for at least 30 minutes of exercise daily, and be sure to include stretching as well as some aerobic activity.
Water Activity
Most practitioners suggest a programme of regular activity, but water activity is especially good, since it doesn't put additional pressure on the joints. This activity must be coupled with periods of rest.Dietary check-up
Increasing the amount of whole, unprocessed foods you eat. Some people with arthritis find that a vegetarian diet can reduce the symptoms. Cut back on coffee, alcohol, chocolate and dairy products, since these foods tend to foster inflammation. Food sensitivities or allergies may also play a role in arthritis, and many people find some relief by eliminating certain foods. The most common foods that can affect arthritis are members of the nightshade family, such as aubergines, tomatoes, peppers and potatoes.Watch your weight
Being overweight in relation to the size of your frame and the thickness of your bones puts undue stress on the joints of the lower extremities.DRUG TREATMENT
Analgesics
Aspirin; paracetamol (Famalgic, Hedex, Medinol, Panadol), paracetamol with codeine (Kapake, Solpadol, Tylex), aspirin.
Function: decrease pain; codeine helps decrease more severe pain. Aspirin reduces both pain and inflammation.
Aspirin side effects: abdominal cramping and pain, deafness, stomach bleeding, ulcers, nausea and vomiting, ringing in the ears, increased tendency to bleed.
Paracetamol side effects: dizziness, excitement, disorientation, liver damage, rash.
Paracetamol with codeine side effects: rare, but after prolonged use may include constipation, dizziness, drowsiness, nausea, weakness, tiredness, vomiting, dependency.
Non-Steroidal Anti-Inflammatories (NSAIDs)
Acemetacin (Emflex), diflunisal (Dolobid), etodolac (Lodine SR), flubiprofen (Froben SR), indometacin (Indocid), ibuprofen (Brufen, Nurofen), mefenamic acid (Ponstan), naproxen (Synflex), piroxicam (Feldene, Brexidol).
Function: block production of prostaglandins, body chemicals that favour inflammation.
Side effects: abdominal pain and indigestion, diarrhoea, headaches, dizziness, fluid retention, stomach ulcers and bleeding, nausea, nightmlares, photosensitivity, rashes, hearing problems such as tinnitus.
Cyclo-Oxygenase 2 Inhibitors
Rofecoxib (Vioxx).
Function: relieves pain by blocking inflammatory prostaglandins.
Side effects: abdominal pain, indigestion, dizziness, stomach ulcers and bleeding, nausea, nightmlares.
Corticosteroids
Cortisone acetate (Cortisyl), dexamethasone (Decadron), hydrocortisone (Efcortesol, Hydrocortone, Solu-Cortef), methylprednisolone (Medrone), prednisolone (.Precortisyl Forte, Prednesol), triamcinolone (Kenalog).
Function: reduce inflammation.
Side effects: with long-term use or high dosage, may cause cataracts, high blood pressure, weight gain, thinning of the skin, weakened bones, increased appetite, elevated blood sugar, indigestion, insomnia, mood changes, restlessness, worsened arthritis, increased susceptibility to infection.
Other Drugs
Methotrexate (Maxtrex).
Function: suppresses the immune system to slow the progression of rheumatoid arthritis.
Side effects: cough, diarrhoea, hair loss, loss of appetite, bleeding, bruising.
Chrysotherapy, gold salts (auranofin).
Function: alter the immune system to slow the progression of rheumatoid arthritis.
Side effects: stomach cramps, bloating, loss of appetite, diarrhoea, indigestion, nausea, vomiting, mouth sores, skin rash, sun sensitivity, headaches, lowered white blood cell count, decreased red blood cell numbers and increased tendency to bleed.
Cyclosporin (Sandimmun, Neoral).
Function: suppresses the immune system to slow the progression of rheumatoid arthritis.
Side effects: sore gums, high blood pressure, increased hair growth, kidney and liver problems, loss of appetite, tremors.
Cyclophosphamide (Endoxana).
Function: suppresses the immune system to slow progression of rheumatoid arthritis.
Side effects: blood in the urine, burning on urination, confusion, cough, dizziness, fever and chills, infertility, loss of appetite, nausea and vomiting, bleeding and bruising, weakness and tiredness, missed menstrual periods, infection.
Hydroxychloroquine sulphate (Plaquenil).
Function: eases the effects of rheumatoid arthritis, though how it works is not well understood.
Side effects: loss of vision, nerve and muscle weakness.
Penicillamine (Distamine, Pendramine).
Function: alters the immune system to slow progression of rheumatoid arthritis.
Side effects: mouth sores, impaired sense of taste, fever, rash, bleeding, infection, anaemia, kidney damage.
