Holistic Treatment Options for Osteoarthritis
For many people with joint pain, the early months of 2005 were very disturbing. Most of the medications commonly prescribed to relieve inflammation in joints, referred to in the literature as non-steroidal anti-inflammatory drugs (or NSAIDs), had been found to have dire side effects. Initially the bad news was the increased incidence of serious heart disease in patients taking the COX-2 class of NSAIDs, especially Vioxx and Celebrex. However the same cardiovascular problems were later reported for the older NSAIDs, including many of the commonly used over the counter drugs like Motrin and Aleve.
Clearly alternative treatments are our first line of defense both for maintaining the health of joints as we age, and to treat already degenerating joints.
Here are my recommendations for holistic treatment options. I have done, or I am currently doing many of the therapies described. Similarly, over the years I have explored many of the dietary options. Finally, I take, or have taken, several of the products described below to manage my joint problems. So I know of what I speak!
The numerous options on this page may appear overwhelming at first (and this is hardly a comprehensive survey of all the options), but it is intended as a guide. I encourage you to work with a skilled practitioner for guidance in choosing what is right for you.
Table of contents
Use this link for extensive discussion of options.
Maintaining a low body weight is critical for the joints of the lower body. Any increase in body weight exponentially impacts the forces on the hip joints. The same is true for knees, as any overweight person will tell you as he/she tries to get out of a chair. Therefore a healthy diet with plenty of colorful fruits and vegetable and whole grains is recommended. The reasoning behind this is that these foods (since they are high in beta carotene, etc.) help the body deal with oxidative ("free radical") stress, which is known to wear down bone. To address inflammation, foods with high levels of Omega 3 fatty acids, such as, flax seed oil, salmon (not farmed), tuna, and sardines, should be emphasized. (See this link for guidelines of safe mercury levels in fish.) As in all healthful diets, saturated fats and refined sugars are to be avoided.
To get more Omega 3 fatty acids I currently take Pure Encapsulation's EPA/DHA–Glucosamine which combines essential fatty acids with glucosamine, boswellia and curcumin (EPA - eicosapentaenoic acid 450 mg., DHA - docosahexaenoic acid 300 mg. glucosamine sulfate 1,500 mg. providing 1,125 mg glucosamine sulfate). They describe the product thusly: Fish oil moderates prostaglandin and leukotriene production, supporting healthy connective tissue. It also plays a role in moderating neutrophil activity, supporting joint comfort. A double blind, placebo–controlled, prospective study involving 66 subjects revealed that fish oil modulates immune mediator activity as well as provides support for joint flexibility. Glucosamine is a naturally occurring compound necessary for the synthesis of proteoglycans, the protein molecules responsible for giving cartilage its strength and resilience. Sulfate, another component of proteoglycans, works synergistically with glucosamine to enhance cartilage metabolism. Boswellia serrata is an Ayurvedic herb that has a long history of use for connective tissue and joint support. Boswellic acids, the active terpenoid constituents of boswellia, may maintain healthy 5–lipoxygenase enzyme activity and healthy leukotriene metabolism to promote joint comfort. Curcumin also promotes joint comfort by supporting healthy histamine production, eicosanoid metabolism and neutrophil response.
In addition I use flax seed oil daily as a salad dressing or on cooked vegetables and eat as much fatty fish as I can. (Note: flax seed oil can not be heated.)
Although there is a lot of anecdotal literature about the value of avoiding nightshades for people with osteoarthritis, most medical authorities dismiss it. Nightshades include potatoes, eggplants, bell peppers, chili peppers, tomatoes and tobacco. I tried this diet and I didn't find it helpful. It is also hard to maintain as many food have pepper added. One physician, however, who is strongly supportive of the diet is the provocative thinker Sherry A. Rogers, MD. All her books are very interesting and radical in their approach. I think her work on detoxification is particularly compelling.
As I have explained many times, from the Chinese Medical point of view the liver organ system (ruling the tendons and ligaments) and the kidney organ system (ruling the bones) must be supported by diet. Therefore avoiding sedatives like alcohol and marijuana that must be detoxified in the liver, and stimulants like caffeine that drive the kidney/adrenal axis. is crucial to maintaining healthy joints.
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There are millions of dollars spent annually by people with joint pain seeking relief. Many claims are anecdotal and unsubstantiated medically. I have tried only some and will recommend those. Again, have a skilled practitioner guide your choices. Many of the products mentioned are available at Turning Point since I tend to stock all the supplements I myself am using.
1.Glucosamine Sulfate and Chondroitin Sulfate:
Many people find taking this compound gives them relief from pain. I never had this experience but I think the literature is persuasive enough to take it to protect further joint deterioration.
Glucosamine sulfate is found in many body tissues. It is the primary substrate for the biosynthesis of proteoglycans, which provide the framework for collagen and give tissue its flexibility and resilience. It also plays a role in the formation of articular surfaces, tendons, ligaments, synovial fluid, skin, bone, nails, heart valves, etc.
For a review of the glucosamine literature see this article in Bandolier, the British journal for "Evidenced Based Health Care".
Most manufacturers recommend 500 milligrams of glucosamine and 400 milligrams of chondroitin three times daily.
I take EPA/DHA–Glucosamine as descibed above.
For good bone growth, a multivitamin should have vitamin D, vitamin C, vitamin E, copper, boron and magnesium. Vitamin C is of particular importance to joint health. It is necessary for the formation of collagen. Vitamin E is an excellent antioxidant (see below about antioxidants).
3. Calcium is vital for the laying down of all new bone. Calcium supplements are especially important for peri-menopausal and menopausal women at risk for osteoporosis Calcium should be taken with Vitamin D and magnesium. If these are in your multivitamin, then I like hydroxyapatite as an easily absorbed format. All calcium should be taken in divided doses and with food since stomach acid is necessary for assimilation.
If you have osteoporosis, refer to my website's Menopause page for calcium recommendations.
4. Medical food
An outstanding product is UltraInflamXTM Nutritional Support for Inflammation Management. I used this for years. This easy to absorb protein drink has many known anti-inflammatory substances such as Ginger Root Extract (Zingiber officinale) 100 mg Turmeric Rhizome Extract (Curcuma longa) 210 mg [standardized to 95% (200 mg) total pungent compounds] Rosemary Leaf Extract (Rosmarinus officinalis)
Metagenics also makes two products to reduce pain:
Inflavonoid Intensive Care® extract of boswellia, turmeric, ginger, cayenne
KaprexTM with LuduxinTM consists of reduced iso-alpha acids (from hops extract, Humulus lupulus) and magnesium salt produced via a proprietary process.
In the period just prior to my hip surgeries I did not find either of these Metagenics products very effective because the joint degeneration was too severe. However, before my second hip really got bad, I found taking Kaprex helpful enough that I do not have to take non-steroidal anti-inflammatory drugs (NSAIDs like Vioxx, Motrin etc).
We can protect cartilage by eliminating oxidative stress by reducing sources of free radicals and consuming a broad array of antioxidants from food (colorful fruits and vegetables) and supplements such as my favorite:
Quercenol by White Tiger (formulated by Subhuti Dharmananda, PhD)
Two tablets provide:
Flavonoids: Quercetin 400 mg Silybum marianum (e) 250 mg Proanthocyanadins 125 mg Green tea polyphenols 150 mg
Vitamins: Mixed carotenoids 30 mg (1000) Vitamin E 300 IU (830) Vitamin C 500 mg
Minerals: (67) Zinc 10 mg (143) Selenium 100 mcg
I have also used as antioxidants:
Grape seed extract
Gamma-linolenic acid (GLA): a fatty acid found in evening primrose oil, borage oil, and black currant seed oil
Pycnogenol (a water extract from the bark of the French maritime pine)
There are many other things to try that I didn't get to:
My current joint protection supplement regime (updated 06/07):
Vitrin (Nutraceutics): one 2x daily
Quercenol (White Tiger): one daily
EPA/DHA–Glucosamine: three 2x daily
And I add acupuncture, yoga, and chiropractic adjustments.
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Note: I am not affiliated with any of the companies mentioned on this website.
A more unorthodox look comes from The Life Extension Foundation:
Finally, SavvyPatients.com has a list of other links of interest:
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