Mother Earth Living

Herbal Treatments for Osteoarthritis Pain Relief

The life expectancy of the average American has
nearly doubled during this century, from forty-seven years in the
early 1900s to seventy-six years today. The potential of a longer
life span is a positive development, but along with extra years
comes the risk of age-­related diseases–including osteoarthritis,
which will affect 59.4 million Americans by the year 2020,
according to the Centers for Disease Control and Prevention.

Osteoarthritis is the most common form of arthritis, a general
term for more than 100 conditions and derived from the Greek words
arthron, meaning joints, and itis, meaning inflammation. Other
common types of this disease are rheumatoid arthritis, a widespread
inflammation of the joints, and gout, a condition in which crystals
develop in the joints. Osteoarthritis affects weight-bearing joints in the hips, knees,
feet, and other parts of the body, and also commonly appears in the
joints of the fingers and spine. It occurs when cartilage, the
cushion between bones, breaks down. Without this protective
padding, bones rub each other, resulting in pain, tenderness,
swelling, stiffness, and, sometimes, deformity.

Osteoarthritis isn’t a new disease. Researchers have found
evidence of it in dinosaurs–a Platycarpus skeleton at the
University of Kansas Natural History Museum in Lawrence exhibits
the same signs of osteoarthritis that physicians observe in humans
today–and in the fossilized bones of humans living during the Ice
Age. This condition afflicts the old more than the young and tends to
develop at an earlier age in men than women. But for people older
than age forty-five, it’s ten times more common in women than men,
a disparity that some medical experts attribute to menopause;
estrogen may play a role. Many in the medical community also
believe that heredity and obesity contribute to the risk of
developing the condition.

Symptoms of osteoarthritis are usually mild at first and can
include morning stiffness that disappears quickly. As the disease
advances, pain becomes apparent when an affected joint moves; the
pain may become worse during periods of activity and abate while at
rest. For some, osteoarthritis never gets beyond this point. For
others, symptoms gradually worsen and may result in the need to
limit daily activities such as walking, climbing stairs, and
typing.

Herbal aid

Nooshin K. Darvish, a naturopathic doctor in Seattle and a
Bastyr University clinical faculty member, says the bulk of her
arthritis patients are postmenopausal women age fifty-five and
older who have osteoarthritis of the spine, knees and ankles. Some
of her patients are younger and have developed osteoarthritis as a
result of injury to the knee or ankle.

Darvish says that two herbs–devil’s claw (Harpagophytum
procumbens
) and boswellia (Boswellia serrata)–are particularly
helpful in decreasing inflammation and managing the pain associated
with osteoarthritis.

Devil’s claw, a plant that is native to South
Africa, is so named because of the clawlike appearance of its
barbed fruit. South African peoples, including the Bantu, dried its
large, tuberous roots in the sun, then used them to make a
decoction for treating digestive problems and arthritis. Colonists
carried devil’s claw to Europe, where it also became a popular
arthritis treatment. Today it is widely available in Western
pharmacies and health-food stores. Darvish prescribes devil’s claw to fight the discomfort that
accompanies ­osteoarthritis. For her patients who find it
effective, Darvish says, devil’s claw works relatively rapidly and
provides ­noticeable benefits, including reduced pain and
inflammation.

Some scientific research supports using devil’s claw to quell
pain and inflammation. In 1997, the European ­Scientific
Cooperative on Phytotherapy conducted a double-blind study of fifty
people with various types of arthritis. Researchers found that ten
days of treatment with devil’s claw provided significant pain
relief; the published report didn’t include information about how
much devil’s claw the participants took. Another study of 118
participants shows that devil’s claw may relieve general back pain,
not just back pain associated with arthritis. Other studies, however, indicate that the herb has little
ability to fight inflammation. These conflicting findings may
reflect the fact that researchers have yet to identify the
constituents in devil’s claw that allow it to ease inflammation. It
may also be a lack of quality control, or standardization, of the
devil’s claw preparations used in the studies.

Boswellia serrata, a relative of frankincense,
is the name of a large branching tree native to India. It yields a
gummy resin known as sallai guggal, which practitioners of
Ayurveda, the herbal medicine of India, have used for centuries to
treat arthritis. Darvish prescribes boswellia to her patients to
help decrease inflammation and promote circulation to the joints.
“This is important because cartilage doesn’t get much blood flow,”
she says.

Boswellia contains substances known as boswellic acids. Research
shows that these acids can fight inflammation, which may explain
the herb’s popularity over many years to treat arthritis. Because
of the scientific findings, coupled with the long history of
traditional use, boswellia has been widely marketed as an herbal
substitute for anti-­inflammatory drugs such as aspirin and
ibuprofen. And other research suggests that boswellia may improve
the biochemical structure of cartilage by increasing blood supply
to joint tissue, inhibiting inflammation, and other actions.

Some scientific research supports using devil’s claw to
quell pain and inflammation.

Other herbs

The remedy most commonly associated with relief from the pain,
stiffness and inflammation of osteoarthritis is capsaicin, the
pungent and pain-relieving compound that comes from red peppers
such as cayenne (Capsicum spp.). When applied to the skin,
capsaicin interferes with the body’s perception of pain by
depleting the body’s pain messenger, known as substance P. Although
the condition remains, the perception of pain disappears.
Researchers have found that capsaicin cream applied directly to
arthritic joints four to five times a day provides significant pain
relief. Creams made with capsaicin are available over the counter
at pharmacies and natural food stores.

A combination made from several other herbs has some evidence to
support its use in treating osteoarthritis. In one 1996 British
study, seventy-two osteoarthritis and rheumatoid arthritis patients
took an herbal combination for pain for two months. The combination
contained white willow bark (Salix alba), guaycum resin (Guaiacum
officinale
), black ­cohosh root (Cimicifuga racemosa), sarsaparilla
(Smilax spp.) and poplar bark (Populus spp.). Patients who took
the combination experienced a significant decline in pain according
to their own rating scores compared to the placebo group, and they
reported no negative side effects associated with the herbal
combination.

White willow has been used as a treatment for pain and fever in
China since 500 b.c. In 1828, European chemists discovered they
could extract a substance from white willow called salicin, which
was soon purified to salicylic acid, an ­effective treatment for
pain and fever. Chemists later modified salicylic acid (this time
from meadowsweet, or Filipendula ulmaria) to create acetylsalicylic
acid or aspirin, the popular pain reliever. Resin from guaycum, an
evergreen tree native to South America and the Caribbean islands,
is report­edly anti-­inflammatory and has been useful in reducing
joint pain and inflammation. The root of black cohosh, a North
American plant known widely for its ability to relieve hot flashes
and other menopausal symptoms, is also anti-inflammatory, as is
sarsaparilla root, which is native to tropical rain forests in Asia
and Australia. The bark of poplar species reportedly contains
constituents that can relieve pain.

According to Darvish’s observations, older patients seem to have
the patience to stick with an herbal regimen, whereas the younger
ones need frequent reminders until they start seeing results. But
while it may take longer for herbal remedies to produce results,
Darvish says the wait is worth it to her patients.

“My patients always get results,” she says. “It might take up to
three months, but they always get relief and they end up feeling
more energetic and calmer.”


Gloria Bucco is a Colorado-based independent journalist who
focuses on alternative medicine and natural health. Her first book, The
Natural Pharmacist’s Guide to Arthritis
, was published in 2000 by Prima Publishing.

Additional reading

Chrubasik, S., et al. “Effectiveness of Harpagophytum procumbens
in treatment of acute low back pain.” Phytomedicine 1996,
3(1):1-10.

ESCOP (European Scientific Cooperative on Phytotherapy).
Harpagophyti radix. Exeter, UK: ESCOP Secretariat, 1997.

Mills, S. Y., et al. “Effect of a proprietary herbal medicine on
the relief of chronic arthritic pain: A double-blind study.”
British Journal of Rheumatology 1996, 35:874-878.

Murray, Michael, and Joseph Pizzorno. Encyclopedia of Natural
Medicine. Rocklin, Calif.: Prima, 1991.

Reddy, C. K., et al. “Studies on the metabolism of
glycosaminoglycans under the influence of new herbal
anti-inflammatory agents.” Biochemical Pharmacology 1989,
20:3527-3534.

Safyhi, H., et al. “5-lipoxygenase inhibition by
acetyl-11-keto-b-boswellic acid.” Phytomedicine 1996, 3:71-72.

Singh, G., et al. “Pharmacology of an extract of salai guggal
ex-bosewellia serrata, a new nonsteroidal anti-inflammatory agent.”
Agents Action 1986, 18:407-412.

  • Published on Nov 1, 1998
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