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.
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.
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.
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