Herbs, supplements and healthy fats can help ease the pain of arthritis and get you moving again.
Sloths may be slow, and bats may be blind, but those lucky species are the only backboned creatures on Earth that don’t suffer from arthritis pain. For all the rest of us bony folk, from hamsters to humans, arthritis is a plague, affecting 70 million adults in the United States and Canada alone. The more than 100 forms of arthritis afflict joints and associated support structures, such as muscles, tendons, ligaments and bones. Osteoarthritis, the most common form, can cause crippling pains in the hands, knees, hips and spine. Other types, such as rheumatoid arthritis, fibromyalgia, lupus, gout, bursitis and tendonitis, produce inflammation and excruciating pain. There is no cure for arthritis, but luckily, nature gives us potent medicine to help relieve the agony. It may even be possible to slow the disease and rebuild some of the damaged joint tissues, all with the power of herbs.
Along with putting the hot in your jalapeños, capsaicin, extracted from chile peppers, is one of the finest topical pain relievers. Creams containing just 0.025 percent of this spicy stuff help desensitize joints to mild pain from osteoarthritis, fibromyalgia and other types of arthritis. Applied three or four times daily, relief should come within days or weeks. Unfortunately, about half of users suffer local irritation and cannot use capsaicin. If you experience skin irritation, discontinue use. After applying the cream, take care not to touch your eyes or any other sensitive areas.
Other good topical painkillers from nature include salicylates from willow bark; menthol from peppermint; eucalyptol from eucalyptus; bromelain from pineapple; helenalin from arnica; and the essential oils of clove and cinnamon (which should be diluted before applying directly to the skin). Several popular commercial products, such as Lakota, 024, Tiger Balm and Nutraflex, combine several of these extracts and are worth trying, as their combination of ingredients increases the likelihood of effectiveness. And recently, according to a 2005 study from the Journal of Strength and Conditioning Research, a new ingredient called Celadrin is turning up in creams. It is an anti- inflammatory fatty acid complex derived from ruminant fat.
Another traditional remedy is stinging nettle (Urtica dioica). Although it seems somewhat counterintuitive, old-timers knew to swat their painful joints with the nettle’s prickly branches, as anti-inflammatory chemicals from the sharp hairs could reduce swelling within minutes. Personally, I would rather smooth on the leaf extract, found recently in a study from Seminars in Arthritis and Rheumatism to ease pain in an osteoarthritic thumb or index finger.
Massaging on topical painkillers stimulates blood flow to the joint area, bringing nutrients like collagen and antioxidants to aid repair. But massage gently, so as not to aggravate tender tissues.
Inflammation is the major pain instigator in many types of arthritis. It can occur in advanced osteoarthritis, but tends to flare up relentlessly in rheumatoid arthritis and lupus—conditions in which the body’s immune system goes into overdrive and ravages healthy tissues.
The omega-6 fatty acid gamma-linolenic acid (GLA) often is the most successful anti-inflammatory for sufferers of rheumatoid arthritis and possibly other inflammatory arthritic conditions. One 2005 study found that rheumatoid arthritis sufferers who took 1.4 grams a day of GLA had 36 percent fewer tender joints and 28 percent fewer swollen joints within 24 weeks (although benefits may come as early as six to 12 weeks). Fortunately, GLA, which works by inhibiting the prostaglandins and leukotrienes that contribute to inflammation, is easy to come by in nature: Black currant and borage seed oils are the richest sources of GLA. For rheumatoid arthritis, 1 to 3 grams a day of GLA supplement typically is advised.
Omega-3 fatty acids also reduce inflammation. Two important ones—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are abundant in cold-water fish, such as salmon, tuna, herring and halibut. The body also converts alpha-linolenic acid, plentiful in flaxseed, walnuts and their respective oils, into EPA and DHA. A review of treatments for rheumatoid arthritis published in Modern Rheumatology confirms that 3 grams daily of fish oil reduces joint tenderness and morning stiffness, but it may take 12 weeks or longer to see results. Do not exceed the recommended dose, as internal bleeding and decreased immune responses are possible with doses exceeding 3 grams daily.
Another good anti-inflammatory is devil’s claw (Harpagophytum procumbens), which contains harpagoside and other inflammation fighters in its roots. In a 2003 study published in Phytotherapy Research, researchers found that devil’s claw extracts reduced osteoarthritic hip or knee pain by 25 percent, and noticeably improved mobility within a few weeks. You can find devil’s claw as capsules, powder or tea—but avoid it if you take blood thinners; if you’re pregnant or nursing; if you have digestive system ulcers; or if you suffer from diseases of the liver or kidney.
You also will find supplements in the health-food store that combine various anti-inflammatory herbal extracts. Two that have been praised in a review of treatments published in the Clinical Journal of Pain are avocado/soybean unsaponifiables and Phytodolor, both from Europe. Unsaponifiables are a blend of sterols, pigments and other substances found in the oils of avocado and soybean, both well-recognized anti-inflammatory foods. (A daily dose of 300 mg soothes hip and knee osteoarthritic pain.) Phytodolor, which has a 40-year reputation of success in Germany, is a liquid extract of European aspen (Populus tremula), European ash (Fraxinus excelsior) and European goldenrod (Solidago virgaurea). It contains salicin and other anti-inflammatories that can help osteoarthritis and other joint conditions.
Glucosamine is a natural substance found in healthy cartilage and its surrounding fluid, and it may be needed for cartilage formation and repair. Clinical randomized trials show that glucosamine helps treat mild to moderate osteoarthritis of the knee and possibly other joints. It eases pain and tenderness, promotes long-term mobility, and may even alter disease progression. Supplements are derived from shellfish cartilage, and the standard dose of glucosamine sulfate—the only form of glucosamine proven effective so far—is 1,500 mg a day. (Most studies have used glucosamine sulfate supplied by one European manufacturer—Rotta Research Laboratorium.)
Chondroitin sulfate, another natural biochemical, forms part of a large protein that gives cartilage its elasticity. Often used with non-steroidal anti-inflammatory drugs, it can relieve pain and improve hip and knee function. Supplements come from animal cartilage; 1,200 mg daily is the standard dose.
Although it sounds reasonable to combine glucosamine and chondroitin in one supplement, as many manufacturers do, clinical studies have not shown conclusively that combinations work better. Preliminary results reported in the New England Journal of Medicine indicate that, over 24 weeks, a daily combination of 1,500 mg glucosamine hydrochloride and 1,200 mg chondroitin sulfate reduced pain by at least 20 percent in almost 80 percent of patients with moderate to severe knee osteoarthritis. But the supplement did not help those with mild arthritis, and neither substance alone performed better than placebo. However, this study has been criticized because it used glucosamine hydrochloride instead of the usual sulfate form. Sulfate may be important for cartilage formation and maintenance, and it is that form that practitioners use to relieve osteoarthritis pain. Clearly, more studies are needed. Meanwhile, when trying a new product, test it for about three months—if it doesn’t help your pain by then, consider switching.
As we age, we lose bone and muscle mass, and that puts extra strain on our joints. So it’s important to get enough of the musculoskeletal nutrients calcium, magnesium, phosphorus and vitamin D. These vital vitamins and minerals are easy to get simply by spending time outdoors and eating well. You only need about 15 minutes of sunshine several times a week (more if you have dark skin) for your body to produce the vitamin D it needs. In recent years, North Americans have begun experiencing widespread shortages of vitamin D because of sunshine avoidance, causing the collagen matrix in joint cartilage to break down and also resulting in poor mineralization of new bone tissue (rickets has even resurfaced in children). To easily get your other muscle- and bone-building minerals, eat dairy products, dark green vegetables, lean meats and fish, whole grains, eggs, and nuts and seeds.
Other important nutrients include copper, iron and selenium, all of which occur in the cartilage synovial fluid and are known to decline in those with rheumatoid arthritis. These are also available through the diet: Eat beans, peas, whole wheat, prunes, wheat germ and seafood.
Your joints also will benefit from an assortment of jewel-toned fruits and vegetables, as these are rich in antioxidants like carotenoids, anthocyanins, glutathione and vitamin C (also needed for collagen synthesis). When inflammation flares up, damaging free radicals are formed and antioxidants are rapidly depleted, so it’s not surprising that antioxidants help manage inflammatory conditions like rheumatoid arthritis. The Mayo Clinic found that the intake of certain antioxidant micronutrients (particularly zinc and the carotenoid beta-cryptoxanthin)—and, therefore, possibly diets high in fruits and cruciferous vegetables — actually might protect against rheumatoid arthritis. Beta-cryptoxanthin is a type of beta-carotene found in many orange and red fruits, such as papaya, mango, peaches and watermelon.
Avocado (Persea americana) is one of the richest sources of anti-inflammatory chemicals, and it is full of the antioxidant glutathione. Slice it up for a superb accompaniment to almost any meal.
Boswellia (Boswellia serrata) has anti-inflammatory and analgesic boswellic acids that may help relieve osteoarthritic knee pain. Take a 150- to 400-mg capsule or tablet (standardized to 30 to 65 percent boswellic acids) three times daily for two to three months.
Ginger (Zingiber officinale) helps mild pain from fibromyalgia and other arthritic conditions. You can take 1 to 4 grams powdered ginger daily, divided into two to four doses. Or enjoy in soups, stir-fries or tea. Roots contain gingeroles, capsaicin and curcumin, for analgesic and anti-inflammatory action.
Oregano (Origanum vulgare ssp. hirtum), rosemary (Rosmarinus officinalis) and thyme (Thymus vulgaris) are rich in analgesic and anti-inflammatory phytochemicals. Oregano has more than 30 anti-inflammatories, and rosemary and thyme help inhibit the inflammatory COX-2 enzyme. Sprinkle these onto just about any dish except dessert!
Pineapple (Ananas comosus) digests inflammatory precursors through the action of its enzyme bromelain, and it also contains the analgesic serotonin. It must be eaten fresh.
Soybean (Glycine max) may help cartilage synthesis and deter its breakdown in men. It has anti-inflammatory, anti-rheumatic and anti-arthritic actions.
Sunflower seeds (Helianthus annuus) and Brazil nuts (Bertholletia excelsa) supply S-adenosyl methionine (SAM-e), a chemical produced in the body that may relieve osteoarthritic pain and improve flexibility.
Turmeric (Curcumin longa) root contains anti-inflammatory curcumin and can help relieve rheumatoid arthritic pain.
Willow (Salix alba) bark tea soothes mild arthritic pain with analgesic salicin and other helpful compounds. But you’ll need several cups for the equivalent of two standard aspirin tablets.
Combating arthritis requires a comprehensive strategy for relieving pain, retarding inflammation and rebuilding joint tissues, muscles and bones. Herbs and supplements are great aids, but they should be coupled with a balanced diet, moderate exercise and a healthy body weight. Miracle solutions? No. But then, the fruits of sensible, persistent effort often seem miraculous.
Gina Mohammed, Ph.D., is a plant physiologist in Sault Ste. Marie, Ontario.
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