I’ve had arthritis in my ankle for two years, and I’ve tried all sorts of remedies. I drink green tea and use vitamins C and E, omega-3s, devil’s claw, calcium, ginseng, ginkgo, echinacea, glucosamine, and chondroitin. Recently, my doctor told me the only way to fix my ankle is to fuse it, leaving my right foot about dead and I wouldn’t be able to drive, etc. I don’t want it fused. Please help!-- M. B. (White River Junction, Vermont)
Rountree responds: In the absence of an X-ray report or physical exam, it is difficult to know whether your doctor’s recommendation is the “only” effective solution. An ankle fusion is usually performed only as a last resort. I would definitely consult an orthopedic surgeon for a second opinion. You might also want to consult with a physiotherapist to find out if any physical modalities might be helpful. Acupuncture is also worth trying.
Arthritic pain results when the cartilage that lines the joint surface becomes eroded, exposing the underlying bone. Nutritional supplements such as glucosamine and chondroitin are not pain-killers; instead they work by attempting to rebuild damaged cartilage. If the erosion is too severe, they may be ineffective. In that case I recommend S-adenosylmethionine, also known as SAMe. The supplement is derived from naturally occurring substances. Its anti-arthritic effect was discovered as a secondary benefit in patients who were taking it as an antidepressant. The dose is 200 mg four times daily. It may take up to a month to work.
Another option is boswellia (Boswellia serrata). It has anti-inflammatory properties comparable to prescription medications. It is commercially available as an extract standardized to contain 37.5 percent boswellic acids; take 400 mg three times daily. Boswellia is usually prescribed in combination with curcumin, an extract of turmeric (Curcuma longa). Curcumin is a potent anti-inflammatory in its own right. The dose is 400 to 500 mg three to four times a day.
Keville responds: You’ve certainly done your homework looking into the appropriate remedies. There are several others that may work, or may not. I think your best bet is to find a holistic practitioner who can work with you personally. Chronic problems such as yours always respond faster and better when someone customizes a healing protocol. The practitioner can take into consideration all your physical strengths and weaknesses, and then design a remedy just for you. Consider a practitioner of Traditional Chinese Medicine who can give you acupuncture as well as herbs. Hopefully it won’t come to having your ankle fused (but don’t rule out driving if this does happen because there are ways to adapt the gas pedal).
The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.
Kathi Keville is director of the American Herb Association (www.jps.net/ahaherb) and the author of eleven herb and aromatherapy books including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.
Robert Rountree, M.D., is a physician in private practice in Boulder, Colorado, where he practices integrative medicine. He is coauthor of Smart Medicine for a Healthier Child (Avery, 1994) and Immunotics (Putnam, 2000) and is an Herb Research Foundation advisory board member.
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