What is Arthritis?
Arthritis is an inflammation of the joints and surrounding joint structures (‘arthr’ denotes joint; ‘itis’ denotes inflammation). There are over 100 different types of arthritis, with osteoarthritis being the most common form.
Osteoarthritis is primarily a result of wear-and-tear due to aging, injuries, and repetitive or excess use, and affects up to 80 percent of people over the age of 55. It is a chronic and progressively degenerative, inflammatory joint condition characterized by pain, swelling, joint stiffness, limited mobility and, in its later stages, deformity. Other factors such as infection, structural trauma or joint misalignments can also lead to osteoarthritis, and diet, exercise and excess weight will impact its development.
Other common forms of arthritis include autoimmune-associated rheumatoid arthritis and psoriatic arthritis.
Understanding Joint Degeneration
A normal, healthy joint consists of a joint capsule lined with a synovial membrane, a very thin structure that produces synovial fluid. Synovial fluid is a nutrient-rich substance that lubricates and cushions the joints. Covering the inner joint surfaces is an articular surface made up of a thick layer of cartilage that prevents bone-on-bone contact. During joint degeneration associated with osteoarthritis, the joint structure loses water and the cartilage thickens and eventually softens due to loss of fluid. Small clefts begin to develop in the cartilage layer, eventually extending down to the bone. Proliferation of bone and cartilage may occur, leading to bone spurs (osteophytes) that cause further joint deformity. As joint degeneration progresses, inflammation of the synovial membrane leads to loss of normal range of motion and the muscles surrounding the joint become weaker, leading to greater instability and increasing pain.
Conventional Treatments for Arthritis
Many who live with arthritis find themselves reliant upon nonsteroidal anti-inflammatory drugs (NSAIDs) or prescription drugs such as COX-2 inhibitors. While these drugs are useful to manage pain, they can contribute to further joint deterioration and often have serious side effects.
Fortunately, a number of excellent natural remedies are available that can help to alleviate arthritic conditions. In fact, unlike their pharmaceutical counterparts, many of them go beyond providing only symptomatic relief and actually aid in repairing and healing damaged joints.
Natural Treatments for Arthritis
Everyday, we hear about the importance of nutritional choices upon health. What we put into our body plays a significant role in chronic degenerative conditions including inflammation and arthritis.
A nutritious, whole-food-based diet rich in fresh fruits and vegetables (especially leafy greens), high-quality protein, and healthy fats including essential omega-3 fatty acids offers excellent support in managing all types of inflammation. Equally important are minimizing those foods that promote inflammation such as processed foods, refined flour products (breads, pasta, muffins, bagels, pastries, refined cereals), sugar, red meat, alcohol, and trans-fats.
Regular, moderate exercise is important for maintaining ongoing joint mobility, increasing strength and flexibility, reducing joint pain, and improving energy and wellbeing. Exercise helps keep the surrounding muscles and tissues strong, providing support to the joints. Lack of exercise can actually make the joints worse by increasing pain and stiffness. As long as the exercise is within your ability (check with your doctor), it won’t aggravate joint pain or worsen the condition.
Herbs & Supplements
Herbal anti-inflammatories including turmeric, boswellia, devil’s claw, and yucca, along with joint-specific nutrients such as glucosamine, chondroitin sulfate, and methylsulfonylmethane (MSM) can decrease inflammation and help repair and rebuild damaged tissues.
Glucosamine is a precursor substance for glycosaminoglycans, long unbranched polysaccharides that are a major component of joint cartilage. It has been widely recognized as being beneficial for joint pain via several mechanisms:
- Stimulates proteoglycan synthesis which strengthens and repairs the cartilage matrix;
- Decreases damage to cartilage and joint structures by inhibiting the synthesis of proteolytic enzymes;
- Stimulates production of hyaluronic acid, an important component of synovial (joint) fluid which acts as a lubricant to reduce friction between joint surfaces during movement;
- Provides anti-inflammatory action.
Like glucosamine, chondroitin is comprise d of long chains of sugars. It also forms a significant part of the structural makeup of cartilage and plays an important role in joint health:
- Provides resilience to cartilage, enhancing its resistance to compression;
- Improves the quality of the synovial fluid;
- May help neutralize destructive enzymes in the joints.
MSM is a rich source of biologically active sulfur. It has been shown to help relieve the symptoms of joint pain through a natural anti-inflammatory action, though the mechanism of this action is not fully understood.
Omega-3 Essential Fatty Acids (EFAs)
The omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are derived from cold-water fish including sardines, mackerel, salmon, anchovies and cod liver. They are also found in algae such as chlorella, spirulina and schizochytrium. By definition, they are ‘essential’—the body cannot produce them so they must be obtained from our diet or by supplementation. Omega-3 EFAs are essential for growth and development throughout life; EPA is an especially important mediator for regulating inflammation in the body.
One of the most important supplements for arthritis—and good health in general—is vitamin C. Like the omega-3 fatty acids, vitamin C is also ‘essential.’ It is integral for the production of collagen, the most abundant protein in the body and found in all connective tissues including ligaments, tendons, and cartilage.
Along with vitamin C and the omega-3 fatty acids, minerals are also ‘essential.’ Minerals compose the very matrix of bones, teeth, joints, ligaments and many other tissues that make up our body - without them, we would literally fall apart!
Amongst the vital roles that they provide, minerals are important co-factors in thousands of enzymatic processes and assist in pH (acid-base) regulation and maintaining nerve transmission.
Bromelain (from Pineapple)
First introduced as a therapeutic supplement over fifty years ago, bromelain is a combination of proteolytic (protein-digesting) enzymes extracted from the stem of the pineapple. Bromelain is a natural anti-inflammatory whose action arises from its ability to block several pro-inflammatory mediators.
Boswellia (Boswellia serrata)
The tree from which the famous resin and incense of Frankincense is derived, Boswellia has been used in Ayurvedic medicine for millennia to treat inflammatory joint conditions. Boswellia contains several anti-inflammatory triterpenoids collectively called ‘boswellic acids’ (BA) which inhibit pro-inflammatory mediators including 5-lipoxygenase and leukotrienes. Studies have revealed a very positive synergistic effect through the combination of boswellic acids with glucosamine. The anti-inflammatory properties of glucosamine are greatly enhanced when these two ingredients are combined together.
Turmeric (Curcuma longa)
In the Ayurvedic tradition of India, turmeric has been used for over 4000 years for both its culinary and medicinal properties. It is one of nature’s most powerful anti-inflammatory herbs. According to a published study (Arthritis & Rheumatism, Nov. 2006), turmeric significantly reduced joint inflammation via the same COX-2 inhibition pathway that prescription anti-inflammatory medications target. Combining turmeric with piperine, an extract of Black Pepper, has been shown to enhance absorption and bioavailability of its many active compounds.
Devil’s Claw (Harpagophytum procumbens)
Native to Africa, devil's claw has a long tradition of use in the treatment of arthritic conditions. Though its name is derived from the appearance of its barbed, claw-shaped fruit, it is the underground tuber that is used medicinally. The tuber contains resin-like constituents (harpagosides) that exhibit an anti-inflammatory effect. Devil's claw has proven to be as effective as NSAIDs, and research has demonstrated its ability to inhibit pro-inflammatory COX-2-mediated prostaglandin and leukotriene release, as well as other mediators of cartilage degradation. Devil’s claw also serves as an excellent digestive stimulant due to its bitter properties. This quality contributes to its overall therapeutic value, as many degenerative conditions are associated with poor digestive function.
Yucca (Yucca spp.)
The root of the desert-loving yucca plant contains constituents collectively referred to as saponins. Structurally, these resemble steroidal hormones such as cortisol, a natural anti-inflammatory hormone produced by our adrenal glands. Through their ability to bind to cortisol-receptor sites in the body, it is theorized that saponins may evoke a similar anti-inflammatory response as cortisol. The saponins of yucca also limit the absorption of bacterial breakdown products (endotoxins) in the intestine. These toxins are released from the cell walls of dying bacteria and have been shown to inhibit the repair of damaged joints by interfering with the synthesis of joint cartilage. Because the intestinal health plays a significant role in many chronic conditions, it is important to maintain a balanced flora in the gut.
The therapeutic benefits of essential oils are often underutilized in the treatment of arthritis and other musculoskeletal conditions. Essential oils of birch and wintergreen provide a natural source of methyl salicylate, a powerful anodyne (topical analgesic). Ginger, juniper, and black pepper help to improve circulation at the site of injury or inflammation, removing toxic wastes such as lactic acid and improving the delivery of healing nutrients and oxygen. Lavender, cypress, and helichrysum provide soothing, pain relieving, and regenerative properties. The pressed oil of Tamanu seed, or the infused oils of arnica and St. John's wort, are excellent carrier oils for blending essential oils into for massage as they provide additional anti-inflammatory and therapeutic benefits of their own.