Complimentary therapies for musculoskeletal disease
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
One word before we start... the correct spelling is "complementary" when it comes to discussing alternative medical therapies...
Mainstream medicine has failed the expectations of many patients. The reason? Too much emphasis on the hard science and not enough emphasis on the healing of the spirit. That is why complementary therapies have become so popular. While each patient, situation, and doctor is different, there are some therapies that most experts agree may be helpful.
Here are the alternatives they generally recommend for arthritis patients.
According to the National Institutes of Health (NIH) Consensus Statement on Acupuncture, it "is a component of the health care system of China that can be traced back for at least 2000 years. The general theory of acupuncture is based on the premise that there are patterns of energy flow through the body that are essential for health."
In Chinese medicine this life energy is known as qi (pronounced chee) and flows through invisible channels known as meridians. Illness can cause an imbalance in qi, and an out of balance qi can cause pain or illness. The acupuncturist is able to influence health and sickness by stimulating certain areas along these meridians to restore the flow of qi. Specific points on the body are stimulated by inserting hair-fine needles, with pressure, or with mild electrical pulses.
A number of controlled trials have been conducted during the past several decades that suggest acupuncture is effective for the treatment of pain associated with osteoarthritis. Reports of at least seven published clinical trials have reported that acupuncture is effective in treating fibromyalgia pain. However, studies have yet to prove acupuncture has a positive effect on rheumatoid arthritis.
It is an invasive medical procedure and the risks of bleeding and infection are always present, however if a qualified practitioner does it correctly, problems are very rare. The NIH Consensus Panel on Acupuncture states that the occurrence of adverse events in the practice of acupuncture has been documented to be extremely low.
It's recommended for pain control, and paid for by some insurers and HMOs.
The balance of the following information comes from the Arthritis Foundation...
This practice uses oils extracted from aromatic plants to improve health. Essential oils can have gentle... almost subliminal, effects on the mind and emotions as well as provide bphysical benefits.
Oils can be administered as baths, massage, inhalation, vapors, compresses, and so on.
Further studies are needed, but early clinical studies indicate that it may very well prove beneficial in treating chronic pain.
If used correctly aromatherapy is safe. A few people can suffer allergic reactions to the oils.
Ayurveda is the oldest medical system in the world, originating in India more than six thousand years ago. The translation of the word means the knowledge (veda) of life (ayur). Today it is still used in India, often along with modern Western medicine.
Ayerveda promotes health through diet and lifestyle with a focus on exercise and personal hygiene. Mental discipline and spiritual control are considered necessary for good health.
In Ayurveda a person is viewed as an individual consisting of 3 forces: vata, the force symbolized by air, pitta, the force symbolized by fire, and kapha, the force symbolized by water. An imbalance of these forces causes disease.
Ayurvedic treatment is aimed at balancing the forces.
Treatment involves diet changes, herbs, supplements, meditation, purging, and exercises such as yoga.
The element boron is a constituent of bones and joints and has a permissive effect on calcium metabolism. Where dietary boron intake is usually 1 mg or less per day, the estimated incidence of osteoarthritis ranges from 20 to 70 percent, while when boron intake is 3 to 10 mg per day, the incidence of osteoarthritis is only zero to 10 percent. Evidence from one small, double-blind, randomized, placebo-controlled trial suggests that boron supplementation may benefit patients with osteoarthritis.
An agent promoted for osteoarthritis is cetyl myristoleate, a material synthesized from cetyl alcohol and myristoleic acid. The rationale for its use in osteoarthritis stems from the hypothesis that cetyl myristoleate may inhibit the cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism and, therefore, decrease production of pro-inflammatory prostaglandins and leukotrienes.
Dimethyl Sulfoxide (DMSO)
Dimethyl sulfoxide (DMSO), a sulfur-containing substance produced from wood pulp, has been used topically for relief of osteoarthritis symptoms. It is a scavenger of reactive oxygen species, and it functions as an anti-inflammatory agent.
One study conducted in Germany examined the effect of percutaneous treatment with DMSO in patients with osteoarthritis. In this double-blind, placebo-controlled study, daily use of a 25-percent gel preparation of DMSO for three weeks resulted in improvement in pain symptoms during activity and at rest. Side effects include skin rash and itching; drug interactions are unknown. DMSO is available as a gel, liquid, or roll-on.
This "therapy" is free, has no side effects and is guaranteed to make you feel and look better, experts agree. But it's probably the hardest of all therapies for people with arthritis to maintain. The Arthritis Foundation offers classes and videos to help get you going. For more information contact your local Arthritis Foundation chapter.
Ginger (Zingiber officinale), obtained from the root of the ginger flower, has been used in Ayurvedic medicine (a traditional Hindu system of medicinal practices using combinations of herbs, purgatives, rubbing oils, etc.) for the treatment of inflammation and rheumatism. It is believed that ginger inhibits prostaglandin and leukotriene synthesis. A recent randomized trial comparing ginger and ibuprofen showed greater efficacy of ibuprofen and no significant difference between ginger and placebo. No side effects or drug interactions have been reported.
Glucosamine and chondroitin sulfate, two naturally occurring substances found in the joints. Glucosamine is synthesized in the body and is one of the building blocks of cartilage, which becomes degraded in osteoarthritis. Chondroitin is also a part of cartilage and may also block enzymes that degrade cartilage.
A few studies have been done, most with results favoring the supplements. One compared glucosamine to ibuprofen, a commonly prescribed NSAID. The results of this study showed glucosamine to be more effective at relieving the pain of OA. It should be noted that 10% of the ibuprofen subjects dropped out of the study because of a variety of adverse reactions to the medication, whereas no subjects in the glucosamine group dropped out for drug-related reasons. Another large, multicenter, randomized, double-blind, placebo-controlled trial study of 150 patients showed that fifty-five percent of the glucosamine group were responders compared with 33% of the group receiving placebo. Very few studies have been done on chondroitin sulfate, which is usually sold in combination with glucosamine.
The National Institutes of Health sponsored a large clinical trial (GAIT), including more than 1,000 patients. This has been felt to be a "negative" study; however, the moderate to severe group of OA patients did show improvement. Also, the glucosamine preparation was different from that used in other clinical trials.
Side effects of the combination seem to be relatively minor. Most often reported are GI complaints, which often can be avoided by taking it with food or switching brands. There is some concern that glucosamine can raise the blood sugar of diabetics and that chondroitin sulfate may enhance the blood thinning effects of anticoagulants. Diabetics and people taking coumadin or heparin should be observed for these side effects.
Herbs and Dietary Supplements
All rheumatologists urged caution in using supplements and varied greatly in what they recommend. Two they agreed on: glucosamine and/or chondroitin, which may relieve osteoarthritis pain and stiffness and possibly stop further cartilage loss; and omega-3 oil (such as in fish or flaxseed oil) to ease inflammation. Others are undergoing study and may be helpful. Only time will tell.
Homeopathy is probably the form of alternative treatment that confuses conventional science the most. The confusion is because it violates every known law of chemistry and physics. Yet many claim it works.
Homeopathy uses diluted portions of natural substances to cure symptoms of disease. The more diluted the substance, the better. The treatment is aimed at revving up an invisible life force or vital energy. At first this may actually stimulate the symptoms, which homeopaths consider good. They believe symptoms are the body's way of healing itself.
Homeopathic practitioners also believe that illness is unique for each person. Two people with the same condition may be treated very differently.
Homeopathy is based on a very unusual group of ideas:
Like cures like. You can cure a problem with a little bit of the same thing that caused it. They take very diluted doses of substances that in large doses would produce the symptoms you are having. This is called The Law of Similars. As an example, large amounts of coffee would make you wired and excitable so they use tiny diluted amounts to treat insomnia. The system of healing by "similars" dates back to the Greek physician Hippocrates in the 5th century BC and was modernized in the 1790s by a German physician named Samuel Hahnemann. Some modern conventional medical treatments, such as allergy treatments and immunizationa, act on the same theory.
Nothing may be something. The substances used are so diluted that they may contain one millionth of a drop of the active ingredient. A standard remedy may be made by taking a single drop of a plant substance and mixing it with 100 drops of water. After that a drop of this mixture is added to 100 drops of water. This process may be repeated as many as 30 times. They call the result a 30C dilution-30 separate 100-1 dilutions.
Water with a memory. The dilutions have to be shaken not stirred. (like a martini??) They claim this leaves an imprint of the substance on the water molecules so it remembers whatever was in it before.
The healing crisis. The part of homeopathy that many find frightening is that you have to expect your symptoms to get worse before they get better. This makes sense when you look at the belief that a symptom is the body's way of healing itself.
Antidotes. Many homeopaths claim that if a remedy doesn't work you are simply using the wrong remedy. Others call that a convenient excuse. Other homeopaths believe you can mess things up by taking an antidote that counteracts the remedy. For example, coffee may antidote certain dilutions. Other antidotes can include electric blankets, xrays, mint, prescription drugs, even acupuncture.
While some regard this as just a "feel good" passive treatment, our experts say the many kinds of massage can help break the pain cycle and help you feel good enough to exercise. Be sure the therapist is qualified to work with your kind of arthritis. And make sure this is real massage therapy... not the kind that provides a "happy ending."
These are prescribed for pain, anxiety, depression and improving attitude. The practices involve focusing and quieting the mind and body, and include meditation, visualization, deep relaxation, deep breathing, hypnotherapy and the moving meditations. These techniques may be taught through stress reduction programs. Once learned, they cost nothing to practice and have no side effects.
The use of magnets for pain relief dates back to the days of Cleopatra. Rumor has it that she slept on a magnet stone to prevent aging.
There are several theories on how exactly magnets work to relieve pain, but no one really knows for sure. Magnets come in different strengths, which is measured in gauss. Refrigerator magnets are about 60 gauss while magnets sold for pain relief range from about 300 to 4,000 gauss.
Therapeutic magnets are sold in many forms.
One study conducted by Dr. Carlos Vallbona at Baylor's Institute for Rehabilitation Research in Houston studied the effect of magnets on 50 post-polio patients. It showed that 76% of the study participants had a significant decrease in pain after using magnets, while only 19% of those using the fake magnets claimed improvement.
More studies are needed; there is no proof that magnets are effective on any type of arthritis pain... other than acting as placebo.
Yoga, tai chi and qi gong exercise the body and the mind, and calm the spirit. They improve balance, mood and strength. They are low cost, but be sure to get a referral to a teacher who is trained to work with people with arthritis and related conditions.
MSM stands for Methyl Sulfonyl Methane, an organic sulfur. Marketers claim it treats everything from arthritis to constipation; it even helps you grow longer fingernails.
It seems unlikely that any one supplement could treat so many things. It is supposedly a substance that is naturally found in fresh fruits and vegetables, milk, fish and grains. It is lost during processing of these foods, so we need to ingest it as a supplement.
No scientific studies have been done on humans, but MSM did ease rheumatoid arthritis like symptoms in mice. Even the doctor who developed MSM, Stanley Jacob, MD, acknowledges that the "arthritis cure" claims are over-hyped. While Dr. Jacob stands by the many benefits of MSM, he does point out that it's not a "cure."
It does appear to be safe; no toxic effects have been noted, though studies are needed.
Prolotherapy is a treatment where a proliferant solution is injected directly into the site where the weakened ligament attaches to the bone. These injections trigger the body's immune system to grow new, healthy tissue that properly stabilizes the bones and joints, relieving musculoskeletal pain and stiffness. Prolotherapy is one of the treatments for chronic pain and many other conditions, including:
Lower back or neck pain
Torn ligaments, tendons and cartilage
Carpal Tunnel Syndrome
Degenerated or herniated discs
Collagen fibers of ligaments and tendons are flexible, but they do not stretch very far. In certain instances, they are frayed or even torn by injuries. Pain is perceived when otherwise normal tensions on these collagenous structures stretches them beyond their normal limits of motion. This in turn results in abnormal tension and stimulation of pain transmitting sensory nerves, because these nerve fibers are not meant to stretch.
Thus, the chief symptom of ligament and tendon relaxation is pain. The pain is aggravated by activity, when tension is placed on the injured ligament and tendon, and usually subsides when they are not under tension. This painful stimulation can result in muscle spasm, pain, and loss of range of motion. Prolotherapy is used to assist the healing process.
The treatment consists of the injection of a proliferant solution into the ligament or tendon near the attachment to the bone. The solutions cause a controlled inflammation at the site of injury. Cells called fibroblasts are stimulated to make more collagen fibers. This in turn "strengthens" the attachment of the ligament or tendon to the bone, and stabilizes the loose and painful connection.
As with many treatments, prolotherapy is not without risks or side effects. Since intent of the technique is to create a specifically localized inflammation, pain, swelling, redness, soreness, temporary stiffness, and bruising at the injection site are normal. Infection is always a risk when a needle is used; however, this is rare. In trained hands, prolotherapy is a safe, effective, and highly successful technique.
S-adenosylmethionine (SAMe) is a naturally occurring compound found in all living cells that is commercially produced in yeast-cell cultures. A methyl donor, it is important in methylation reactions that aid in the production of cartilage proteoglycans. SAMe has been available by prescription in Europe since 1975, where it is used to treat arthritis and depression. A number of studies have found SAMe to be more effective than placebo in improving pain and stiffness related to osteoarthritis. However, many of these studies were non-randomized, uncontrolled, and unblinded, and some were flawed statistically. No studies documenting disease arrest or reversal are found in the literature. There is, however, some evidence that SAMe is often as effective as NSAIDs, with a lower incidence of side effects.
Side effects include occasional gastrointestinal disturbances, mainly diarrhea.
Patient education and empowerment are tops with integrative doctors. They recommend self-help courses to virtually every arthritis patient. These courses, offered for minimal fees in many places by the Arthritis Foundation, provide information and support and teach coping skills to help take control of the disease.
Get more information about complementary therapies for musculoskeletal disease as well as...
• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!
• Devastating ammunition against low back pain... discover 9 secrets!
• Ignored remedies that eliminate fibromyalgia symptoms quickly!
• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!
• The stiff penalties you face if you ignore this type of hip pain...
• 7 easy-to-implement neck pain remedies that work like a charm!
• And much more...
Click here Second Opinion Arthritis Treatment Kit
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