Osteoarthritis complimentary therapies
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
The most common form of arthritis is osteoarthritis. It is also the one where most people look for relief from alternative or complementary therapies.
Here are some alternative treatments that are occasionally recommended... These come from both the National Institutes of Health as well as the Arthritis Foundation.
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.
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.
It is the art and science, of using oils extracted from aromatic plants to enhance health and beauty. Essential oils can have subtle effects on the mind and emotions as well as physical benefits.
The ways to use essential oils in aromatherapy are many and varied. Baths, massage, inhalation, vapors, compresses and others may be used.
Certain scents are calming and relaxing for the majority of people. But most of you are probably asking if it works to relieve pain. Further studies are needed, but early clinical studies indicate that it may very well prove beneficial in treating chronic pain.
For the most part if used correctly aromatherapy is safe. A few people may suffer allergic reactions to the oils.
Ayurveda, the oldest medical system in the world, originated in India some six thousand years ago. The translation of the word means the knowledge (veda) of life (ayur). Today it remains a major form of healthcare in India, often used in conjunction with modern Western medicine.
Ayerveda is a holistic science that promotes health through an appropriate diet and lifestyle with a focus on exercise and personal hygiene. Mental discipline and control as well along with strict moral and spiritual values are considered prerequisites for good health. The success of the therapy depends on the person's willingness and ability to commit to the lifestyle.
In Ayurveda a person is viewed as a unique individual made up 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.
The Ayurvedic treatment is highly individualized, because the ancients believed that no two individuals are alike even when they suffer from similar disease. It is aimed at a cure, by balancing the forces, but does accept limitations.
Treatment involves strict diet changes, herbs, supplements, and exercises such as yoga. Meditation will allow the wisdom of the body to be heard. Fasting, laxitiives, vomiting, blood letting and other methods of removing toxins from the body may be recommended.
The element boron plays a key role in the chemical make-up of bones and joints through its effects on calcium metabolism. In areas of the world where dietary boron intake is usually 1 mg or less per day, the estimated incidence of osteoarthritis ranges from 20 to 70 percent, while in areas of the world where 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.
A new agent promoted for osteoarthritis treatment 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. Physicians should hesitate to advocate the use of this product until higher-quality clinical evidence has been published.
This has become a mainstream type of treatment for patients with osteoarthritis, particularly when the spine is involved. There is excellent data showing that acute low back problems respond well to chiropractic. There is less convincing data regarding the value of chiropractic for chronic spinal issues. How manipulation works is a subject of conjecture; however, there are legions of patients who agree that chiropractic has helped them. Therefore... it is worth trying.
Select a chiropractor based on reputation just as you would any other physician.
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. These results have not been replicated in any trials in the United States. Side effects include skin rash and pruritus; 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 the large clinical trial, called GAIT. It included more than 1,000 patients. The findings indicated that for mild OA, glucosamine was ineffective; however, for moderate to severe disease it appeared to have some beneficial effect. The study has been criticized since it didn't use the same type of glucosamine that is used most often.
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. The old hair of the dog. 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.
These were second on the list, prescribed for pain, anxiety, depression and improving attitude. These 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 that are low cost or covered by insurance. 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 guass. Refrigerator magnets are about 60 guass while magnets sold for pain relief range from about 300 to 4,000 guass.
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.
Yoga, tai chi and qi gong get high marks for doing double duty. These ancient Easter practices 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.
Prolotherapy is a treatment where a proliferant solution of natural substances is injected directly into the site where the weakened ligament attaches to the bone. These injections trigger the body's immune system to grow the 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:
• Degenerative Arthritis
• Lower back or neck pain
• Torn ligaments, tendons and cartilage
• Carpal Tunnel Syndrome
• Sports injuries
• Degenerated or herniated discs
Prolotherapy is known to have been in existence for more than 2500 years when Hippocrates used a somewhat crude but successful technique to treat the injured shoulder of a javelin thrower. More modern techniques were started in the 1930's and have gone through much evolution since then.
The collagen fibers of ligaments and tendons are flexible, but they do have their limits. In certain instances, they are injured. Pain is perceived when tension on these collagenous structures stretches them beyond their limits. This results in stimulation of pain transmitting sensory nerves.
The chief symptom of ligament and tendon injury is pain. The pain is aggravated by activity, when tension is placed on the injured ligament and tendon, and gets better when they are not under tension. Ligaament or tendon injury can result in muscle spasm and loss of range of motion or joint movement. When the ligament or tendon does not healon its own, 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 to stimulate cells called fibroblasts to make more collagen fibers. This in turn "strengthens" the "weld" of the ligament or tendon to the bone, and stabilizes the formerly 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. Often there is temporary numbness, tingling, or itching over the injection site. Piercing the skin with a needle always allows for the possibility of infection, although very few have ever been reported. For this reason, needle placement technique is important. Prolotherapy is generally a safe, effective, and highly successful technique when utilized appropriately.
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 un-blinded, 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.
SAMe is not cheap. Reported dosage ranges vary from 400 to 1,200 mg per day. 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 osteoarthritis complimentary therapies and related topics as well as...
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• 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...
Second Opinion Arthritis Treatment Kit
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