Conditions

Osteoarthritis

Osteoarthritis, also called degenerative joint disease, involves deterioration of the cartilage protecting the ends of the bones. It is sometimes caused by injury or an inherited defect. More commonly, it is a result of the wear and tear of aging, diet, and lifestyle.

Osteoarthritis causes the cartilage to begin to breakdown and become pitted and irregular. The tendons, ligaments, and muscles holding the joint together become weaker and the joint becomes deformed, painful and stiff. As osteoarthritis advances, bony outgrowths called osteophytes (spurs) tend to develop.

Signs and Symptoms:

• Morning stiffness or stiffness after inactivity for less than 15 minutes
• Joint pain, worsened by movement and improved with rest (in severe cases, constant pain)
• Soft tissue swelling
• Crackling noise with movement
• Bone spur formation
• Limited range of motion
• Incomplete or partial dislocation

Diagnosis:

Your doctor may make a diagnosis from a physical exam and medical health history. He or she may order one of the following imaging procedures:

• Magnetic resonance imaging (MRI) for diagnosis and evaluation of osteoarthritis of the spine. MRI is not particularly helpful in evaluating peripheral osteoarthritis.
• X rays can detect joint space narrowing as cartilage is lost, bony sclerosis, bony cysts, osteophytosis
• Arthroscopy - to diagnose osteoarthritis

Treatment Options:

The goals of treatment are to reduce pain, minimize disability, and maintain range of motion and mobility.

Traditional Treatments:

• The normal treatments involve a combination of painkillers and anti-inflammatory drugs, including over-the-counter medication - acetaminophen (Tylenol, Datril, etc.), aspirin (Bayer, Ecotrin, etc), and nonsteroidal anti-inflammatories (NSAIDs) ibuprofen (Advil, Motrin IB, Nuprin, etc), ketoprofen (Orudis), and naproxen (Aleve).
• Other nonsteroidal anti-inflammatories are available with prescription ­ diclofena (Voltaren), diflunisal (Dolobid), fenoprofen (Nalfon), indomethacin (Indocin), piroxicam (Feldene), and tolmetin (Tolectin).
• Higher strengths of painkillers are also available with prescription ­ ibuprofen (Motrin, Ibu-Tabs), ketoprofen (Oruvail), and naproxen (Anaprox, Naprelan, Naprosyn).
  Warning: Severe side effects can occur with these medications, including ­ ulcerations and bleeding of the gastrointestinal tract, kidney damage, liver dysfunction, abdominal pain, indigestion, constipation, diarrhea, nausea, mouth sores, headache, dizziness, itching, rashes, ringing in the ears, bloating, shortness of breath, and palpitations)
• Carafate, a drug that is commonly prescribed for ulcers, can give the same relief as aspirin or an anti-inflammatory without stomach lining damage.
• A supervised exercise program may be prescribed to improve joint function without aggravating the situation.
• Injections of synthetic corticosteroids into the most affected joints are sometimes prescribed.
• In severe cases where pain or lack of mobility becomes unbearable, joint-replacement surgery may be recommended.

Complementary and Alternative Therapies:

Alternative therapies can help improve joint function and decrease inflammation by providing nutritional, herbal, and lifestyle support.

Nutritional Supplementation:

• Take a good multivitamin and mineral complex daily, to correct any possible deficiencies.
• Bromelain (derived from pineapple) has a notable anti-inflammatory action. Take 200 to 400 mg three times daily, between meals.
• Doctors are sometimes prescribe fish oil, flaxseed oil and others that contain essential fatty acids. Fatty acids increase the production of anti-inflammatory prostaglandins. Take 500 to 1,000 mg of any of these oils, twice daily. (May take several weeks to see improvement)
• Chondroitin sulfate provides nutritional support for strengthening joints, ligaments and tendons. Take 500 ­ 1,000 mg daily.
• Glucosamine has been shown to be an effective natural means of slowing cartilage breakdown and encouraging cartilage repair. Take 500 mg of glucosamine sulfate three times daily.
• Sea cucumber is a rich source of specific lubricating compounds found abundantly in all connective tissue, especially the joints and joint fluid. Take as directed on label.
• Many people with arthritis are deficient in manganese, which is necessary for normal skeletal development. Take 5 mg, twice daily, for one month.
• Methylsulfonylmethane (MSM) is a natural source of sulfur, which can help relieve arthritis pain and maintain joint health. Take 500 mg, three or four times daily, with meals.
• Silica supplies silicon, which is important for the formation of apatite crystal, the primary constituent in bone. Take as directed on label.
• Shark cartilage may be useful in treatment of arthritis. You should consult your doctor before taking shark cartilage as it may inhibit the formation of new blood vessels.
• Studies have shown that supplementation with pantothenic acid (a B vitamin) can improve symptoms of pain, stiffness, and limitation of motion. Take 100 to 250 mg of pantothenic acid twice daily for three weeks.
• Selenium is a powerful antioxidant that fights free-radical damage. Take 200 mg of selenium daily.

Alternative Therapies:

• If you have swelling and are retaining water, try the following: 250 to 500 mg of bladderwrack two or three times daily, 250 to 500 mg of horsetail twice daily, and 250 to 500 mg of juniper berry twice a day.
• Tiger balm (an over-the-counter rub that contains many common herbal remedies), along with other preparations such as heat, may ease pain and stiffness.
• Dolorac and Zostrix can be helpful in relieving pain and stiffness.
• Devil's claw is a good anti-inflammatory agent. Take 1,000 mg twice daily.
• Feverfew has been used for centuries for arthritis. Take 250 mg one or twice daily.
  Caution: Do not use feverfew while pregnant.
• Yucca also has anti-inflammatory action. Take 2,000 mg twice daily.
• Cayenne can be used in poultices and mixed with wintergreen oil to make a topical paste that will help diminish pain. Cayenne can also be taken in capsule form.
• The homeopathic treatment, rhus toxicodendron, will help if you feel better with movement, such as after a short walk.
• Consult a homeopathic practitioner for a constitutional remedy that's tailored to your specific symptoms.
• Du Huo Jisheng Wan is an herbal Chinese patent combination formula designed to support joint health.
• Noni has been used for over 2,000 years for pain, arthritis, and other health problems.
• Alfalfa contains all the minerals that are essential for bone formation and it may be helpful in treating arthritis.
• Olive leaf extract is good for infectious arthritis.
• Soothing aromatherapy baths and massages can help to ease the pain and inflammation of arthritis. Choose one or more of the following essential oils to add to bath water or massage oil: basil, black pepper, eucalyptus, myrrh, and pine.
• Phytodolor from either PhytoPharmica or Enzymatic Therapy is a patented blend of ash bark, aspen bark and goldenrod. It has been used in Germany for more than thirty years.
  Caution: Do not use this formula if you are sensitive to salicylates.
• Many people claim they get relief by wearing copper or magnetic bracelets, however there are no studies to support their use.
• Tumeric contains curcumin, which has anti-inflammatory and pain-relieving properties. Take 600 mg daily.
• Cat's claw is helpful for relieving arthritis pain. Caution: Do not use cat's claw while pregnant.
• Ginger is a powerful antioxidant that has anti-inflammatory effects.
• Dimethylsufoxide (DMSO), a byproduct of wood processing, is a liquid that can be applied topically to relieve pain, reduce swelling, and promote healing.
  Other beneficial herbs include brigham tea, willow bark, buchu leaves, burdock root, celery seed, corn silk, nettle, and parsley tea.

General Recommendations:

• Eat more sulfur-containing foods, such as asparagus, eggs, garlic and onions.
• Exercise can both increase ease of movement and reduce pain and stiffness. Gentle stretching exercises, mild yoga, and tai chi can all be helpful.
• Maintain a healthy weight for your height.
• Try using cold gel packs for relief of pain as these retain cold for long periods when frozen. Alternate with applications of heat.
• In the morning take a hot shower or bath to help relieve morning stiffness.

Warnings:

• Silicone gel breast implants and other silicone prostheses may cause arthritis-like symptoms, such as swelling of joints, contractures, fever, chronic fatigue and pain.
• Lyme disease can mimic arthritis.
• Pregnant women should not take cat's claw or feverfew.
• Those people who sensitive to salicylates should not take phytodolor.
• Many traditional remedies have serious side effects. Discuss all options with your doctor and make sure you are aware of all the possible complications.