Conditions

Rheumatoid Arthritis

Rheumatoid arthritis is classified as an autoimmune disorder, a result of the immune system mistakenly attacking the body's own tissues. Rheumatoid arthritis begins with irritation and inflammation of the synovial membrane, causing pain, stiffness, and swelling. The inflamed membrane responds by sending out enzymes that cause the cartilage of the joint to break down. The cartilage is then replaced with fibrous tissue that can calcify and form bony knobs that may fuse the joint and restrict movement.

Signs and Symptoms:

• Multiple joints may be involved
• Warmth
• Redness
• Pain
• Stiffness (often improving during the day)
• Development of rheumatoid nodules (roundish lumps that occur under the skin)
• Possibly signs of inflammation in other parts of the body

Diagnosis:

Diagnosis hinges on the presence in the blood of a specific protein called rheumatoid factor, the development of rheumatoid nodules, and, possibly signs of inflammation in other parts of the body, including the heart, lymph glands and other sites.

Treatment Options:

Treatment is typically aimed at relieving symptoms, preventing joint degradation, and preserving joint function.

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.
• For rheumatoid arthritis, alternating applications of heat and cold, alternating rest and exercise therapies, and splints and other assertive devices may be prescribed.
• 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.
• A chemotherapy drug, methotrexate (Rheumatrex) helps people with rheumatoid arthritis and can be effective within about a month of treatment, sometimes highly so. However, it is also highly toxic, causing bone-marrow suppression, liver damage, and sever lung damage, among other serious side effects.
• If other drugs have failed to treat rheumatoid arthritis, doctors will sometimes prescribe gold salts (most often administered by injection). These drugs include ­ aurothioglucose (Solganal), gold sodium thiomalate (Mychrysine) and auranofin (Ridaura). As with methotrexate, its mode of action is unknown and side effects are serious.
• Hydroxychloroquine (Plaquenil) is also used in some cases of rheumatoid arthritis. It's effective in less than half the cases treated and can take up to 6 months for effect; however, it is considered less toxic than some other drugs used for this condition.
• Penicillamin (Cuprimine, Depen) is another drug that may be prescribed for rheumatoid arthritis. As with all the others, the mode of operation is unclear and the side effects can be substantial.
• Sulfasalazine (Azulfidine) is a highly toxic treatment that is sometimes used when other therapies have failed.
• If none of the standard treatments work, your doctor may recommend more experimental treatments that are deliberately aimed at suppressing the immune system. Some of these are cyclophosphamide (Cytoxan) or chlorambucil (Leukeran). These are cancer chemotherapy drugs with extremely powerful and serious side effects.

Complementary and Alternative Therapies:

The goal of alternative therapy is to decrease inflammation and preserve joint function.

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 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, 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.