Natural Medicine Q&A
Ask Dr. P
by Kasra Pournadeali, ND
Natural Medicine Specialist
After giving a talk to a local senior group about Alternative Medicine, I found myself inundated with questions about natural treatments for Osteoarthritis. I had just reviewed some of the scientific literature available on arthritis, so I was prepared with all my statistics. I guess I shouldn't have been surprised that most of the participants wanted to know what results I had seen clinically, regardless of the literature. To answer: I've seen natural therapies work for most of my patients with arthritis, the exception being a few who had end-stage disease. These patients had just waited too long to start with natural therapies, although they still benefited by preventing arthritis progression in other joints. Also, when surgery is necessary, nutrition and herbal therapies can help a person make an optimal and more rapid recovery.
Q: Why should I use natural approaches for arthritis?
You need to better understand the conventional medical approach. Aside from surgery for the most severe cases, NSAIDs or Non-steroidal anti-inflammatory drugs are what is recommend. They work by suppressing the perception of pain, and inhibiting inflammation. They have undesirable side effects however, and can interact with many drugs like antacids, blood pressure medications, diuretics (water pills), diabetes drugs, blood thinners, and some antibiotics. The most common side effect of NSAIDs is gastrointestinal bleeding which occurs to some extent in everyone who uses them. Less common side effects are liver or kidney damage, and bone marrow suppression. What's perhaps most important is that NSAIDs only control pain; they cannot induce remission of arthritis, and in fact, promote the destructive process by interfering with cartilage repair. This is well documented in the scientific literature. So the answer to your question is simple: NSAIDs only control pain. They do not treat the arthritis, and promote its progression by inhibiting normal joint cartilage repair. Plus, NSAIDs have significant side effects and risks with use.
Q: What are the natural treatments for osteoarthritis?
First, Prevention: Diets rich in whole, unprocessed foods, fruits, vegetables, and fiber, low in animal products (with the exception of fish), low in sugar, caffeine, alcohol, and saturated fat, correlate with decreased incidence of arthritis. Elimination of food allergies/ intolerances can reduce joint inflammation as documented in several studies. Achieving optimal body weight, is also helpful by reducing joint load. Finally, reducing further damage to the joints, part of which involves oxidant damage through either supplements or diet rich in antioxidants and flavonoids, is recommended.
Second, Treatment: Numerous double-blind studies showed Osteoarthritis was inhibited and reversed with Glucosamine Sulfate. Glucosamine, a natural substance and precursor (or building block) for joint cartilage has also been shown to be more effective than NSAIDs in reducing pain and inflammation. Glucosamine usually takes longer than NSAIDs to reduce pain because Glucosamine has no analgesic (or pain reducing) activity. Glucosamine works by improving the joint structure, so pain is relived as healing occurs. This is unlike NSAIDs, which just block pain perception, while joint destruction continues. Other natural approaches such as physical therapy, niacinamide, omega 3 oils, vitamin E, S-adenosylmethionine (SAM), and plant medicines such as Zingiber o., Boswellia s., Curcuma l., Bromelain, Harpagophytum p., Yucca, and Capsaicin are sometimes also helpful. Your Naturopathic Physician will help you determine which treatments are appropriate for you.
Are all glucosamine products the same?
No. A problem with natural medicine is that regulation of product quality is up to manufacturers some of which are less reputable than others. This means one glucosamine may not be equivalent to another. For example: One woman I saw, who had been on high dose glucosamine for over a year had only minimal effects. Her x-rays showed only mild osteoarthritis, so theoretically she should have been getting more benefit. I recommended she change her glucosamine to a higher quality one, from a more reputable company. On the new glucosamine, at an even lower dose than before, she had complete resolution of all her arthritic symptoms in a few weeks. I've seen this happen in a several of my patients taking cheaper natural products recommended by non-physicians. They just don't achieve the same benefit.
Does Chondroitin sulfate work?
Chondroitin, like glucosamine, also a precursor for joint cartilage, potentially could help cartilage repair. However, it has a larger molecular structure, is not thought to be well absorbed, & has not been as studied as extensively as glucosamine. Many people do claim some benefit, so I'm keeping an open mind.
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