By Karta Purkh Singh Khalsa

REMEDIES FOR OSTEOARTHRITIS

This condition can be as painful as stepping on broken glass, but herbal and complementary treatments, combined with massage, can work wonders.

Photos By Leonard Gertz

cont'd....

Saint-John's-Wort Flowering Tops (Hypericum Perforatum)--Nature's Medicine For Connective Tissue And Nerve Injury
Saint-John's-wort has become the all-time phenomenon of the natural healing world. Expanding from anonymity to becoming a household name in a few short years, it has become a mainstay in the self-care armamentarium. The flowers of this herb are commonly used for mild to moderate depression.

Hypericum is an ancient medicine, however, and has been used in Europe for hundreds of years. Clinically, European and North American herbalists use the herb to benefit mild painful conditions, including arthritis, neuralgia, sciatica and muscle inflammation.50

The typical dose is 2-5 grams of raw herb, 10-15 milliliters of tincture, or 900 milligrams of standardized extract (0.3 percent hypericin) per day.

Feverfew Leaf (Tanacetum Parthenium)--The Aspirin Of The 18th Century
This popular decorative relative of the daisy, sometimes called the "aspirin of the 18th century," has been rediscovered. Traditionally used in European herbalism for all types of pain, such as menstrual cramps, headache and arthritis, this remedy has gotten serious attention recently as a migraine preventive. Taken daily, it significantly reduces the incidence of migraine attacks, according to several studies.

Some herbalists are now reviving the historical use, recommending feverfew for acute pain, including arthritis flares and headache.51,52 Often, it is taken in doses of 300 milligrams every 15 minutes for an hour when the pain starts. Feverfew can produce a little queasiness, so work the dose up cautiously.

For migraine prevention, herbalists often begin with 125 milligrams per day, and work up to the dose that gives the best prevention, but larger doses may be necessary to control arthritis pain.

Newcomers To Watch For--Thunder God Vine Root (Tripterygium Wilfordii) ("Lei Gong Teng") And Butterbur Root And Leaf (Petasites Hybridus)
Thunder god vine root is used in the modern practice of Chinese medicine. As evidence for its effectiveness mounts, it is gradually gaining attention from herbalists. Although still obscure here, more than 200 studies of thunder god vine have been published in scientific literature.

Thunder god vine is used primarily in treating autoimmune diseases, such as rheumatoid arthritis, in which it is a successful substitute for corticosteroid drugs.61 In one multicenter study of rheumatoid arthritis involving 226 patients, overall effectiveness of the remedy surpassed 90 percent.62 Studies have shown the herb to inhibit the function of immune effector cells, such as neutrophils, macrophages and B lymphocytes. A recent study from China sought to investigate the mechanism of action for Tripterygium. In this test-tube study, researchers determined that the herb was immunosuppressive in autoimmune diseases.63

A 2000 scientific article written by the Arthritis Center at the University of Texas Southwestern Medical Center in Dallas confirmed that accumulated data from the clinical trials suggest efficacy of this treatment in a number of rheumatic diseases, including rheumatoid arthritis and systemic lupus erythematosus.64 The article indicates that the immunosuppressive and anti-inflammatory effects suggest that diterpenoid compounds account for the therapeutic effects.

While most of the research on this herb suggests uses for inflammatory arthritis, some OA patients find that it benefits their condition.

Thunder god vine contains some components, apparently unrelated to the active ingredients, which make the herb tricky to use. Chinese herbalists process the herb specially to remove these compounds. Many modern herbalists are administering the isolated diterpenes, which seems to work just as well and to avoid the adverse reactions. Preparations of tripterygium are just beginning to show up in American markets. When taking, use the dose suggested on the package or recommended by a qualified herbalist.

The other herb, butterbur, has been used in European traditional herbalism to treat pain. Modern research is confirming this use.65 Research reveals that the herb is anti-inflammatory and antispasmodic.66

In scientific studies, butterbur produced significantly fewer migraine attacks, fewer migraine days and a reduction in migraine pain.67 The qualities of this herb lend it to treatment of OA.

Standardized extracts of butterbur are now available in the United States. The adult dosage ranges from 50-100 mg of standardized extract twice daily with meals. When used to treat chronic conditions, administration is preventive and supplementation should be carried out daily until symptoms improve, and then tapered to a maintenance dose that gives the best results.

With all these effective herbal medicines available, OA victims don't have to live with pain. They truly can feel the way they would like, day after day. If pain strikes, give it the boot. Herbs can help.

Corydalis Tuber (Corydalis Yanhusuo)--Nature's Medicine For Aches And Anxiety
Corydalis ("yan hu suo") is the main herb used in traditional Chinese medicine for treating pain. It is another relative of the poppy, containing isoquinoline alkaloids, mainly tetrahydropalmatine. The raw herb is about 1 percent the strength of opium.53 Like morphine, it promotes relaxation and relieves pain. While morphine is addictive and creates tolerance, tetrahydropalmatine doesn't have these problems. Chinese herbalists value yan hu suo as a muscle relaxant, and predominantly use it for menstrual pain.

Several studies in animals have confirmed the benefits.54,55 A 1999 animal study performed at the University of Maryland Dental School demonstrated that yan hu suo significantly reduced pain and inflammation.56

Corydalis is relaxing and promotes sleep, a particularly relevant benefit for OA sufferers, considering the sleep connection. Don't take it while driving, and exceed the recommended dose only with caution. Increase the dose gradually until you are familiar with the pain-relieving and sedative effects. As a tea, start with 1-ounce dry weight of chopped herb, brewed, per day.

Devil's Claw Root (Harpagophytum Procumbens)
Devil's claw is a South African traditional herb, so named because its peculiar appearance is claw-like. Its large tuberous roots are chopped up and sun-dried for three days before being used medicinally. Native South Africans use the herb to reduce pain. European colonists took note and brought devil's claw back to Europe, where it became a popular arthritis treatment.

In modern European herbalism, devil's claw is used to treat all types of joint pain, including osteoarthritis, rheumatoid arthritis, gout and soft-tissue pain, such as back pain.

A recent double-blind study compared devil's claw to a European arthritis drug. In this trial, 122 patients with arthritis of the hip and/or knee were given either devil's claw or the drug for four months. The results showed that devil's claw was as equally effective as the drug, as measured by pain levels, mobility and need for pain-relief medications, such as acetaminophen or ibuprofen.57

A typical European dosage of devil's claw is 750 milligrams, three times daily of a preparation standardized to contain 3 percent iridoid glycosides.

Ashwaganda Root (Withania Somnifera)
This herb has a wide range of effectiveness. Considered to be the main long-term, stamina-enhancing tonic for men in Ayurveda, it can be taken by women, too. Ashwaganda is said in Ayurveda to build and solidify tissue growth; it is "anabolic." Since OA is a disease of "catabolism," or tissue destruction, ashwaganda seems like a good choice. Modern research is bearing this out.58

The demonstrated effectiveness of ashwaganda in a variety of rheumatologic conditions may be due in part to its anti-inflammatory properties, which have been established in several studies.59 One clinical trial supports the use of ashwaganda for arthritis. In a double-blind, placebo-controlled crossover study, 42 patients with osteoarthritis received a formula containing ashwaganda or placebo for three months. Patients were evaluated for one month, prior to treatment, during which time all previous drugs were withdrawn. During both the pretreatment and treatment phase, pain and disability scores were evaluated weekly. The herbal formula significantly reduced the severity of pain and disability scores.60

Take ashwaganda at a dose of up to several grams per day for symptom relief. A maintenance dose is about 1 gram per day.

Other Dietary Supplements For OA
When osteoarthritis starts to develop, the body responds by rebuilding healthy joint cartilage. This natural process can delay the development of actual pain and loss of mobility for years. Glucosamine, which functions in cartilage formation and repair, is one of the best-known and most well-researched nutrients for OA. Findings published recently in the Lancet journal suggested that the long-term combined structure-modifying and symptom-suppressing effects of glucosamine sulfate indicate that it could be beneficial in OA.68 The medical director of the Arthritis Foundation called this a "landmark study providing evidence that glucosamine has an important role in the management of osteoarthritis."

Scientists speculate that the sulfur content of glucosamine increases its therapeutic effects. Patients with arthritis, particularly OA, have been shown to have lower than normal concentrations of serum and synovial sulfur.1

Three popular remedies include arnica oil (left), Saint-John's-wort (center) and Po Sum On (right).

Along with glucosamine sulfate, patients are also experiencing relief from two additional sulfur-containing supplements, MSM (methyl-sulfonyl-methane) and SAM-e (S-adenosylmethionine). MSM is known to pick up joint flexibility, diminish stiffness and swelling, enhance circulation and lessen pain, while the sulfur in SAM-e is used by the body in the production of proteoglycans and the manufacturing of cartilage.1

Diet For OA
Clinicians have suggested that identifying and avoiding allergenic foods will sometimes benefit OA. Also, one report has implicated nightshade foods: tomato, potato, eggplant, bell pepper and tobacco.69 These may be triggering agents for OA. Patients appear to benefit from individualized dietary modifications. Avoiding allergenic foods typically produces benefits quickly, within several weeks, but it may take months on a nightshade-free diet for results to manifest.

Most evidence for the diet-arthritis link is anecdotal, but the theory has some scientific backing. A 1986 placebo-controlled, double-blind study published in the Lancet investigated the effects of diet therapy on 53 arthritis patients. For the first week, patients ate only foods of which they were "unlikely to be intolerant." Certain foods were then reintroduced individually. The result was "significant objective improvement during periods of diet therapy." The conclusion of the study was that dietary manipulation "may give benefit to at least some patients."70

No matter what the methodology, a diet that concentrates on fruits, vegetables and whole grains is likely to accomplish one valuable goal: weight loss. And it's well established that losing extra pounds often leads to at least some arthritis relief. One study found that overweight women can "significantly lower their risk for developing osteoarthritis of the knee by losing weight."71,72

Overweight people have a higher risk of developing knee osteoarthritis, and may be at an elevated risk of hand and hip OA. Additionally, excess body weight accelerates disease progression in knee OA. Increased joint stress attending obesity may explain the strong connection between obesity and knee OA risk, but it does not explain very well why obese people have a high risk of hand OA. Also, obese women are unexplainably at higher risk of knee OA than obese men. Studies of metabolic factors connected with obesity have not explained these discoveries. There is a scarcity of data on weight loss as a treatment for OA, but preliminary investigation implies that it is principally effective in knee conditions, and that even a small degree of weight decrease may have positive effects.73

Derivatives of ginger (above) are often used to alleviate muscle spasms.

Putting Together A Lifestyle To Manage OA
In addition to these effective natural treatments, authorities have identified lifestyle adjustments that can help people make the most of their lives as they work to conquer OA.74

First and foremost, individuals should maintain ideal body weight. The more the weight, the more stress on joints, especially hips, knees, back and feet. Movement and exercises are critical. Good posture will protect the joints in the neck, back, hips and knees. When lifting or carrying, the largest and strongest joints and muscles should be used. Alternating periods of heavy activity with periods of rest will avoid repetitive stress. Pain is an important message; it should not be ignored. Changing positions regularly will decrease stiffness in muscles and joints. New activities should be started slowly and safely to feel how the body will react to them. Appropriate safety equipment should be part of activities. Patients must ask for help whenever they need it; no heroics allowed.

Fortunately, natural healing methods work very well for the terrible degeneration of osteoarthritis. Victims can get their lives back. If you don't have this all-too-common problem, begin now to prevent the disease. Give these treatments a try; you'll be walking long after you thought you could.

•••

Karta Purkh Singh Khalsa, AHG, CN, NCTMB, is a massage therapist, nutritionist and herbalist. He is on the faculty of Bastyr University in Bothell, Washington, where he teaches botanical medicine to naturopathic medical students. His forthcoming book is entitled The Way of Ayurvedic Herbs (Lotus Press). He can be reached at: contactkpkhalsa@hotmail.com.

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