Naturopathy for Arthritis

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Arthritis Pain Overview

The word "arthritis" is derived from two Greek words that together mean "inflammation of the joint." A joint is where two bones meet. A healthy joint is cushioned by cartilage (a coating on the end of each bone) and by synovial fluid (a fluid in the space between the two bones). Arthritis occurs in joints where cartilage has become damaged.

Over time, stiffness, pain, inflammation, and loss of movement develop in affected joints. People with arthritis may have difficulty with very basic movements and every day activities, such as walking, climbing stairs, typing, or brushing teeth.

While some people believe that little can be done to treat arthritis effectively, the reality is that the condition usually can be controlled. The key is to team up with your health care provider to obtain a correct diagnosis and devise an effective treatment plan.

Types of Arthritis

The term "arthritis" actually refers to over 100 distinct conditions. The most common are osteoarthritis and rheumatoid arthritis. Other arthritic conditions include the following:
  • Ankylosing spondylitis
  • Fibromyalgia
  • Gout
  • Juvenile arthritis
  • Lupus
  • Pseudogout
  • Psoriatic arthritis
  • Reactive arthritis

The most prevalent form of arthritis is osteoarthritis (OA). Approximately 21 million people in the United States are diagnosed with OA. This condition is most common in women over the age of 60; however, in those under the age of 55, more men than women develop OA. In general, OA that develops after years of wear and tear is called primary osteoarthritis. OA that develops from another cause (e.g., obesity, injury, heredity) is called secondary osteoarthritis.

Rheumatoid arthritis (RA) affects over 2 million people, mostly women. Unlike OA, rheumatoid arthritis is an autoimmune disease. In patients with RA, the immune system mistakenly attacks healthy joint tissue as if it were an infection or invading organism. This immune response and the damage it causes lead to joint stiffness, pain, and inflammation. If left untreated, RA can lead to permanent disfiguration and joint damage.

Incidence and Prevalence of Arthritis

Approximately 52.5 million adults in the United States have been diagnosed with some form of arthritis and it's estimated that about 70 million have arthritis. The condition affects men and women of all races and ethnicities, as well as children. However, arthritis is more common in women and in older people.

Diagnosing Arthritis Pain

In general, a primary care physician can diagnose osteoarthritis by reviewing the patient's medical history and performing a physical examination. The diagnosis is often confirmed using x-rays and laboratory tests (e.g., joint aspiration).

A medical history involves questions concerning any past surgeries and medical procedures, current health conditions, and family history of arthritis. Questions that the physician may ask include the following:
  • Does the pain feel sharp, grinding, or burning?
  • Does the pain increase or decrease throughout the day?
  • Is the pain associated with any particular activity?

During a physical exam, the physician determines if joint swelling and tenderness are present, evaluates the range of motion, and looks for bony growths in or around the joint(s).

Joint aspiration is another test that may be used to diagnosis OA. In this procedure, the synovial fluid (fluid within the joints) is examined for signs of damage. A local anesthetic is used and a needle is inserted into the joint to withdraw fluid.

Primary care physicians may offer a preliminary diagnosis of rheumatoid arthritis, but if the condition is suspected, the patient is referred to a rheumatologist for a complete diagnosis and for treatment. The diagnosis of RA may also involve taking a complete medical history, and performing a physical examination, laboratory tests, and x-rays. Questions that the physician may ask include the following:
  • Does the joint pain occur symmetrically (on both sides of the body)?
  • Have there been periods of weakness, fatigue, and discomfort?
  • At what time of day is the pain most severe?

During a physical exam, in addition to looking at the joints, the doctor may also examine the skin, lungs, and eyes for signs of RA.

Laboratory tests used to diagnose RA vary, as there is no test or combination of tests used specifically to diagnose the condition. One test that may be performed is a complete blood cell count (CBC). Patients with rheumatoid arthritis may have lower counts of red blood cells (causing anemia), higher counts of white blood cells (indicating an immune response), and higher platelet counts (a sign that inflammation is present).

An erythrocyte sedimentation rate (ESR or sed rate) is another common test used to diagnose RA. This test measures how fast red blood cells fall to the bottom of a test tube, indicating how much inflammation may be present in the body. Following diagnosis, this test may also be done periodically to monitor the progression of the condition and the success of treatment.

Additional diagnostic tests that may be used include rheumatoid factor (RF), C-reactive protein (CRP), and antinuclear antibodies (ANA) tests. X-rays may be first used to evaluate current joint conditions, and then to determine the progress of the disease and the effectiveness of treatment. Magnetic resonance imaging (MRI scan) may also be performed to detect early inflammation that is not shown on x-ray.

Naturopathic (Natural) Treatment for Arthritis

Arthritis is the degeneration of a joint and the related pain. There are many types of arthritis and osteoarthritis (OA) is the most common. Osteoarthritis can be caused by trauma, joint overuse, infections, and other factors.

Osteoarthritis is a progressive disorder that results when the hyaline cartilage, which allows joints to move (articulate) freely, undergoes degenerative change. This change results in the destruction of cartilage and the development of conditions such as bone spurs. It occurs in both men and women, and is a natural result of aging. Individuals in their 20s and 30s may have joint changes and by their 50s and 60s symptoms frequently occur.

Symptoms include pain, swelling, morning stiffness, restricted mobility, and joint noise (crepitus) when moving. Commonly affected sites are fingers, shoulders, spine, knees, and hips. The disorder is frequently asymmetrical (affects joints on one side).

Arthritis & NSAIDS (Non-steroidal Anti-inflammatory Drugs)

NSAIDs (e.g., aspirin, ibuprofen, naproxen, indomethacin) are often used to treat the pain and inflammation of osteoarthritis. They are relatively inexpensive and usually effective. However, there are often side effects, due to the drug itself or to the high dosages required. Studies indicate that NSAIDs not only reduce the ability to repair cartilage, but also increase the degeneration process. While NSAIDs may provide symptomatic relief, they may, in fact, worsen the condition.

Arthritis & Nutrition

Dietary changes can provide the proper nutrients needed to repair damaged joint tissue and eliminate foods that can damage joint tissue. Excess body weight adds to the stress on joints, so losing weight can be beneficial.

Removing foods in the nightshade family (solanaceae) from the diet may also be beneficial. The nightshade family includes tomatoes, potatoes, eggplant, peppers, and tobacco. They contain alkaloids (a plant constituent) that may interfere with joint repair and increase inflammation.

Eat kale, artichoke, celery, turnip greens, mustard greens, lettuce, millet, barley, almonds, black mission figs, cherries, pineapple, blackberries, black currants, limes, olive oil, and gelatin.

Avoid sugar, dairy products, refined foods, fried foods, junk food, caffeine, spinach, asparagus, rhubarb, and the nightshade family.

Eliminate food sensitivities from the diet. Use an elimination and challenge diet to determine food sensitivities.

Drink 1/2 ounce of water per pound of body weight daily (e.g., a 150 lb person would drink 75 oz of water).

Arthritis & Supplements

Copper—Take 1 mg daily
Essential fatty acids (flaxseed oil)—Take 1-2 tbsp daily.
Glucosamine sulfate—Take 500 mg 3 times daily. Glucosamine sulfate is believed to rebuild the cartilage in joints. It may take up to 6 weeks for symptoms to improve.
Methionine—Take 250 mg 3 times daily.
Niacinamide—Take 500 mg 3 times daily. Clinical results show niacinamide to be effective in treating osteoarthritis. Caution: Using niacinamide at this high dose can cause side effects (liver damage) so use with a physician's supervision only.
Vitamin A—Take 10,000 IUs daily.
Vitamin B-5—Take 12.5 mg daily.
Vitamin B-6—Take 50 mg daily.
Vitamin C—Take 1-2 grams daily.
Vitamin E—Take 400-800 IUs daily.
Selenium—Take 200 mcg daily.
Zinc—Take 45 mg daily.

Arthritis & Herbal Medicine

Herbal medicines rarely have significant side effects when used appropriately and at suggested doses. Occasionally, an herb at the prescribed dose causes stomach upset or a headache. This may reflect the purity of the preparation or added ingredients, such as synthetic binders or fillers. For this reason, it is recommended that only high-quality products be used. As with all medications, more is not better and overdosing can lead to serious illness and death.

The following herbs are used to treat osteoarthritis:
  • Alfalfa (Medicago sativa)—Is nutritive.
  • Black Cohosh (Cimicifuga racemosa)—Is an anti-inflammatory, an antispasmodic, and a digestive stimulant.
  • Burdock (Arctium lappa)—Is nutritive and an alterative.
  • Chaparral (Larrea mexicana)—Is an antiinflammatory and an antihistamine.
  • Devil's claw (Harpagophytum procumbens)—Is an antiinflammatory and an analgesic.
  • Juniper (Juniperus communis)—Promotes digestion and excretion of uric acid and dispels gas. Caution: Juniper can cause kidney irritation. Do not use more than 6 weeks in succession. Do not boil leaves, infuse only for 20 minutes.
  • Yucca (Yucca sap)—Is an antiinflammatory and an antispasmodic.

Arthritis & Homeopathy

The standard dosage for acute symptom relief is 3 pellets of 30C every 4 hours until symptoms resolve. Lower potencies, such as 6X, 6C, 30X, may be given every 2 to 4 hours. If the right remedy is chosen, symptoms should improve shortly after the second dose. If there is no improvement after 3 doses, a different remedy is given. The following remedies have been shown to be effective in acute, symptomatic relief of osteoarthritis:
  • Bryonia—Indicated for pain in limbs and joints that are better with warmth, swollen joints, and joints worse with touch.
  • Kali bichromicum—Indicated for shooting, pricking pain; wandering pain; stiffness all over; and pain worse in the morning, with motion, or with cold.
  • Rhus toxicodendron—Indicated for the sensation of stiffness on first moving limbs after rest and when pain is as if bruised or sprained.
  • Ruta graveolens—Indicated for inability to bend; pain in all joints and hip bones; and pain worse in wet, cold weather.
  • Ledum—Indicated for stiffness in all joints that move only after applying cold water; painful, hard nodes; and pain worse by warmth of bed.

Treating depression and anxiety aids in improving arthritis pain

Not only can arthritis make your joints ache, it can affect your mood, too. One-third of arthritis patients ages 45 and older suffer from anxiety, depression or both, a new federal study reports—and half of these patients don’t seek help for their mood disorder.

Anxiety and depression in people with arthritis can have a profound impact on their quality of life. The disorders can contribute to declining levels of physical function, affect the ability and willingness to cope with arthritis and interfere with adherence to treatment.

The Centers for Disease Control and Prevention (CDC) estimates that 50 million Americans have one of several forms of arthritis, including rheumatoid arthritis, osteoarthritis, gout, lupus and fibromyalgia. Together, these rheumatic conditions are the leading cause of disability in the United States. It came as no surprise to CDC researchers who performed the new study that many arthritis patients suffer from depression, since depression is common among people with chronic pain.

But they didn’t expect to see such high rates of anxiety. Anxiety was almost twice as common (31 percent) as depression (18 percent) in arthritis patients. Eighty-four percent of patients with depression also had anxiety—not surprising since anxiety is a risk factor for depression.

Some anxiety may be attributed to the distress caused by arthritis' physical limitations. Lack of confidence to perform certain everyday tasks can contribute to anxiety as well. Consequently, anxiety, as well as depression, can be an obstacle to making lifestyle changes like physical activity, which can reduce pain.

Identifying barriers to wellness

For the CDC study, researchers surveyed 1,793 adults ages 45 and older with arthritis about their emotional well-being and physical function (the ability to walk several hundred feet; wash or bathe; bend, kneel or stoop; and run errands and shop). Among the findings published online in Arthritis Care and Research in April 2012:
  • Increasing levels of depression and anxiety led to decreasing levels of physical function and independence.
  • People who were depressed had little confidence in their ability to manage their arthritis or joint symptoms.
  • The study authors say that anxiety and depression are underdiagnosed and undertreated in people with arthritis, so they encourage doctors to screen arthritis patients for both disorders—especially for anxiety, which doctors don't traditionally screen for. If a mood disorder is detected, the appropriate treatment can help reduce joint pain and improve physical function.

What we already know

Anxiety and depression are far more common in people with arthritis than in people in the general population. Moreover, past evidence has already shown that:
  • People with rheumatoid arthritis who are depressed are more likely than patients who aren’t depressed to experience a higher level of pain, a greater number of painful joints, more frequent visits to their doctor, more days spent in bed and an increased risk of death.
  • Osteoarthritis patients who are depressed report higher pain intensity than patients who aren’t depressed.
  • Arthritis patients who believe they can manage or influence their symptoms are more likely to have better outcomes than patients who don’t believe they can control their symptoms.
  • Depression and anxiety can have overlapping symptoms, such as trouble sleeping or concentrating, nervousness and irritability—and many people who’ve had an anxiety disorder in the past develop depression later. Anxiety isn’t a single condition; it consists of several disorders, including generalized anxiety disorder (constant, excessive worrying), phobias, panic disorder and post-traumatic stress disorder.

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