If you are a sufferer of osteoarthritis I don't need to tell you that the major complaint is - the achy stiffness, discomfort, pain and eventual inflammation. As the symptoms progress and cartilage erodes, the pain gets increasingly worse to the point that in many cases pain relief is required to simply function on a daily basis. This is what drives most people to have the offending joint or joints replaced with artificial ones. However, this option is only open to those with hip or knee problems and does nothing for those suffering from osteoarthritis of the hands or spine.. Even for those who choose to attempt to heal their condition through lifestyle changes, nutritional re-balancing, and re-mineralization will have to continue to deal with the discomfort until their body has had time to return to balance. Depending on the progression of the condition the healing process can take some time. So at the end of the day, whether one is awaiting surgery, dealing with the condition in an area of the body without a surgical solution, or is taking the time and effort to heal their condition, dealing with pain is the common primary concern for those with osteoarthritis.
The standard allopathic response to this issue is naturally a pharmaceutical one. Unfortunately the types of drugs commonly prescribed in these situations are associated with many adverse drug reactions (ADRs), especially after long term use. The group of drugs to which I am referring are among the most widely used in the developed world. They are called NSAIDs (nonsteroidal anti-inflammatory drugs). These are drugs with analgesic (pain-reducing) and antipyretic (fever-reducing) properties. One report published in Clinical Cornerstone stated that NSAIDs account for 70 million prescriptions and $30 billion in over-the-counter sales in the United States alone. Whether or not these numbers are accurate, the market is obviously huge. Some common names that you may be familiar with in this category of drugs are ibuprofen (Advil and Motrin), naproxen sodium (Aleve), ketoprofen (Orudis KT) and even good old aspirin, to name a few.
The main ADRs associated with prolonged or over-use of NSAIDs are well documented and on the increase. One of the immediate effects is on the gastrointestinal system. The molecular nature of NSAIDs is acidic, which causes irritation of the gastric mucosa. This in turn leads to digestive problems including nausea, gastric ulceration and intestinal bleeding, and even diarrhoea. Another area of concern with overuse of NSAIDs is that of renal interference. They impair the synthesis of prostaglandins, which are vasodilators. This in turn leads to the restriction of blood flow to the kidneys, which can cause fluid retention, sodium-potassium imbalance, as well as potential hypertension (high blood pressure). Of particular interest to OA sufferers are the studies going back as far as the late 70s that also indicated an acceleration of cartilage breakdown. Yes, that's right. When you take these pain medications to relieve headaches, migraines, menstrual pain, postoperative pain, arthritis pain, or any kind of pain, you may be actually accelerating the breakdown of your cartilage. If you are currently using one of these drugs to treat your osteoarthritis, you might want to consider potential alternatives for pain control, especially in the case of long term use.
In this area there are a few options that can be used individually or combined that have been shown to be effective in various studies. Given our acquired metabolic strengths and weaknesses, some experimentation may be required to find out which product or combination of products works best for you. In my experience the efficacy of a supplement is often determined by quality, sourcing, and processing, which will speak to issues of bio-availability. In this regard you usually get what you pay for, so caveat emptor.
One of the oldest and most overlooked treatments for joint pain is sulphur, which tends to occur naturally in many hot springs and is probably why people with arthritis find relief after bathing in them. Elemental sulphur used to be present in our drinking water but has been long lost to our diets through municipal filtration. In supplemental form it is usually found as a compound called methylsulphonylmethane (MSM). To my knowledge the clinical trials are scant and inconclusive; however, the ones I have looked at that show marginal success are dealing with pretty low dose ranges. Dr. Al Sears in a recent newsletter was recommending a daily dose of 850 mg for the treatment of joint pain. What MSM appears to do is to improve the permeability or flow-through of your cellular membranes. If this flow-through is impaired, toxins can build up in the cells, contributing to cellular pressure, inflammation and discomfort. When the flow-through is improved toxins are released, pressure is relieved, and inflammation decreases. This form of sulphur also appears to function as an effective anti-oxidant, which is always a good thing.
I suppose glucosamine sulfate needs to mentioned given that it is the most common non-vitamin, non-mineral supplement purchased by American adults. In the case of glucosamine, clinical studies appear to be all over the map with some showing improvement of symptoms while others show it to be no more effective than a placebo. Anecdotally it would appear that some people do experience significant relief of symptoms but only after many weeks or months of use. This probably has to do with the absorbability of glucosamine, which some studies have indicated may be as low as 15-20% of dose. This would indicate that glucosamine is not likely to be of use in the short term for control of pain.
Omega 3 oils have been shown to be a worthwhile investment for their many benefits to health in general. Their anti-inflammatory properties as well as the general metabolic need for omega 3s have been well documented and there are now numerous studies showing improved joint mobility. The turning of our collective diets away from saturated fats to seed and corn oils has led to an over abundance of omega 6s and 9s and fewer omega 3s than would have been present in a more traditional or evolved diet. Over abundance of omega 6s and 9s actually contribute to the potential for increased inflammation. When it comes to supplementing with omega 3s, source and processing will I believe determine effectiveness to a large degree. Although fish oil has been popular in the past, they can easily become rancid through oxidation, thereby losing any anti-oxidant effect they would have in the body. Another more contemporary issue with fish oil is the potential for bio-accumulated toxins like mercury and PCBs. This problem will obviously increase the further up the food chain you go for sourcing. For my personal use I have found the best bang for the buck is with a good quality Krill product. Krill is one of the largest biomasses on the planet; in fact, some large species of whales feed on it exclusively. Since it is harvested from relatively cleaner Antarctic waters, as well as being at the bottom of the food chain, bio-accumulated toxins become a relative non issue. Krill also contains the highest levels of a 'super' anti-oxidant called astaxanthin, which protects the omega 3 oils from becoming rancid and improves bio-availability and activity immensely.
From Ayurvedic Eastern traditions we know that turmeric has long been used as another potent anti-oxidant and anti-inflammatory. The most active component of turmeric is curcumin, which is what gives turmeric the intense yellow colour. There are now a growing number of studies as well as anecdotal evidence indicating a significant decrease in discomfort and increase of mobility for osteoarthritis sufferers, described by some as equivalent to the effect of NSAID's. Turmeric appears to be another one of those 'super' anti-oxidants that have many beneficial effects throughout the metabolism and seems particularly adept at helping the body deal with chronic low-grade inflammation. I have been using turmeric myself for some time now and can personally attest to its benefits. The turmeric powder which is used in food and medicinally is ground from the root of the plant. As with any supplement, sourcing is everything and you're probably best to find an organic source raised and harvested in the Ayurveda tradition. After all, they've been at it for 5000 years so they should know what they're doing by now.
One last potential alternative I would like to make mention of is something called Pycnoginol, which is a registered trade mark. I came upon this product quite recently while attending a webinar so I'm still in the process of investigation myself. However, given what I've read so far in the research, this product certainly warrants further investigation. Pycnoginol is an extract made from the bark of a maritime pine tree which only grows on the southwest coast of France. The claims of the manufacturer are backed by 280 published scientific studies and reviews as well as data collected from 7000 patients in 98 clinical studies. I'll leave this one simply as a heads up to provide further options in the pursuit of pain relief.
Given the problems inherent with the long term use of NSAID's, I hope this information, if nothing else, has at least provided options that can be used safely and in the end possibly do more to correct your osteoarthritis rather than contributing to its progression.
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