Arthritis

There are several types of arthritis.  Osteoarthritis develops with age, often where there have been old injuries or in joints that have been overused, perhaps because of the type of work a person has done.  Rheumatoid arthritis is a disease of immune system which occurs when the lining of the joints becomes inflamed and swollen.  There are rarer forms which come from virus or bacterial infections.  Rheumatism is a general term for muscular aches and pains that may be the forerunners of rheumatoid arthritis or due to a virus infection.

In osteoarthritis the cartilage covering the surface of the joint breaks down and the underlying bone becomes the thickened and distorted, making movement difficult and painful.  The joints most commonly involved are the hips, knees, and spine.  Being overweight or taking too many laxatives makes things worse.  It is most common in the elderly – some surveys says that 80 percent of those over 50 have it.  Before the age of 45 it is much more common in men and after that point much more likely to affect women.

Described as a disease of the immune system, rheumatoid arthritis, besides affecting the joints, can also involve the skin, lymph nodes, heart, lungs, blood and nervous systems.  Joint pains are combined with a low-grade fever.  It affects people of all ages, although three times as many women as men get it.  It is still not clear why rheumatoid arthritis develops.  Blood tests show a special antibody which acts against the normal antibodies in the blood.  The pain and swelling happen because the body’s white blood cells respond to this intruder by attacking the joints.

THE ORTHODOX APPROACH

The first line of treatment for both types of arthritis is ordinary pain-killers, such as ibuprofen or a group of drugs, which includes aspirin, called non-steroid anti-inflammatory drugs (N.S.A.I.D.’s).  These reduce joint inflammation and pain but the amounts used are quite large – 2-4g (200-400mg) per day – and side-effects may include irritation of the stomach and tinnitus.  There is also evidence that N.S.A.I.D.’s actually speed up the rate at which cartilage degenerates – the key effect of osteoarthritis.

In severe cases of rheumatoid arthritis more aggressive treatments with potentially severe side-effects are used, such as gold salt injections, d-pericillamine and corticosteroids, which may be used to reduce inflammation.

There are also a number of mechanical treatments.  Splints may be applied to prevent deformities, fluid can be drawn directly off a joint and anti-inflammatory drugs injected straight in.  Physiotherapists have a program of exercises to keep joints mobile and they also make use of heat treatment or exercise in a warm pool  Other techniques, none of them very effective, include paraffin wax baths and infra-red lamps.  In severe cases surgeons can replace damaged joints with artificial ones made of metal or ceramic.  There are also operations to fuse joints, which relieves pain but leads to a loss of movement.

THE HALE APPROACH

A sudden onset of joint pain needs to be taken to your physician in case there is an infective element, which could rapidly destroy the joints.  A more slowly progressive development of arthritis can be tested by certain blood tests, again through your physician.  Once a diagnosis has been made and the form of arthritis is clear and non-aggressive, then complementary treatments can be very effective and keep you drug free.  If drugs are required, the complementary therapies should be used alongside them, to help the curative process as well as diminishing the side-effects of the drug treatment.

The effectiveness of complementary medicine in the treatment of arthritis varies considerably from individual to individual, from a dramatic improvement to some relief of painful symptoms.

Diet is a key factor in arthritis, so I would first recommend seeing a Western nutritionist or following an Ayurvedic diet as part of a general Ayurvedic treatment.

Once diet has been addressed, homeopathy, acupuncture, and light therapy can bring an improvement to the condition and contribute to the relief of pain, as can osteopathy, chiropractic, and aromatherapy.

The Supportive Treatments can all be of benefit, not in effecting a complete cure but in the relief of symptoms.

ACUPUNTURE/CHINESE HERBS

The causes are wind, cold, and dampness which cause the blood and the chi energy in the body to become stuck.  Needles are usually inserted near the affected area, mostly to relieve pain.  Sometimes herbs are also given to relieve pain and promote circulation. More about acupuncture...

NUTRITION

In general, a diet of complex carbohydrates (instead of sugars) and lots of cod liver oil and cold-water fish is recommended.  One specialized diet involves cutting out all consumables from the nightshade family, which includes tomatoes, potatoes, aubergine (eggplant), chillies and tobacco.  The idea is that some people are genetically susceptible to the alkaloids found in this family.  Eating ginger may be beneficial.  Certain mineral and other supplements have also been found to be useful in repairing damaged cartilage, including; bromelina, niacinamide (this can sometimes have a harmful effect on the liver), methionine (an essential amino acid), Vitamins C and E, and pantothenic acid.  The herbs yucca, Boswellia serrata, devil’s claw, Curamia longa and Withania somnifera have been shown, in controlled experiments, to improve osteoarthritis.

Many sufferers from rheumatoid arthritis have bowel problems which allow bacteria out of the gut and into the bloodstream and this may be what lies behind the auto-immune response.  Certainly the disease is rare in societies that don’t eat Western diet.  Food allergy also seems to contribute, so besides cutting out foods from the nightshade family, wheat, corn, dairy products, sugar, and beef should also go.

A vegetarian diet is useful because arachidonic acid, which makes inflammatory conditions worse, is made from animal products.  Inflammation may be further reduced by increasing the intake of eicosapentaenoic acid (E.P.A.), which comes from cold-water fish such as mackerel, herrings, sardines, and salmon.  Supplements are also advised; I addition to those for osteoarthritis, they might include the antioxidant selenium, some manganese and flavonoids.  Liquorice, turmeric (right), and ginseng would also be liberally included in the diet.  More about nutrition...

AYURVEDA

According to Ayurvedic practitioners, arthritis stems from eating the wrong sort of food.  If we eat the foods that don’t fit in with our type (dosha), then toxins build up and are stored in the joints.  In general our Western diet – in which meat, dairy products and foods high in acid, such as alcohol and certain fruits, predominate – are the cause of the problem, since they affect the vata dosha, which controls the central nervous system.

Patients need to switch to a more alkaline diet with rice, fruit, grains and vegetables.  A complete panchakarma detoxification is essential and will use such methods as enemas, laxatives, herbal steam inhalation, and oil massages.  Patients will also be advised to take some exercise and to find the right activity for the mind such as meditation.  More about ayurveda...

OSTEOPATHY

Treatment for osteoarthritis varies according to the stage the disease has reached.  In acute, recent-onset cases, the osteopath’s first job is to reduce pain through muscle manipulation and deep muscle massage to ease pressure on the affected joints.  This treatment also improves blood supply to the joints as part of the body’s natural healing process.  Ice or cold water therapy may be used to reduce swelling, and advice would be given on how this can be done at home.

In chronic cases an x-ray may be necessary to establish whether there is any problem such as osteoporosis or a fracture, in which case the spine would be treated very delicately.  If there is no such problem, treatment concentrates on mobilizing joints.  Soft tissue manipulation improves the condition of the muscles and blood vessels around the affected joints.  Treatment of the nerves in the spine through pressure techniques improves neurological supply to joints and muscles.

Diet is absolutely crucial with arthritis and most osteopaths will give advice, first testing saliva and urine to assess the body’s pH balance.  Bad diet may lead to excess acidity, which the body can eliminate only at the cost of its reserves of alkaline minerals such as calcium and magnesium.  Loss of these minerals can lead to osteoporosis and many arthritic conditions.

For rheumatoid arthritis, treatment centres on lifestyle, diet and control of the problem.  Good nutrition can support glandular function, reducing stress.

Manipulation to relieve pressure on the spine also relieves pressure on the immune glands.  More about osteopathy...

CHIROPRACTIC

The term arthritis (from the Greek arthros, a joint, and it is, inflammation) is a generally used description for joint disease, of which there are about 200 different types.  A more appropriate name for what many people suffer would be arthrosis, in which the joint is not inflamed and may not itself be painful.  This problem is also commonly called “wear and tear” and can happen to anyone over the age of about 30.  Pain comes not just from the joints but more often from the tight and tender muscles associated with the worn joints, which no longer function with optimal movement.

Chiropractic does not claim to be a cure for arthrosis, but it can relieve the symptoms in the joints.  By locating the problem area and freeing up stiffened joints and muscles, mechanical correction usually improves joint function and significantly reduces pain and discomfort.  Often this means a reduced intake of medication and a more enjoyable lifestyle.  More about chiropractor...

HOMEOPATHY

When cases of osteoarthritis flare up there are a number of specific remedies, depending on the particular case, such as:

•           When the pain is relieved by heat but aggravated by cold and damp, is worse when resting and in the morning but gets better with movement and as the day wears on – Rhus tox.

•           Severe pain made worse by heat and movement, helped by cold applications – Bryonia.

•           Heat and warm rooms make pain worse, patient feels weepy – Pulsatilla.

For rheumatoid arthritis the treatment generally aims at strengthening the whole system and pays special attention to diet. More about homeopathy...

SELF-CARE

Indian Medicine

If the knee joints are affected walk on tip toes every day.

Avoid all acidic foods such as citrus fruits and seafood.

Make a paste of ginger powder and turmeric in equal parts and put it on the affected part for 30 minutes.  Alternatively rub in arnica balm or tiger balm.

Nutrition

An alkalinizing diet – cutting out acidic food – may be recommended, because a poor digestion doesn’t break down toxic acids properly; they therefore accumulate in the joints, where they cause inflammation and pain.  Do not stay on this diet for more than a month – after that other foods should be introduced gradually.  Full details are available from a naturopath, but the foods to avoid include red meat, dairy products, wheat products, sugar, and coffee.  Instead go for things like white fish, pulses, chicken, goats’ milk, oats, and vegetables.  Foods said to be especially beneficial include green-lipped mussel, devil’s claw, and kelp.  You will also be recommended vitamin and mineral supplements.

SUPPORTIVE TREATMENTS

Healing

Improvements from healing take longer with arthritis than with many other conditions, but the treatment does reduce the pain and dramatically increases mobility.

Remedial Yoga

When patients are in acute pain and joints are inflamed, yoga is not appropriate, but when the inflammation is under control yoga can be useful to improve circulation and help to relax muscles that have been tense for a long time.  Long-term pain can unbalance the body and make you lose confidence; yoga can rebalance the body and give you a greater feeling of control.

Reflexology

A reflexologist would give a full treatment, then concentrate on the points on the foot relevant to the location of the pain  The reflex area for the shoulder, for example, is on the top and sole of the foot just below the little toe.  For the hip, it is across the top of the foot just below the ankle bone.  In either case, the right foot refers to pain on the right-hand side of the body and the left foot to the left-hand side.

Hypnotherapy

According to hypnotherapists, the outlook of someone with arthritis is ossified and stuck.  The sufferer tends to be entrenched in one view and stuck on their path in life.  Under hypnosis they are likely to say that they can see no way out of their present plight.  Even the part of the body affected can be significant – arthritis in the right hand suggests problems with practical, worldly matters; in the left hand it represents problems

Clinical Aromatherapy

Massage using analgesic, anti-inflammatory, anti-arthritic oils helps reduce pain and inflammation and improve mobility.  Acupressure, lymphatic drainage, and neuro-muscular techniques are used in the massage.  Oils for use at home include rosemary, yellow birch and juniper.  A low acid/low toxin diet, including herbs and food supplements, is recommended.  Exercises will be prescribed for self-care.

TIPS

Take light exercise where possible – swimming is especially good.  Rest occasionally during the day and sleep on a firm bed.