NATURAL THERAPIES FOR ARTHRITIS Zoltan P. Rona, M.D., M.Sc. Arthritis is a disease of the

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NATURAL THERAPIES FOR ARTHRITIS Zoltan P. Rona, M.D., M.Sc. Arthritis is a disease of the joints characterized by pain, swelling, redness, heat, and, at times, structural changes. The two most common forms, osteoarthritis and rheumatoid arthritis, are more common in women than men. Osteoarthritis involves the gradual deterioration of cartilage usually in the larger, weight-bearing joints such as the hips, knees, and spine. This wear and tear is thought by doctors to be a normal and inevitable process in people age 55 and older. By the eighth decade, approximately 90% of all people have some degree of osteoarthritis. Rheumatoid arthritis is a chronic joint disease affecting one or more joints, usually those of the hands and feet, particularly the knuckle and toe joints. The synovium and other parts of the joint may gradually become inflamed and swollen with tissue destruction and deformities occurring in the most severe cases. Rheumatoid arthritis, unlike osteoarthritis, is a condition that waxes and wanes, occurring as a single attack or as several episodes which leave the victim increasingly disabled. The disease may also be associated with damage to the lungs, heart, nerves and eyes. Although this form of arthritis predominantly affects those between the ages of 40 and 60, it can also affect children and teenagers (Juvenile Rheumatoid Arthritis). The cause of the disease is unknown but considered to be an autoimmune process (components of the immune system attacking the joints). Conventional medicine treats arthritis with anti-inflammatory drugs (most commonly aspirin) and physiotherapy. In severe cases of Rheumatoid arthritis, more potent anti-inflammatory drugs are used: nonsteroidal anti-inflammatory drugs such as Indomethacin, cortisone-like drugs, antimalarials, gold salts, penicillamine and even experimental cytotoxic drugs. Although this approach may produce pain relief, it does little, if anything, to alter the arthritic process itself. Surgical removal of badly inflamed joint synovium may be required (synovectomy), arthroplasty (joint realignment and reconstruction), tendon repair, arthrodesis (joint fusion) and even artificial joint replacement. Conventional medical treatments for arthritis are a multi-billion dollar a year industry. The failure of drugs and surgery to produce a cure in the majority of sufferers has led millions in North America to seek alternatives such as acupuncture, chiropractic, nutritional, herbal, homeopathic and folk therapies. For the most part, the medical profession approves of very few of these alternatives, claiming that there is no proof of efficacy. Nutritional approaches to arthritis seem to have the most supporting scientific research and documentation behind them. For example, weight reduction, particularly in those suffering from osteoarthritis of the hips, knees and ankles may be very important. Losing weight alleviates some of the stress on the joints. The main types of foods that should be reduced as much as possible are refined carbohydrates (sugar and white flour products) and animal fats (especially those found in red meats). There are certain types of fats, however, which may, in higher than average intake amounts, act in the same way as standard anti-inflammatory drugs. Examples of this include cold-pressed linseed oil (Flaxseed oil), gamma linolenic acid (GLA found in Evening Primrose Oil) and EPA (found in cod liver oil, halibut liver oil, salmon oil, shark oil and many others). Increasing these in the diet or taking them in encapsulated supplement form while decreasing the intake of saturated animal fats can have a remarkably good anti-inflammatory effect. D,L-Phenylalanine is an amino acid which has been shown to help release the body's own natural opiates (endorphins) and can provide substantial pain relief naturally. Unfortunately, this product is only available in the U.S.A. in health food stores. In osteoarthritis, optimizing the body's trace mineral balance may be crucial. It is therefore necessary to avoid foods known to interfere with mineral absorption such as bran, coffee and tea. Minerals that may be involved in osteoarthritis include iron, zinc, copper, manganese, calcium, magnesium, boron and selenium. Vitamins such as A, B-complex, C, beta-carotene, bioflavonoids and E can be supplemented in higher than RDA doses because of their anti-oxidant properties that help prevent certain aspects of inflammation. The recommended intake doses for all these nutrients would have to be determined for the individual by a qualified health care practitioner based on appropriate biochemical tests. Many arthritis sufferers have reported benefits from the use of certain herbs. Alfalfa, for example, has been extensively studied. It contains many important substances including saponins, sterols, flavonoids, coumarins, alkaloids, vitamins, amino acids, minerals, trace elements and other nutrients. Aside from its ability to lower blood cholesterol levels through its saponin content, numerous clinical and anecdotal (unproven) reports support its use in arthritis treatment. Other herbs that have been reported to have beneficial effects for arthritis include devil's claw, comfrey and sassafras. Like vitamin and mineral supplements, herbs are not without their side effects and are best administered and supervised by an experienced health care practitioner. There are a growing number of studies which demonstrate the relationship between food allergies (hypersensitivity) and arthritis. The purported benefits of juice or water fasting for all types of arthritis may simply be because the fast eliminates the food or foods to which the person is allergic. For years, anecdotal reports have suggested that some individuals are adversely affected by plants from the Solanacea group (the Nightshades). These include tomatoes, potatoes, eggplants, peppers, paprika and tobacco. It certainly can do no harm for an arthritis sufferer to exclude these foods from the diet for at least two months to see whether or not avoidance has any impact on the disease process. For those who find the rigors of fasting and food elimination diets too inconvenient, there now exist some very good blood tests (IgG4 RAST and the ELISA/ACT test) which can pick up allergies to not only the Nightshades but also to other hidden food hypersensitivities. In some people that react adversely to all foods (pan-allergic), the possibility of an intestinal tract parasitic or fungal (Candida) infection needs to be investigated and treated before starting on a food allergy elimination program. Although one cannot say that parasites or Candida cause arthritis, many nutrition oriented physicians and clinical ecologists have reported successes in the treatment of arthritis when either the Candida or parasitic infection was cleared first. The wearing of copper bracelets may be beneficial to many arthritis sufferers. Double blind studies have proven that copper from the bracelet can penetrate the skin and produce an ant-inflammatory effect. Assorted anecdotal reports have claimed beneficial effects with supplemental Niacinamide (vitamin B3), the New Zealand green-lipped mussel (mucopolysaccharide content) and DMSO. Many homeopathic remedies have been used for arthritis. Since the right remedy alleviating the symptoms may be different for different individuals, the best thing to do is see a homeopath who can take a proper case history and prescribe the remedy on an individual basis. Let us not forget the very important body/mind/spirit connection or pscho-nueuro-immunology, as some would like to term it. This is a vast subject that requires an individual to do quite a bit of personal work and study. Authors that are widely read in this field include Louise Hay, Dr. Deepak Chopra, Dr. Norman Shealy, Dr. Bernie Siegel, Shakti Gawain, Norman Cousins and dozens of others. Over the years, I have noticed that people who suffer from arthritis are reflecting feelings of anger, frustration, irritation or resentment. Such individuals are often obsessed with controlling another person or with being controlled by the emotional or psychological needs of someone with whom they are closely involved. This scenario seems to be more obvious in auto-immune forms of arthritis such as rheumatoid arthritis but may also be present in other types. Meditation, yoga, self-healing techniques of various types, Trager massage or psychotherapy may all be effective in alleviating both conscious and subconscious feelings that lie at the bottom of arthritis. There are no quick and lasting remedies that work in all cases. One of the most important things that must be stressed in any holistic program for arthritis is that treatment is long term. Sufferers should be prepared to actively involve themselves in all aspects of therapy and not just passively wait for something to happen. Any holistic approach requires a far greater degree of self responsibility than just taking aspirins. Occasionally one hears of spontaneous remissions or overnight successes with the "right remedy", but the vast majority take 3-6 months or more to stabilize. Unfortunately, there are resistant cases where anti-inflammatory drugs cannot be avoided if one wants to prevent joint destruction. The safest thing to do is to consider the drugless approach to arthritis as complementary rather than alternative therapy. A holistic health care practitioner's guidance is essential. REFERENCES Blake, D.R.; Lunec, J. 1) Copper 2) iron free radicals and arthritis. Br J Rheumatol 1985 May;24(2):123-5. Nuki, G. Apatite associated arthritis. Br J Rheumatol 1985 May;23(2):81-3. Dieppe, P.A.; Doherty, M.; Macfarlane, D.G.; Hutton, C.W.; Bradfield, J.W.; Watt, I. Apatite associated destructive arthritis. Br J Rheumatol 1985 May;23(2):84-91. Chen, L.H.; Liu, S.; Newell, M.E.; Barnes, K. Survey of drug use by the elderly and possible impact of drugs on nutritional status. Drug Nutr Interact 1985;3(2):73-86. Solomons, N.W. Biochemical, metabolic, and clinical role of 3) copper in human nutrition. J Am Coll Nutr 1985;4(1):83-105. Crary, E.J.; McCarty, M.F. Potential clinical applications for high-dose nutritional 4) antioxidants. Med Hypotheses 1984 Jan;13(1):77-98. Krupp, M.A. and Chatton, M.J. (Ed). Current Medicinal Diagnosis and Treatment. Lange Medical Publications, U.S.A., 1984. pp. 367-368. The Arthritis Foundation. Home Care Programs In Arthritis. 1314 Spring St. NW,

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