Suffering from arthritis is very common and the conventional treatment with non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen is fraught with side effects and risks. I’ve written before about the dangers of NSAIDS, including ulcers, kidney toxicity, high blood pressure, heart attack and stroke. So what are some good alternatives?
What is arthritis?
Arthritis is a degenerative inflammatory process. The cartilage that cushions our joints slowly wears away leaving painful and inflamed “bone-on-bone” contact. Some types of arthritis are caused by an underlying disease, such as rheumatoid arthritis, but most arthritis is the simple wearing out process leading to the formal disease called osteoarthritis (OA). Low grade inflammation in the body will cause arthritis to accelerate. As the cartilage disappears and localized inflammation sets in the body responds by adding calcium deposits to the inflamed joints which causes the familiar thickening around the joints and calcium spurs noted on xrays.
Support for healthy cartilage is difficult since it has a limited blood supply to assist healing. Once cartilage is worn out and gone it is not able to be replaced nor does it regenerate on its own. Cartilage injuries are very slow to heal.
Safe arthritis treatments
There are many safe and effective natural treatments for arthritis, including compounds that fight inflammation and support healthy cartilage. Herbs, vitamins, minerals, enzymes, and oils are part of a long list of potential treatments.
Nutrients such as chondroitin sulfate and glucosamine sulfate have had mixed results in studies on arthritis. However, the “Glucosamine/Chondroitin Arthritis Intervention Trial” showed these supplements were equal to the much more expensive and dangerous prescription drug called Celebrex. Neither treatment was better than placebo in mild arthritis, but for severe arthritis the supplements did indeed work better.
MSM (Methyl Sulfonyl Methane) was isolated in the early 80’s. MSM is a natural sulfur compound found in all living things and while MSM is normally found in many common foods it is normally lost from our food during preparation. MSM has been shown to add flexibility to cell walls while allowing fluids to pass through the tissue more easily. MSM enhances tissue pliability and encourages the repair of damaged skin and many clinical studies support the use of MSM for arthritis.
Cetyl myristoleate (CMO) is a cetylated fatty acid—a natural ester of myristoleic acid. CMO is thought to relieve arthritis symptoms through a combination of anti-inflammatory, lubricating, and immunomodulatory mechanisms, although its exact mode of action is still not fully understood.
Vitamin C is critical for growth and healing of tissue including cartilage. Most studies show vitamin C helps prevent arthritis from starting but does not change the course of the disease once it is already established. Collagen replacement, especially “type 2” chicken collagen, shows promise in calming the inflammation process. Collagen powder provides the amino acids necessary for building cartilage. A scoop once or twice per day is a good idea.
Many herbs have potent anti-inflammatory benefits. There is a long, long list to consider, but a few that I routinely use with good success include boswellia, curcumin, pycnogenol, ginger, green tea, oregano, basil and more. ReJoint is my go-to product in recent years. A combination herbal called “Zyflamend” has worked well for many of my patients. Omega-3 oils also lower inflammation.
Systemic enzyme support (SES) is yet another potent method of lowering inflammation. By packaging certain enzymes so they get absorbed into the bloodstream, they are able to activate a protein that “mops up” inflammation. Wobenyzm is a well known product from Germany that is a mainstay of arthritis treatment in Europe and has been used by millions of patients.
Topical prescription gels are a fantastic method of delivering an anti-inflammatory NSAID medication directly into the joint without getting significant blood levels and the risks that come with it. Studies on topical ketoprofen show 4-7x higher levels of the medication inside the cartilage with 100x less in the bloodstream, thus working better with less side effects. I recommend ketoprofen gel, available by prescription only, and made by a compounding pharmacist at Western Colorado Compounding Pharmacy (243-5050). I have found this product to work much better than some of the topical gels available through commercial pharmacies.
Hormones
Hormones such as estrogen and testosterone stimulate cartilage growth. Women start development of arthritis rapidly after menopause and the same happens with men over the years of dropping testosterone levels. Research shows that estrogen receptors are present in cartilage and that estrogen stimulates cartilage growth. Similarly testosterone has been shown to have a direct effect on cartilage growth.
Nutrition
Low grade inflammation in the body will accelerate degenerative arthritis. This may be caused be foods that cause inflammation, such as sugar, processed foods, meat and dairy. More striking is the inflammation caused by immune reactive foods such as wheat, dairy, soy, corn, etc. Testing for delayed food allergies is a good idea for anyone with arthritis.
Regenerative Injections
Regenerative injections are becoming a large part of our practice, because they work so well. Regenerative injection techniques are an area of growing clinical interest. These procedures may include the use of ozone, platelet-rich plasma (PRP), or stem cell-derived products. While some patients report improvement in joint discomfort and mobility, these therapies have not been approved by the FDA for the treatment of arthritis or joint degeneration, and their safety and effectiveness are still being studied. PRP is derived from the patient’s own blood and is used in some settings to support tissue healing. The use of stem cells and ozone in joint care is considered investigational and should be discussed thoroughly with your healthcare provider as part of a personalized treatment plan.
Peptides
Peptides are short chains of amino acids that act as signaling molecules in the body. Over 7,000 naturally occurring peptides have been identified, including insulin, which plays a key role in blood sugar regulation. Some peptides are being investigated for their potential roles in joint and tissue health. Some examples are Pentosan Polysulfate, and BPC157, which are used in some clinical protocols via subcutaneous injection or injection into the joint. While preliminary research suggests potential benefits for joint discomfort and function, peptide therapies have not been FDA-approved for the treatment of osteoarthritis, and further research is ongoing. These therapies should only be used under medical supervision in accordance with applicable laws and regulations.
Summary approach to arthritis
Rule out underlying causes for the joint pain and inflammation, such as autoimmune disease, delayed food allergies, low thyroid or declining estrogen or testosterone levels. Then, once osteoarthritis is confirmed, try to get on as many natural anti-inflammatory supplements and cartilage support as possible. Pain medications such as acetaminophen can help, while severe, advanced cases often require the addition of modest doses of a pain medication such as codeine, which is safe when prescribed in moderation.
Author
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.
