Bone Up On Arthritis
by Thomas Garvey May
Arthritis is the leading cause of disability in this country, affecting 15 percent of the population. And according to the Centers for Disease Control and Prevention in Atlanta, that number will swell to 20 percent, or 60 million people, by 2020. Managed-care associations provide little relief for patients with chronic conditions, according to the Arthritis Foundation. And conventional medicine produces dozens of anti-arthritis drugs a year, but the list of adverse effects resulting from these products includes nausea, indigestion, diarrhea and peptic ulcers.
A healthy diet and regular exercise may help prevent or slow the onset of chronic conditions like arthritis, says James Lembeck, D.Ch., C.H., president of N-Path Nutrition Inc. based in Parker, Colo. "But unfortunately, most of us have crosses to bear in terms of bad habits," Lembeck says. "My brother always says, 'If I'd have known I was going to live this long, I would have taken better care of myself.'"
The good news for America's aging population is that scientific studies and volumes of anecdotal evidence show that several natural supplements can be effective tools for staving off this increasingly widespread condition.
Arthritis is a blanket term for more than 100 conditions, but osteoarthritis is the most common. It is characterized by the breakdown of the plastic-like cartilage on the end of bone joints in the hands, hips, knees and back, says Ed Burke, Ph.D professor of Sports Science at the University of Colorado at Colorado Springs. Without that protective cushion, bone rubs against bone, and pain, swelling and even deformity can result. "Cartilage is like the body's shock-absorbing system," Burke says.
Glucosamine sulfate is the most popular supplement with arthritis sufferers, and it's one of the top-selling supplements at Cambridge Naturals, in Cambridge, Mass., says Michael Kanter, co-owner of the store. "It's one of the ones that even first-timers ask for by name."
Popularity aside, the supplement lives up to its billing. Glucosamine sulfate plays a significant role in the manufacture and maintenance of cartilage as well as other forms of connective tissue, says Burke. It's a naturally occurring substance that the human body creates from sugar (or glucose), and taking the supplement has been shown to facilitate the synthesis of new cartilage. More than 20 clinical trials, both short- and long-term, have shown that the supplement relieves pain and stimulates healing in aching joints.
"It works in varying degrees for different people," Lembeck says. "But when you give the tissue what it needs to grow, you're definitely helping, not hurting."
Although glucosamine is the best-selling arthritis supplement at Cambridge Naturals, Kanter agrees with Lembeck that it's not right for everyone. "Some people want a silver bullet," he says. "But it's not going to help everybody."
MSM (methylsulfonylmethane) is the second-most requested supplement for arthritis at Spartan Health Food in Las Vegas. "MSM has that movie-mogul aspect," says Marge Roman, supplements department manager at Spartan, referring to the supplement being mentioned by this year's Academy Award-winning best supporting actor. "Once James Coburn told the world about it, I couldn't keep it in stock."
The supplement works by providing the body with extra organic sulfur. Many of the components of joints, including collagen and glucosamine, are sulfur-dependent. "It works synergistically to help rebuild the base material in joints," Lembeck says.
A preliminary study on MSM and osteoarthritis conducted at the Oregon Health Sciences Center in 1997 found that the supplement provided pain relief equal to over-the-counter nonsteroidal anti-inflammatory drugs such as Advil-- "For acute pain, or in advance of [athletic] training that might cause acute pain, I take MSM," Burke says.
Another popular new supplement, SAM-e, has been touted as an arthritis reliever as well. In one study, a deficiency in this substance that occurs naturally in the body was shown to lead to a loss of the shock-absorbing qualities of cartilage in the hands.
Both of the new supplements have generated interest through media coverage, but SAM-e for arthritis is cost-prohibitive for most consumers, says Spartan's Roman. "The problem with SAM-e is that you have to take so much," Roman says. "People want to try it, but not that bad."
About half of Roman's customers who come in looking for arthritis products ask for things such as SAM-e, MSM and glucosamine. But for the ones who come in asking more general questions or those who want to learn about other options, she talks about diet, exercise, and basic vitamins and minerals.
"Changing those things, that's the hard stuff that nobody wants to do," Roman says. She encourages customers to start taking a good multivitamin.
Vitamins and minerals play a large role in assuaging chronic conditions such as arthritis. The body has its own mechanisms for rebuilding joints and connective tissue, and providing it with optimal levels of essential nutrients can stave off degenerative diseases, Burke says.
"Vitamin C can be important in developing and maintaining healthy cartilage," Burke says. "It supports the system, and you can't undervalue that."
Research also has shown that other antioxidants, such as vitamins A and E as well as vitamin D, play a role in the fight against arthritis. In a study published in the Annals of Internal Medicine, worsening knee problems were two to four times more likely in vitamin D-deficient osteoarthritics.
There are herbs for arthritis as well, but they draw a narrower audience, says Kanter. Many people don't have time to learn all the options. "I recognize that this is a fast-paced world, and we don't want to be hostile to people with hectic lifestyles," Kanter says. "But if people give us the time, we'll give them more solutions than the media has."
The few studies conducted on these herbs have been inconclusive, but anecdotal evidence abounds. For instance, devil's claw is native to South Africa, and its roots, once dried in the sun and steeped as a tea, have been used for centuries to ease joint pain. The boswellia tree is native to India, and it yields a gummy resin that contains boswellic acid, a substance with anti-inflammatory properties. White willow has been used to treat pain and fever in China since 500 B.C., and the study of its chemical constituents led directly to the discovery of aspirin.
So with an aging population that has been overworked and undernourished, the problem of arthritis seems unlikely to disappear. But natural products may be an integral stop on the road to recovery.
What To Do When It Hurts
While few items in a natural products store will have the same effect as the pain inhibitors prescribed by pharmacists, there are choices that provide some immediate relief for fiery joints.
Non-steroidal anti-inflammatory drugs, such as ibuprofen, work by blocking the production of prostaglandins, hormone-like substances that can cause inflammation. However, essential fatty acids, such as fish oil, evening primrose, black currant and borage oil, affect the body's prostaglandin ratio without the nasty side-effects. Studies on arthritic patients have shown that fish oil supplements lessened joint tenderness, swelling and stiffness.
Capsaicin, the pain-relieving compound found in hot peppers, has been used for centuries by indigenous peoples to thwart joint pain. When applied to the skin, capsaicin interferes with the body's perception of pain. It triggers the release of endorphins, nature's own pain relievers, and often provides near-instant relief.
While these products will provide some relief, remember: Making the pain stop should not be the final solution.