Joint pain is a common complaint that shows up at the doctor’s office every day. Arthritis is a general term meaning inflammation in the joints. Is it rheumatoid or osteoarthritis? What’s the difference and what are the best natural treatments?
About 50 million North Americans (approximately one in seven people) have some form of arthritis. In another 20 years, as baby boomers grow older and people live longer, close to 70 million people in Canada and the U.S. will have arthritis.
The most common types of arthritis are osteoarthritis, rheumatoid arthritis, gout, lupus, and ankylosing spondylitis. Severity can range from mild to crippling and may even be life threatening in rare cases. Both osteo and rheumatoid involve painful, stiff joints with a limited range of motion, warmth and tenderness in the affected areas, and an increased intensity of symptoms upon arising in the morning. Both types are more common in women than men, but rheumatoid can develop at any age while osteo is more common in older adults in their 50s and 60s.
Symptoms of Osteo and Rheumatoid Arthritis
Rheumatoid arthritis can develop in children (Juvenile Rheumatoid Arthritis), with early symptoms such as low-grade fever, muscle aches, and severe fatigue. In adults, the more severe forms can include painful lumps underneath the skin near the joints (rheumatoid nodules).
Osteoarthritis is limited solely to the joints and doesn’t affect the entire body. Lumps under the skin near the joints are also possible, but these are different from those that are seen with rheumatoid. Bone growths at the edges of the affected joints, called bone spurs, can occur with osteoarthritis but not rheumatoid.
Osteoarthritis is the commonest form and is most often caused by wear and tear on the joints. In osteoarthritis there is basically a breakdown of the cartilage that provides cushioning of the joints. On the other hand, rheumatoid occurs when the immune system attacks the lining of the joints and can affect the whole body. Rheumatoid is therefore classified as an autoimmune systemic condition and generally can cause much greater joint deformity than osteoarthritis.
Although there are exceptions, rheumatoid tends to affect the middle joints of the fingers while osteo affects the joints at the end of the fingers and at the base of the thumbs. Rheumatoid tends to affect the joints symmetrically on both sides of the body while osteo usually doesn’t do that. Rheumatoid tends to start with the smaller joints in the hands and feet and spread to the larger bones as the disease progresses. In osteoarthritis, the most likely joints to be involved are the ones that have been the subject of the most wear and tear. So the commonest sites for osteo are the spine, hips and knees. With osteoarthritis there tends to be stiff joints early in the morning but this stiffness gradually improves within 20 minutes of initiating movement. With rheumatoid the same thing happens but stiffness takes longer to resolve (usually 45 – 60 minutes).
Causes of Arthritis
• Family History and Previous Injury: A family history of arthritis appears to play a part in the disease, but the exact mechanisms are still a mystery. The wear and tear of aging and previous joint damage or injury is specifically associated with osteoarthritis.
• Hydrochloric acid deficiency: Another potential cause of osteoarthritis, and of rheumatoid arthritis, is a deficiency of hydrochloric acid produced by the stomach. Released in digestion, this acid helps us to absorb the minerals we need for healthy bones and joints. Mineral deficiencies can either cause or worsen just about any type of arthritis. Calcium, magnesium, zinc, copper, manganese, silicon, sulfur, boron, strontium and numerous other lesser-known minerals are involved in bone synthesis, breakdown and repair. These minerals can be inhibited from being absorbed if one uses antacids and stomach acid-suppressing drugs like the PPIs (proton pump inhibitors). The longer one uses antacids, the likelier the arthritis.
• Fluoride: We have all been brainwashed by public health authorities about the importance of fluoride for dental health. If you look at the actual research, you’ll find studies indicating that fluoride, at levels as low as one part-per-million in drinking water, can cause osteoarthritis by breaking down collagen, the mesh-like protein in bone and other connective tissue.
• Vitamin D deficiency: A deficiency of vitamin D may cause loss of cartilage and degenerative bony spur formation, which are linked to an increased risk for osteoarthritis progression. Vitamin D is anti-inflammatory, so deficiency can also be part of the cause in rheumatoid arthritis. In fact, any autoimmune disease can be worsened by vitamin D deficiency.
• Food Allergies: These may be a hidden cause of chronic inflammation in joints and are linked with the immune system dysfunction that occurs in rheumatoid arthritis. It is a well-known fact that fasting for extended periods of time (juice or water fasting) improves arthritis symptoms.
Food allergies are also linked to leaky gut syndrome – a condition in which damage to the gut lining allows large protein molecules to be absorbed. The immune system then treats the molecules as foreign substances and makes antibodies that can attack the joints, leading to inflammation.
Known food allergies and foods that are ‘pro-inflammatory’ such as red meat, synthetic fats (margarine), genetically modified oils (canola, corn, soy), as well as sugar, caffeine, and wheat, to name a few, may worsen or cause symptoms and should be eliminated. Members of the nightshade family (tomatoes, potatoes, peppers, eggplants, and tobacco) might have to be eliminated by some sensitive individuals.
• Mercury: Another cause of immune system inflammation is mercury. This toxin is increasingly found in higher amounts in fish and seafood, as well as dental fillings which can leak mercury vapour into the body on a daily basis. Mercury also acts like a magnet for fungi like candida. An overgrowth of candida can also be linked to rheumatoid arthritis.
• Fungi and Parasites: Yeast, fungi, and their mycotoxins initiate many autoimmune diseases involving joint inflammation. Parasites and unfriendly bacteria compete with us for nutrients like vitamins, minerals, and amino acids, and secrete waste products into the gut and bloodstream capable of causing various allergic or autoimmune reactions.
The Arthritis Diet
Pro-inflammatory foods and known food allergies should be eliminated. These most often include beef, pork and fried foods, sugar and refined carbohydrates in any form, coffee, regular tea and alcohol, dairy products, corn, yeast, all citrus and gluten-containing grains especially wheat, rye, oats and barley. Nightshade foods (tomatoes, potatoes, peppers, eggplants, tobacco) might have to be eliminated by some sensitive individuals. Foods like flax and hemp seed are anti-inflammatory, in that they have the reverse effect. For more details on diet, see my two books Rheumatoid Arthritis and Osteoarthritis, both published by Alive Books.
(in order of importance)
We are all biochemically unique, and consequently no single regimen will work equally well for one and all. One or a combination of the following nutritional supplements is generally effective for most people afflicted with arthritis.
• Omega-3 Fatty Acids (help both osteo- and rheumatoid) – Long before supplements like glucosamine sulfate became household names for reversing osteoarthritis, millions of people found great relief from joint pain, stiffness, and reduced range of motion by swallowing cod liver oil daily. Cod liver oil works. It continues to help reverse osteoarthritis naturally, and is, I believe, first-line therapy for any inflammatory condition. Cod liver oil, halibut liver oil, krill oil, seal oil, salmon oil and shark liver oil all contain fats that stimulate the body to manufacture anti-inflammatory hormones called prostaglandins. These fats, referred to as eicosapentaenoic acid (EPA), are found in large amounts in cold water fish (trout, salmon, cod, halibut, mackerel, catfish, etc.), and are highly effective as natural anti-inflammatory agents. Good results can be anticipated in three to six months. When the above are combined with glucosamine sulfate, osteoarthritis can be significantly improved within six weeks or less. Typical therapeutic dosages are 9 to 12 grams daily of capsules or two to three tablespoons of the oil.
Dosage: 9 to 12 grams daily of capsules, or 2 to 3 tablespoons of the oil. An alternative but less potent source of omega-3 oils comes from hemp seed, a favourite of the vegan set.
Dosage: 2 to 3 tablespoons daily
(NB: Any omega-3 supplement manufactured in Canada, by law, must have what is called an NPN number (Natural Product Number). This ensures that any mercury that came with the fish in question has been removed. This guarantee only applies to Canadian products, and is not given for any American products.)
• Glucosamine sulfate (helps osteoarthritis) – This is the building block of articular cartilage. Numerous double-blind studies done in the 1980s concluded that supplementation reverses osteoarthritis, and other studies show it to be superior in pain relief to ibuprofen and NSAIDS. Glucosamine is required for the synthesis of glycosaminoglycans, which aid in the repair of the cartilage destroyed by arthritis.
Glucosamine supplementation has produced a 95% response rate in patients, compared to 72% in patients taking nonsteroidal anti-inflammatory drugs. Glucosamine sulfate has been the “drug” of choice for treatment of osteoarthritis in Portugal, Spain, and Italy since the early 1980s. Shark, cow, and chicken cartilage are other sources of glycosaminoglycans, but may be more expensive than glucosamine sulfate therapy.
“There is such a treatment that inhibits the degradation and actually starts rebuilding the cartilage, costs less, does not require a prescription, does not make the osteoarthritis worse by further destroying the cartilage, and does not have all of the extremely dangerous side effects of NSAIDs [e.g. ibuprofen and other drugs which can cause nausea and even hemorrhaging]. This substance is glucosamine sulfate.”
(Sherry A. Rogers, M.D., Health Counsellor, “Osteoarthritis is Repairable”, v8, no3, p55-6, 1997)
Glucosamine helps bind water in the cartilage matrix and has been shown to help produce more collagen. It normalizes cartilage metabolism, the substance that helps to keep the cartilage from breaking down. Glucosamine can also improve joint function and help reduce the pain of those suffering from osteoarthritis. Double-blind studies show that glucosamine sulfate helps symptoms such as joint tenderness, pain on standing, pain on walking, and joint swelling. Glucosamine may speed healing of recurrent joint injuries such as chondromalacia patella, and thus prevent the development of osteoarthritis.
Dosage: 500 mgs, 3 times daily
• Methyl Sulfonylurea Methane (MSM) (helps osteoarthritis) – MSM is a natural form of organic sulfur, a critical component of the amino acids methionine, cysteine, and cystine contained in the cellular proteins of all living organisms. Next to salt and water, MSM is the third largest ingredient found in the body. Sulfur is needed for the proteins of hair, nails, and skin as well as glutathione, one of the body’s most important antioxidants. MSM is present in raw fruits, vegetables, and some grains but is commonly lost during cooking, food processing, and storage.
MSM is an odourless and stable metabolite of DMSO, a compound used in conventional medicine to treat scleroderma and chronic urinary bladder inflammation (interstitial cystitis). DMSO was a short-lived fad treatment for arthritis and other sports related injuries (tendinitis, sprains, strains, and non-specific musculoskeletal pain). The drawback to DMSO therapy was that it gave users a powerful garlic breath odour. When DMSO was applied to the skin, it rapidly absorbed into the circulation and provided pain relief to the affected areas. The garlic odour problem, however, made its use unpopular to all but the most motivated to take it. MSM is as powerful in its effects as DMSO, but without the offensive odour.
A deficiency of MSM can result in fatigue and an increased susceptibility to arthritis. Long used in veterinary medicine as a supplement to control arthritic pain, MSM also has proven therapeutic benefits in humans. MSM is also effective in controlling symptoms from allergies and is a natural anti-parasitic nutrient. It can also help the body offset the harmful effects of toxic heavy metals such as mercury, lead, cadmium and arsenic.
Dosage: 6 to 12 grams daily
• Vitamin D (helps both osteo and rheumatoid) – This hormone-like nutrient comes primarily through the effects of sunshine on the skin, and plays an essential role in calcium metabolism. It is strongly anti-inflammatory. Thus, daily intake of vitamin D is an effective treatment for all types of arthritis.
Dosage: 5,000 IU daily from May to October; 10,000 IU daily from October to May; dosages need to be adjusted downwards for those living closer to the equator and exposed to more sunlight.
• Curcumin (helps both osteo and rheumatoid) – The yellow pigment of the herb turmeric is called curcumin. In some studies it has been shown to be as effective as cortisone, without any of the associated side effects. Curcumin also has powerful anti-cancer effects and protects the liver from damage from various environmental toxins. The best-absorbed forms of curcumin are the BCM-95 fraction or Meriva. Beware of synthetic forms of curcumin that are actually derivatives of petrochemicals.
Dosage: 500 – 1,000 mgs. 3 times daily
• Boswellia serrate (helps both rheumatoid and osteo) – Boswellia is an herb native to India with well proven anti-arthritic effects through the inhibition of inflammatory mediators, prevention of decreased cartilage formation, and improved blood supply to the joints. Boswellia contains boswellic acids, which have been shown to be responsible for the tissue-protective actions, and the inhibition of leukotrienes – a class of mediators of the body’s inflammatory response.
Dosage: 400 mgs. 3 times daily
• Devil’s Claw (Harpagagophytum procumbens) (helps both rheumatoid and osteo) – Devil’s claw root is a South African plant observed to have an action comparable to that of an NSAID (non-steroidal anti-inflammatory drug) in several European studies.
Dosage: 500 mgs. 3 times daily with meals
• Hyaluronic Acid (helps both rheumatoid and osteo) – This is an important lubricating component of synovial fluid found in all joints. Deficiency can lead to a loss of cushioning needed to prevent pain and inflammation.
Dosage: 50 mg daily
• Vitamin C (helps both rheumatoid and osteo) – Vitamin C has been proven to have an anti-inflammatory effect.
Dosage: 6,000 mgs or more daily to bowel tolerance
• Vitamin E (helps both rheumatoid and osteo) – At dosages of 800 IU daily, vitamin E may be a prostaglandin inhibitor similar to NSAIDS, but without the side effects.
Dosage: 800 IU daily
• Glutamine (or L-glutamine) (helps rheumatoid) – This amino acid supplement helps repair leaky gut syndrome, a phenomenon associated with most autoimmune forms of arthritis, like rheumatoid arthritis (RA).
Dosage: 500–15,000 mg daily
• Boron (helps both rheumatoid and osteo) – Boron is essential to the body’s synthesis of steroid hormones and vitamin D, both of which are vital for normal bone growth and repair. Dosage: 6 to 9 mgs daily
• Selenium (helps both rheumatoid and osteo) – Daily supplementation with selenium helps elevate levels of glutathione peroxidase, a selenium-containing antioxidant enzyme that is a potent free radical scavenger.
Dosage: 200 to 600 mcg daily
• Zinc and copper (helps osteo) – Levels of these minerals are often low in those suffering from osteoarthritis.
Dosage: zinc – 30 mg daily; copper – 4 mg daily
• Manganese (helps osteo) – Manganese is an important component of articular cartilage, and is, therefore, helpful in treating osteoarthritis.
Dosage: 15 to 30 mgs daily
• Chondroitin sulfate (helps osteo) – Although very poorly absorbed from the gastrointestinal tract, chondroitin sulfate taken orally appears to have a beneficial effect. The body also manufactures it directly from glucosamine sulfate, provided there is enough of it on hand.
Dosage: 500 mgs 3 times daily with food
• Quercetin (helps both rheumatoid and osteo) – This is a naturally occurring bioflavonoid which has potent anti-inflammatory and anti-oxidant properties.
Dosage: 500 mg. 3 times daily
• Niacinamide (helps osteoarthritis) – This B vitamin (a synthetic form of niacin) may enhance glucocorticoid secretion, a naturally produced anti-inflammatory adrenal hormone. Dosage: 500 mgs six times daily
• Enzymes (helps both rheumatoid and osteoarthritis) – Plant-based digestive enzymes (bromelain, papain) and pancreatin enzymes (animal-based) work as powerful anti-inflammatory agents, reducing pain, swelling, and infection while improving joint flexibility. The proteolytic enzymes trypsin and chymotrypsin, usually considered as enzymes that break down dietary protein in the gastrointestinal tract, also have been shown to promote the healing of many exercise-damaged tissues. Bromelain (from pineapple stalks) and papain (from papayas) have been reported to have similar beneficial effects.
A lesser known, but very effective, enzyme supplement is Serrapeptase, derived from the silk worm.
Dosage: 1-5 capsules, 3 times daily, on an empty stomach depending on the type of enzyme and severity of the arthritis.
• Ginger (Zingiber officinale) (helps both rheumatoid and osteo) – Regular supplementation for 3 months or longer can reduce pain, swelling, and inflammation in 75% of people.
Dosage: 1,000 mgs or more, 4 times daily
• Yucca (osteo) – A saponin extract of the desert yucca plant has been demonstrated to help reverse osteoarthritis within 3 months of use, without side effects.
Dosage: 500 mgs, 4 times daily
• Velvet elk antler (helps both rheumatoid and osteo) – Velvet elk antler is said to prevent aging, boost energy, and enhance immunity. It has started to become a popular supplement in Canada and the U.S. owing to its anti-arthritis effects.
Dosage: 500 – 1,000 mgs daily
• Oil of Oregano (helps both rheumatoid and osteo) _ Oil of oregano has been used successfully as an anti-arthritis, anti-inflammatory remedy by millions.
Dosage: 2 or 3 drops (mixed with some olive oil to improve palatability) under the tongue several times daily, or applied topically
• S-Adenosylmethionine (SAMe) (helps osteo) – This supplement has been used extensively in Europe for the treatment of osteoarthritis. It stimulates the synthesis of proteoglycans, which provide essential nutrition for cartilage cells. Dosage: 200 to 400 mgs, 3 times daily
• Pantothenic Acid (helps osteoarthritis) – Some studies indicate that supplementing with vitamin B5 (pantothenic acid) improves osteoarthritis pain and mobility by enhancing the adrenal gland secretion of glucocorticoids, which are hormones with an anti-inflammatory effect.
Dosage: 500 – 1,000 mgs. 3 times daily
• Vitamin B12 and Folic Acid (helps both rheumatoid and osteo) – One double-blind study indicates that high doses of vitamin B12 and folic acid works as well as NSAIDS for pain control.
Dosage: vitamin B12 – 1,000 mcgs. daily; folic acid – 5 mgs. daily
The treatment approach taken for any form of arthritis depends on many different factors and is best individualized for the patient by a natural health care practitioner.
Dr. Zoltan Rona is a graduate of McGill University Medical School and is a past president of The Canadian Holistic Medical Association. He is the author or co-author of 12 books on natural medicine. His latest book is Vitamin D: The Sunshine Vitamin. He has had a private medical practice in the Toronto area for the past 38 years. He currently writes regular articles for Vitality magazine and for several websites. Visit http://www.tristarnaturals.com. Office located at 390 Steeles Ave. W. Unit 19, Thornhill, Ontario. Tel: (905) 764-8700
Catch Dr. Rona at his next public appearance on Saturday, Oct. 22, at Whole Life Expo where he will give a talk entitled: “My Top 10 Supplements for Longevity and Disease Prevention,” from 4:30 to 5:30 pm. You can also visit him at the High Level Wellness booths (#86,87) where he’ll be signing books and answering questions all weekend. Admission to his lecture is included with a $15 Weekend Lecture Pass (admits one to over 80 lectures Friday, Saturday, Sunday). Location: Metro Toronto Convention Centre, 255 Front St. West, Toronto. More information: visit http://www.wholelifeexpo.ca, or see Showguide inserted in October issue of Vitality.
• The effect of niacinamide on arthritis, description by PubMed.gov: http://tinyurl.com/zy73bob
• For WebMD description of MSM: http://tinyurl.com/gmtt9e6
• Arthritis advice. National Institute on Aging. http://tinyurl.com/hn3b7fv . Accessed March 19, 2014.
• AskMayoExpert. What is the distinction between rheumatoid arthritis (RA) and osteoarthritis (OA)? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
• Rona, Zoltan. Osteoarthritis. Alive Natural Health Guides #16. Vancouver:Alive Books, 2000
• Rona, Zoltan. Rheumatoid Arthritis, Alive Natural Health Guides#26. Vancouver:Alive Books, 2000
• DrovantiA, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo-controlled double-blind investigation. Clinical Therapeutics 1980; 3(4): 260-272.
• Muller-Fassbender H, Bach GL, Haase W, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis and Cartilage 1994; 2: 61-69.
• Noack W, Fischer M, Forster KK, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis and Cartilage 1994; 2: 51-59.
• Vaz AL. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in out-patients. Current Medical Research and Opinion 1982; 8(3): 145-149.