Osteoarthritis
Osteoarthritis is the most common form of arthritis in the UK. It is a condition caused by injury, loss of cartilage structure and function and an imbalance in inflammatory and anti-inflammatory pathways. In people affected by osteoarthritis, the cartilage between their bones gradually wastes away, leading to painful rubbing of bone on bone in the joints. The most frequently affected joints are in the hands, spine, knees and hips. Osteoarthritis often develops in people who are over 50 years of age; however, it can develop at any age as a result of an injury or another joint-related condition.
The aim of any treatment is to relieve pain, maintain or improve joint mobility and increase strength of the joint. Drug treatment includes non‐opioid analgesics such as paracetamol, non‐steroidal anti‐inflammatory drugs (NSAIDs), topical analgesics, opioid analgesics and intra‐articular steroid injection. Such treatments may however prove ineffective in some patients and NSAIDS often have serious adverse effects. They relieve pain by inhibiting the activity of the inflammation-causing enzyme called COX-2. But during the process they also inhibit the activity of the beneficial COX-1, the enzyme that protects the lining of the digestive tract and blood vessels. So while anti-inflammatory medications can help ease pain, long-term use can damage the kidneys and increase the risk of stomach ulcers and bleeding.
These limitations in the conventional medical management of osteoarthritis indicate a real need for safe and effective treatment of osteoarthritis patients. A systemic review of randomized controlled trials on the effectiveness of herbal medicines in the treatment of osteoarthritis found that some herbal medicines may offer an alternative for patients with osteoarthritis (1). A recent Cochrane review of topical herbal therapy found that Arnica gel improved pain and function as well as NSAIDs drugs, and comfrey reduced pain more than placebo (2). Other studies have confirmed the effectiveness of comfrey treatment (3,4).
The approaches taken by a medical herbalist depend on the particular presentation of each individual patient but would aim to decrease inflammation and pain, improve circulation, repair cartilage, enhance elimination and maintain energy and stamina. Some of the following herbs might be selected:
Ginger (Zingiber officinalis) contains compounds such as gingerols which inhibit prostaglandins and reduce the inflammation and pain of osteoarthritis.
Boswellia (Boswellia Serrata) contains boswellic acids which help to reduce inflammation and pain. By shrinking the inflamed tissues, these acids help to increase the blood flow, and stimulate cartilage growth.
Cat’s Claw (Uncaria tomentosa) is a native herb to the Amazon forests of Peru which can reduce joint pain.
Devil’s Claw (Harpagophytum procumbens) is an African fruit which helps to reduce pain and inflammation. It also increases mobility in the joints.
Horsetail (Equisetum arvense) helps to strengthen the connective tissues in the joints.
Cayenne (Capsicum fructescens and annum) contains capsaicin and when applied topically can be used to control joint pain.
Turmeric (Curcuma longa) is an effective anti-inflammatory. The active ingredient, curcumin, is a healthy alternative to painkillers because while it inhibits the inflammation-causing COX-2, it does not alter the healthy levels of COX-1. Curcumin not only relieves inflammation and pain but also builds worn cartilage, thereby restoring joints. Curcumin’s potent antioxidant powers repair the oxidative damage caused by inflammation.
White willow (Salix alba) contains salicylate glycosides which have anti-inflammatory and pain-relieving effects. Although the analgesic actions of willow are typically slow-acting, they tend to last longer than aspirin.
Celery seed (Apium graveolens) acts as an anti-inflammatory and diuretic.
Nettle (Urtica dioica) leaf reduces inflammation and has nutritive and diuretic properties which are beneficial in the treatment of osteoarthritis.
Rosehip (Rosa canina) is anti-inflammatory. Rosehip powder was shown to be effective in reducing joint pain in a meta-analysis of three randomised controlled clinical trials (5).
1. Long, L., Soeken, K., Ernst, E. (2001) Herbal medicines for the treatment of osteoarthritis: a systematic review. Rheumatology 40 (7): 779-793
2. Melainie Cameron1,, M., Chrubasik (2013) Topical herbal therapies for treating osteoarthritis. Cochrane Database Systemic review DOI: 10.1002/14651858.CD010538 15.8.2013
3. Grube B, Grunwald J, Krug L, Staiger C. Efficacy of comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind randomised, bicenter, placebo-controlled trial. Phytomedicine. 2007;14(1):2-10.
4. Staiger C. Comfrey: a clinical overview. Phytother Res. 2012 Oct;26(10):1441-8. doi: 10.1002/ptr.4612.
5. Cohen, M. (2012) An evidence based herbal medicine for inflammation and arthritis. Australian Family Physician 41 (7) : 495-498.
Suggested Lifestyle Changes
· Maintain a healthy weight to prevent excess mechanical stress on the affected joint(s).
· Avoid intense activities that injure or strain the joint cartilage.
· Exercise at a level that does not stress the affected joint(s). Strengthening surrounding muscles will support and protect the joint, and physical activity helps improve and maintain joint mobility and aids weight-reduction efforts. The safest activities are swimming, stationary cycling and light weight training - which put little stress on the joints.
Nutrition & Supplements
· Dietary changes may help alleviate or reduce the pain associated with osteoarthritis. Research has shown that foods rich in omega-3 fatty acids and the spices ginger and turmeric may help reduce inflammation. Foods rich in anti-oxidants - plentifully found in most vegetables and fruit - may help reduce tissue damage from inflammation.
· Eat oily fish such as salmon, or try another source of omega-3 fatty acids such as walnuts or freshly ground flax seed daily.
· Eat plenty of vegetables and fruit every day.
· The following supplements are recommended for joint health:
· Glucosamine sulfate provides the joints with the building blocks they need to help repair the natural wear on cartilage. Specifically, glucosamine sulfate provides the raw material needed by the body to manufacture a mucopolysaccharide (called glycosaminoglycan) found in cartilage.
· Chondroitin protects the cartilage and attracts fluids that give the tissue its shock absorbing quality.
· Evening primrose oil is a source of gamma-linolenic acid (GLA) which may help maintain healthy joints by modifying inflammation.
· Omega-3 fatty acids primarily EPA and DHA, have been shown in studies to help maintain bone health and flexibility.
Osteoarthritis is the most common form of arthritis in the UK. It is a condition caused by injury, loss of cartilage structure and function and an imbalance in inflammatory and anti-inflammatory pathways. In people affected by osteoarthritis, the cartilage between their bones gradually wastes away, leading to painful rubbing of bone on bone in the joints. The most frequently affected joints are in the hands, spine, knees and hips. Osteoarthritis often develops in people who are over 50 years of age; however, it can develop at any age as a result of an injury or another joint-related condition.
The aim of any treatment is to relieve pain, maintain or improve joint mobility and increase strength of the joint. Drug treatment includes non‐opioid analgesics such as paracetamol, non‐steroidal anti‐inflammatory drugs (NSAIDs), topical analgesics, opioid analgesics and intra‐articular steroid injection. Such treatments may however prove ineffective in some patients and NSAIDS often have serious adverse effects. They relieve pain by inhibiting the activity of the inflammation-causing enzyme called COX-2. But during the process they also inhibit the activity of the beneficial COX-1, the enzyme that protects the lining of the digestive tract and blood vessels. So while anti-inflammatory medications can help ease pain, long-term use can damage the kidneys and increase the risk of stomach ulcers and bleeding.
These limitations in the conventional medical management of osteoarthritis indicate a real need for safe and effective treatment of osteoarthritis patients. A systemic review of randomized controlled trials on the effectiveness of herbal medicines in the treatment of osteoarthritis found that some herbal medicines may offer an alternative for patients with osteoarthritis (1). A recent Cochrane review of topical herbal therapy found that Arnica gel improved pain and function as well as NSAIDs drugs, and comfrey reduced pain more than placebo (2). Other studies have confirmed the effectiveness of comfrey treatment (3,4).
The approaches taken by a medical herbalist depend on the particular presentation of each individual patient but would aim to decrease inflammation and pain, improve circulation, repair cartilage, enhance elimination and maintain energy and stamina. Some of the following herbs might be selected:
Ginger (Zingiber officinalis) contains compounds such as gingerols which inhibit prostaglandins and reduce the inflammation and pain of osteoarthritis.
Boswellia (Boswellia Serrata) contains boswellic acids which help to reduce inflammation and pain. By shrinking the inflamed tissues, these acids help to increase the blood flow, and stimulate cartilage growth.
Cat’s Claw (Uncaria tomentosa) is a native herb to the Amazon forests of Peru which can reduce joint pain.
Devil’s Claw (Harpagophytum procumbens) is an African fruit which helps to reduce pain and inflammation. It also increases mobility in the joints.
Horsetail (Equisetum arvense) helps to strengthen the connective tissues in the joints.
Cayenne (Capsicum fructescens and annum) contains capsaicin and when applied topically can be used to control joint pain.
Turmeric (Curcuma longa) is an effective anti-inflammatory. The active ingredient, curcumin, is a healthy alternative to painkillers because while it inhibits the inflammation-causing COX-2, it does not alter the healthy levels of COX-1. Curcumin not only relieves inflammation and pain but also builds worn cartilage, thereby restoring joints. Curcumin’s potent antioxidant powers repair the oxidative damage caused by inflammation.
White willow (Salix alba) contains salicylate glycosides which have anti-inflammatory and pain-relieving effects. Although the analgesic actions of willow are typically slow-acting, they tend to last longer than aspirin.
Celery seed (Apium graveolens) acts as an anti-inflammatory and diuretic.
Nettle (Urtica dioica) leaf reduces inflammation and has nutritive and diuretic properties which are beneficial in the treatment of osteoarthritis.
Rosehip (Rosa canina) is anti-inflammatory. Rosehip powder was shown to be effective in reducing joint pain in a meta-analysis of three randomised controlled clinical trials (5).
1. Long, L., Soeken, K., Ernst, E. (2001) Herbal medicines for the treatment of osteoarthritis: a systematic review. Rheumatology 40 (7): 779-793
2. Melainie Cameron1,, M., Chrubasik (2013) Topical herbal therapies for treating osteoarthritis. Cochrane Database Systemic review DOI: 10.1002/14651858.CD010538 15.8.2013
3. Grube B, Grunwald J, Krug L, Staiger C. Efficacy of comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind randomised, bicenter, placebo-controlled trial. Phytomedicine. 2007;14(1):2-10.
4. Staiger C. Comfrey: a clinical overview. Phytother Res. 2012 Oct;26(10):1441-8. doi: 10.1002/ptr.4612.
5. Cohen, M. (2012) An evidence based herbal medicine for inflammation and arthritis. Australian Family Physician 41 (7) : 495-498.
Suggested Lifestyle Changes
· Maintain a healthy weight to prevent excess mechanical stress on the affected joint(s).
· Avoid intense activities that injure or strain the joint cartilage.
· Exercise at a level that does not stress the affected joint(s). Strengthening surrounding muscles will support and protect the joint, and physical activity helps improve and maintain joint mobility and aids weight-reduction efforts. The safest activities are swimming, stationary cycling and light weight training - which put little stress on the joints.
Nutrition & Supplements
· Dietary changes may help alleviate or reduce the pain associated with osteoarthritis. Research has shown that foods rich in omega-3 fatty acids and the spices ginger and turmeric may help reduce inflammation. Foods rich in anti-oxidants - plentifully found in most vegetables and fruit - may help reduce tissue damage from inflammation.
· Eat oily fish such as salmon, or try another source of omega-3 fatty acids such as walnuts or freshly ground flax seed daily.
· Eat plenty of vegetables and fruit every day.
· The following supplements are recommended for joint health:
· Glucosamine sulfate provides the joints with the building blocks they need to help repair the natural wear on cartilage. Specifically, glucosamine sulfate provides the raw material needed by the body to manufacture a mucopolysaccharide (called glycosaminoglycan) found in cartilage.
· Chondroitin protects the cartilage and attracts fluids that give the tissue its shock absorbing quality.
· Evening primrose oil is a source of gamma-linolenic acid (GLA) which may help maintain healthy joints by modifying inflammation.
· Omega-3 fatty acids primarily EPA and DHA, have been shown in studies to help maintain bone health and flexibility.
