A Holistic Approach to the Treatment of Arthritis

by Michael Tierra

Arthritis is an inflammation of one or more joints characterized by pain, swelling, redness, heat, and, sometimes, structural changes. This condition is more common in women than in men. Arthritis may result from another condition - over eighty diseases may cause arthritis - or it may simply develop on its own. Further, any disease involving the sinovial membranes or causing degeneration of cartilage may cause arthritis.

Western medical diagnosis of arthritis consists of a thorough medical history, clinical examination of the affected joints, noticing the pattern of distribution, x-rays, blood tests, and examination of sinovial fluid obtained by aspiration of a swollen joint.

Arthritis may have a number of causes, hereditary, metabolic and from a history of unusual use involved with sports or work.

The two most common forms of the disease are called osteoarthritis and rheumatoid arthritis. Osteoarthritis, the most common form is also the most amenable to herbal treatment. It is a degenerative joint disease, often in heavier set individuals and usually beginning with the gradual deterioration of cartilage that affects primarily the larger weightÑbearing joints such as the hips, knees, and spine. This wear and tear is a normal process predominantly found in people aged 55 and older and by the eighth decade of life, approximately 90% of all people are affected by osteoarthritis. As the cartilage that serves as a cushion against normal wear and tear, breaks down, friction gradually damages the bones causing them to flake and crack due to overuse or injury. In advanced cases, the underlying bone becomes thickened and distorted and scar tissue may then replace damaged cartilage. This type of arthritis may at the early stages, not exhibit characteristic inflammation or the inflammation may only be episodic. As movement becomes painful and restricted, lessened use of the associated muscles will lead to their atrophy. This type of arthritis is very common with athletes who have played contact sports earlier in their lives.

Rheumatoid arthritis is a more chronic autoimmune form, often with a family history of the disease. It may also have a viral origin. It may affect one or more joints with the joint fluid or synovium becoming gradually inflamed and swollen. While Inflammation may occur in all joints, the most commonly affected are those of the hands and feet, particularly those of the knuckle and toe joints.

Rheumatoid arthritis may occur as a single mild attack or as several episodes which can leave the victim increasingly disabled. In a few persons, rheumatoid arthritis causes extensive deterioration of joint and bone tissues leading to joint deformities. Further complications can result in damage to the lungs, heart, nerves and eyes, making it difficult to lead an active, normal life. This form of arthritis can affect people of any age, but predominantly affects those between the ages of 40 and 60. Statistically, slightly less than one half of affected individuals have complete remission.

Psoriatic arthritis is a form of arthritis associated with psoriasis and can be confused with rheumatoid arthritis. It occurs only in a small minority of patients with psoriasis but may be painful and disabling. It often affects small joints such as the terminal joints of the fingers and toes or the spine (spondylitis) and sacroiliac (sacroiliitis). As a rule, psoriatic arthritis is seen where the skin or nails are affected as a spinÑoff from arthritic joints. Although this disease seems akin to rheumatoid arthritis in many ways, it is less difficult to discover where the problems stem from and what kind of treatment is needed.

The four primary medical objectives in the treatment of arthritis are the reduction of inflammation and pain, preservation of the jointsÕ function, prevention of deformity, and treatment of the cause (if known).

A rational western medical approach towards both prevention and treatment is to lessen or remove weight from the joints. This may entail using a walking stick, going on a balanced weight reduction diet, sleeping on a bed which properly conforms to the shape of the body, and getting frequent rest. Since the muscles also play a vital role in supporting the bones and joints of the body, regular exercise, both active and passive, will keep the affected muscles from weakening. Many individuals may benefit from a hydrotherapy program with the daily application of hot and cold water packs to induce muscle relaxation and consequently lessen or eliminate pain.

Anti-inflammatories ranging from aspirin to cortical steroids are commonly used to suppress inflammation and hence, reduce pain and swelling. Because various individuals exhibit differing levels of sensitivities to these drugs a rheumatologist may may try several, to determine which has the least adverse effects. These range from nonsteroidal anti-inflammatory drugs, corticosteroids, and (in the case of rheumatoid arthritis) antimalarials, gold salts, penicillin and experimental cytotoxic drugs.

As a last resort, surgical removal of badly inflamed joint synovium may be required. Other common surgery includes fusion of the joint or artificial replacement of some joints.

The herbalists goal is to first enhance overall health and vitality emphasizing a diet of organic, whole foods, raw or lightly cooked, avoiding those foods including overly refined and processed foods, foods with artificial coloring or flavoring agents and over consumption of red meat, eggs and refined sugar, coffee (a stress stimulant), excess salt, alcohol, sodaÕs which usually contain bone weakening phosphates, smoked foods, flour products any foods such as dairy or wheat or any other foods that may adversely affect digestion or cause subtle allergic reactions. Because stress, both physical and emotional can aggravate arthritis, this must also be reduced as much as possible

A general principle is to avoid acid - producing foods in favor of foods which provide an alkaline reaction. This is achieved by avoiding or strictly reducing the use of meat (especially red meat), eggs and dairy products, obviously acidic foods like vinegar and pickles, refined carbohydrates and sugars (white sugar, white flour and all their products including cakes, cookies and pasta), most spices, and foods rich in oxalic acid (rhubarb, spinach, gooseberries, black or red. It is also wise to avoid or reduce coffee, black tea, alcohol, sugar and salt since these all contribute to the accumulation of toxins and are detrimental to the cleansing process.

The diet should consist of whole grains, organic seasonal fruits and vegetables, particularly green and root vegetables. At least three pints of fluid (preferably water with low mineral content) should be drunk daily to assist the body in flushing out its toxins. Fish and white meat may be eaten, though never more than two to four ounces in a day. In fact, a protein-restricted diet is of paramount importance in all metabolic disturbances. While in deficiency conditions first class protein is of paramount importance, care should be taken to use only those amounts, usually 4 ounces in the course of a day that a patient in a weakened digestive state can absorb. Vegetarians may also need to reduce their intake of legumes, which may consist of as little as only three servings of pulses (peas, lentils, beans) in a week and no more than three servings of tofu a week. Protein, necessary for rebuilding degenerated tissues, however should be present at every meal. By a judicious variety of fish, white meat (such as chicken or turkey), beans, pulses, tofu, tempeh or seitan (wheat gluten) even, if one can tolerate them, the use of a couple of eggs once or twice a week for breakfast it should be possible to incorporate the desired four ounces of protein at each meal.

Fruit and fruit juices that are high in sugar, while less of a problem than refined sugar can also aggravate arthritic conditions.

Because acid causing foods can aggravate arthritis, orange juice, tomatoes and eggplants may need to be restricted. In many cases I have found the problem more from the fact that these foods are often picked in an unripened state for commercial purposes. When taken in a fully ripened state they may not be at all harmful.

Dr. Vogel writes in Swiss Nature Doctor:

"To condemn the tomato in general because it is unwholesome in its unripened state is unfair. (This) unreasonable argument has been propagated by scientists whose experiments have been confined to research laboratories and whose procedures have been far removed from actuality ... In reality, ripe tomatoes are healthful and contain at least five different vitamins which are a necessity for our bodies." (p.231Ñ232)

If organic acid was a major contributor of arthritis foods such as the lemon or the highly effective and famous apple cider vinegar and honey would be contraindicated. Instead these foods are specifically valuable to the treatment of arthritis and seem to flush and neutralize toxins and acids in the body.

Another well known naturopathic treatment for arthritis is potato juice. Before breakfast drink half a glass of raw potato juice made fresh from grated potatoes. This should be sipped slowly in order to salivate before swallowing. Potato juice is highly alkaline and a very effective antidote for uric acid conditions such as arthritis and rheumatism. This is easily made by grating an organically grown potato, then squeezing the juice through a natural fiber cloth.

Specific for psoriatic arthritis but useful for all types as well is to eat one quarter to one half pound of grated carrots daily and drink one or two cups of fresh carrot juice. This supplies betaÑcarotene which is apparently outÑof-balance in the metabolism and is helpful for the liver. Kale juice in small amounts is sometimes used as well.

A very effective treatment for most is to being with a short three day fast consisting of only fresh organic apple or carrot juice. This consists of taking no less than one 8 ounce glass of organic apple juice hourly at room temperature. In this way, oneÕs blood sugar will remain stable and the fruit juice will contribute powerfully to the elimination of toxins. To assist the process, one may also take a small amount (from a quarter to a teaspoon according to tolerance) of cayenne pepper either straight up or in capsules three or more times daily to promote circulation. On the fourth day, one would break the fast with a strict vegetarian diet consisting of a raw vegetable salad, vegetable juice or broth, or the use of a small amount of brown rice or low salt miso soup.

For maintenance, a similar one day a week fast, choosing a regular day each week so the body will learn to accommodate itself to the regime for maximum detoxification, can be implemented.

For various reason, this approach may not be indicated for someone who is in a severely emaciated or deficient state however, for most it will work wonders and after even three or four days, many people find themselves pain free.

Another fast that is more moderate is the use of kicharee consisting of brown rice and mung beans cooked with a little organic rock or sea salt, turmeric, coriander and cumin seed and a little sesame oil. This is a traditional Indian food appropriate for balanced detoxification widely used in the Indian Ayurvedic tradition for all difficult diseases. Kicharee can be advantageously varied and supplemented with the addition of green leafy vegetables, carrots, onions or other vegetables. This food is completely life sustaining and for maximum benefit should be followed for a minimum of ten days.

A number of nutritional supplements have also proven to be of benefit for the treatment of arthritis. This would include a comprehensive vitamin- mineralÑtrace element regime, supplemental Vitamin C (500mg Ñ 4 gins) is suggested, as are the B vitamins, Vitamins A, D, and E, minerals such as calcium, magnesium, iodine, manganese, selenium and zinc, and sometimes amino acids. EPAÕs derived from cod liver or other fatty salt water fish is also very important because they are anti-inflammatory and promote circulation. More recently glucosamine sulfate, a synthetic supplement that was originally derived from the shells of crustaceans, for many has provided relief for arthritis sufferers. MSM SULFUR and the externally applied DMSO (Dimethylsulfoxide) has been used for the treatment of arthritis, gout, bronchitis, constipation and many other health problems for years. Because sulfur is necessary for the formation of connective tissue formation, it is particularly useful for joint inflammation, improving flexibility and circulation, reducing stiffness and swelling, reducing pain, reducing scar tissue and helping to break up calcium deposits.

External treatments are generally used to manage pain and to some extent to improve flexibility. Liniments, plasters, poultices and magnets are all variously effective in stimulating blood flow and reducing inflammation and pain in a specific area. Rubifacients like cayenne, ginger, cinnamon oil, eucalyptus, tea tree, menthol or prickly ash bark relieve pain by reducing congestion in a specific area. Antispasmodics such as St. Johnswort oil, lobelia tincture and/or comfrey root can be topically applied in an oil, alcoholic liniment or poultice. Cabbage leaf poultices alternated with clay packs on the affected area is also effective. Clay disperses and cabbage draws together so that their alternating actions produce an effect similar to that of a counterÑirritant. Club moss poultices left on overnight soothe and heal arthritic joints. Maria Treben recommends her famous Swedish bitters as a compress once daily for four hours (calendula ointment should be rubbed into the skin first to avoid drying and to add its own healing properties). As well she advises the patient to take six small doses of Swedish bitters daily with nettle tea. Dr. Shook suggests black berry glycerite applied to swollen joints three to four times daily. Black berry juice is a solvent of calcareous deposits, and the external treatment coupled with an internal dosage of one tablespoon blackberry vinegar in a large cupful of distilled water three or four times daily will ease arthritic pain and slowly dissolve the deposits.

A folk remedy that works is based on the use of formic acid found in stinging nettles and in the bite of bees and ants. Many people achieve extended relief by gently flogging themselves with the stem of stinging nettles. Providing one is not allergic, beeÕs confined in a small jar can be induced to sting a local area and is used to relieve pain of arthritis as well as pains associated with multiple sclerosis.

A number of herbs and formulas from around the world have been traditionally used for rheumatic and arthritic conditions. In general, these should be used based on the underlying constitution and humoural predisposition of the patient. Herbalists would incorporate the use of immune tonics for deficiency conditions, antispasmodics and nerviness to relieve associated muscular pain, cooling anti-inflammatories for severe inflammation aggravated by heat and warmth, warming circulatory tonics if the condition is more chronic with impaired joint circulation and diuretics to reduce swelling. These are used singly in formula according to the individual needs of the patient.

A Planetary herbal formula that I routinely prescribe and has been used successfully by thousands of people throughout the United states is Glucosamine-MSM Herbal consisting of both glucosamine and MSM together with specific Western, Ayurvedic and Chinese botanicals including Rehmannia glutinosa, Dioscorea villosa, Dipsacus, Eucommia, Boswellia gum extract, drynaria root calcium citrate and myrrh gum resin.