Alternative Ways to Easing Arthritis Pain (cont.)
The University of Maryland School of Medicine recently completed a four-year NIH-funded study, the largest ever undertaken, to determine how well acupuncture works. The results, published in December 2004 in the Annals of Internal Medicine, found that traditional Chinese acupuncture significantly reduces pain and improves function for patients with knee osteoarthritis who have moderate or more severe pain despite taking pain medication.
Larry Altshuler, MD, is a board-certified internist in Oklahoma City who practices both conventional and alternative medicine. He uses acupuncture on his arthritis patients and says he was "pleasantly surprised" when his patients reported they were getting relief from their pain. "Most of my patients have had beneficial results from acupuncture," says Altshuler.
Helpful, Healthy Supplements?
Glucosamine and chondroitin are nutritional supplements that are also being studied for their effectiveness in treating arthritis.
Jason Theodosakis, MD, says that "first-line therapies" for the treatment of arthritis should always be improving biomechanics, injury prevention, weight control, and low-impact exercise. Theodosakis is an assistant clinical professor at the University of Arizona College of Medicine; he serves on the oversight committee for a $16 million NIH trial on glucosamine and chondroitin.
"But there is also enough scientific evidence -- 42 human clinical trials to date -- to recommend the use of glucosamine and chondroitin," says Theodosakis, also the author of The Arthritis Cure.
An article published in 2001 in the medical journal Lancet, for example, reported the results of a three-year study that followed 212 arthritis sufferers. The survey participants were divided into two groups, with one group given 1,500 milligrams of glucosamine daily for three years; the other group was given a daily placebo for three years.
The group given the glucosamine showed little or no deterioration in joints, while the group given the placebo showed the joint deterioration expected of arthritis sufferers.
After further follow-up, a recent study published in Osteoarthritis and Cartilage, found that those in the glucosamine group had 74% fewer knee replacements.
Erin Arnold, MD, recommends not only glucosamine sulfate for her patients (1,500 milligrams a day, taken in two to three doses a day), but also 400-800 international units of vitamin D. Arnold is a rheumatologist at the Illinois Bone and Joint Institute in Chicago.
"Lower levels of vitamin D in the body are associated with higher levels of pain," she says. She also recommends 1,000 milligrams a day of vitamin C, 200 milligrams of omega-3 fatty acid twice a day, and 2 cups of green tea every day for its anti-inflammatory effects.
One nutritional supplement that has been receiving much attention lately is MSM (methyl sulfonyl methane).
MSM, which can be found in fresh fruits and vegetables, milk, fish, and grains, is destroyed when foods are processed; if your diet is made up of a lot of processed foods, you may be low in MSM levels.
Several animal studies have seemed promising, including one published in 1985 in the journal Immunopathology that reported that MSM eased rheumatoid-arthritis-like effects in mice. In a recent small study of 50 men and women conducted by Leslie Axelrod, ND, of the Southwest College of Naturopathic Medicine in Tempe, Ariz., patients who received MSM reported 12% less pain and 14% more knee function than those who were given a placebo.
Because the quality of herbs and supplements can vary, even some of these treatments might not work, cautions Tod Cooperman, MD, president of ConsumerLab.com.
ConsumerLab.com reviewed supplement products touted for their pain-relieving benefits. It found that one product, claiming to contain 500 milligrams per serving of "chondroitin sulfate complex" actually contained less than 90 milligrams of chondroitin sulfate -- only 18% of the 500 milligrams.
"Fortunately, most products contain what they claim," says Cooperman. "But consumers should choose their supplements wisely. If a product is not working, it may be the product itself that is flawed, and not the approach."
Useless, Dangerous Remedies?
There are a number of other alternative remedies that arthritis sufferers try.
Many of those -- such as copper bracelets or magnets -- may not have much, if any, scientific evidence to back them up or disprove them. Indeed, Kerry Ludlam, a spokeswoman for the Arthritis Foundation, reports that there is a lack of research both for and against the usefulness of alternative therapies.
"There's a void of information," she says. Since many of the alternative therapies cited for the relief of arthritis are considered harmless (other than perhaps to your pocketbook), many doctors say that if you want to try them, go ahead.
Other therapies, however, can be dangerous.
Bee venom could cause a potentially fatal reaction in those allergic to stinging insects. And even glucosamine, generally safe for most people, could be dangerous for people allergic to shellfish. (Shellfish-free glucosamine is now available.) For these reasons, it's important to check with your doctor first before trying any alternative treatment.
It's also important to note that herbs and supplements may have unknown and potentially dangerous interactions with medication. If you're taking medication, it's best to check with your doctor before trying any supplements.