Arthritis: can pain-free be drug-free? Alternative medicine can provide relief for aching joints - Natural Remedies

Troubled by a persistent ache in her hip, Suzanne Farrell, George Balanchine's most celebrated ballerina, finally went to a doctor in 1983, only, she says, to receive "the very last diagnosis I wanted to hear"--arthritis. In her memoirs, Holding On to the Air (Simon & Schuster, 1990), Farrell wrote, "I was only 38 and at the height of my physical abilities as a dancer in every way, except for my right hip. That hip, the x-rays showed, had the cartilage erosion of someone twice my age."

Farrell began a long and determined search for effective treatment, a journey on which she has many fellow travelers. An estimated 40 million Americans--one in seven people--suffer from this disabling disease in which the joints become inflamed, enlarged and swollen, and ligaments and muscles around the joints lose tone and flexibility. The various types of arthritis (rheumatoid and osteoarthritis are the most common) cost the U.S. economy $65 billion annually in medical care and lost wages.

Conventional medicine views arthritis as incurable but manageable. Most treatment programs include a combination of medication, exercise, rest, use of heat and cold, joint protection techniques and sometimes surgery. Physicians commonly prescribe nonsteroidal anti-inflammatory drugs (NSAIDS), which can put a swift stop to arthritis pain but also upset stomachs, even causing ulcers. Another tack is corticosteroid injections to reduce inflammation, but these also bear serious side effects.

Not too surprisingly, when faced with the prospect of powerful drugs and major surgery, many arthritis sufferers wonder if alternative medicine can help. They rapidly discover that most holistic practitioners believe that natural remedies bring dramatic relief from this chronic disease, whether they mean changing the diet, taking certain supplements and vitamins, or going on a regimen of herbs or homeopathic treatments.

What puts patients in a difficult position is the opposition of the conservative Atlanta-based Arthritis Foundation to what it calls "unproven treatments"those lacking the support of "repeated scientific studies."

In one of its "fact sheets," the Arthritis Foundation argues: "Even if an unproven remedy is itself harmless, it can still have a detrimental effect if it causes a person to stop or slow down proven treatments to control arthritis."

How, then, to account for case histories, such as that of Kathleen Billis, an artist from Boothbay Harbor, Maine. When she was 15, she was diagnosed with rheumatoid arthritis, an autoimmune inflammatory condition. At age 22, when many people are starting careers, Billis spent a year in the hospital, having three knuckles on each of her hands replaced with plastic joints. For many years, she resisted her husband's pleadings to try the low-fat vegetarian diet he'd heard could be helpful. But when Billis' physician wanted to switch her to a more powerful anti-inflammatory drug, vegetarianism got the go-ahead--she feared the drug's toxicity.

Results came swiftly. "The first week I was on the diet I felt a remarkable change," Billis says. In two months, she was able to wean herself off of all medication, and eight years later, at age 51, she is virtually pain-free, climbing mountains in Italy to find the perfect village to paint.

THE DIETARY DIFFERENCE

Since the ancient Greek physician Hippocrates coined the word arthritis--it means, not surprisingly, "swollen joints"people have complained of pain, swelling and stiffness in their limbs.

Modern thinking is that osteoarthritis, the most common form of arthritis, is caused by wear and tear, overuse, injury and obesity, but a genetic predisposition often exists as well. How could this degenerative joint disease be affected by diet? One theory: Certain foods trigger a chemical reaction in the body similar to an allergic response. A substance called histamine is released causing inflammation in the joints and--over time--arthritis. When these foods are removed from the diet, arthritis subsides.

Hari Sharma, M.D., a medical researcher from Ohio State University College of Medicine, says a poor diet high in animal fat and refined foods leads to imbalances in our bodies. Because we are unable to absorb badly needed nutrients, toxins accumulate. According to Sharma, an advocate of the ancient Ayurvedic medical tradition, this absorption failure causes an autoimmune reaction that leads to arthritis. "If you want a quick fix for pain, take aspirin," Sharma says. "But if you fix the cause, you are no longer affected."

According to naturopathic medicine, which tries to tap into the body's inherent ability to heal itself, the conventional American diet, crammed with processed foods, is at the root of many chronic diseases, including arthritis. Lauri M. Aesoph, N.D., a naturopathic physician from Sioux Falls, S.D., and author of How to Eat Away Arthritis (Prentice Hall, 1996), says a poor diet causes the evocatively named "leaky gut syndrome"--partially digested food and harmful chemicals leak out of a sieve-like gastrointestinal tract and into the bloodstream, causing food allergies and arthritis. Certain foods--called stressors--trigger inflammation, says Aesoph. They include meat, alcohol, chocolate, coffee, dairy products, eggs, sugar and all processed foods.

Another advocate of eliminating certain foods is John McDougall, M.D., author of numerous books on diet and health and president of the McDougall Program at Saint Helena Hospital in Deer Park, Calif. He believes animal and dairy products cause autoimmune reactions in people suffering from rheumatoid arthritis. Says McDougall, "If you can get people who have the disease to try an animal- and fat-free diet, they will have a whole new life."

Most support for the diet-arthritis link is anecdotal, but the theory is not without scientific backing. A 1986 placebo-controlled, double-blind study published in the British medical journal Lancet researched the effects of diet therapy on 53 arthritis patients. During the first week, patients ate only foods of which they were "unlikely to be intolerant." Then certain foods were reintroduced, one by one. The result was "significant objective improvement during periods of diet therapy." The study concluded that dietary manipulation "may give benefit to at least some patients."

While the Arthritis Foundation stops far short of advocating vegetarianism, its Diet & Arthritis Fact Sheet calls for plenty of vegetables, fruits and grain products; and moderation in fat, cholesterol, sugar, salt and sodium. Significantly, the foundation does not dismiss a diet-arthritis connection and, in fact, opens the door to supporting it once more scientific data become available. "Diet may change the way the immune system reacts in certain kinds of arthritis that involve inflammation," states the fact sheet.

No matter what the philosophy, a diet that focuses on fruits, vegetables and whole grains is sure to accomplish one important goal: weight loss. And losing extra pounds usually leads to at least some relief from arthritis. In a study partially funded by the Arthritis Foundation, researchers found that overweight women can "significantly lower their risk for developing osteoarthritis of the knee by losing weight."

THE SUPPLEMENTS CURE

The debate over the recent bestseller. The Arthritis Cure: The Medical Miracle that Can Halt, Reverse and May Even Cure Osteoarthritis by Jason Theodokis (St. Martin's Press, 1996) continues to rage. The book's main premise, that a nutritional supplement--glucosamine sulfate--cannot only relieve arthritis symptoms but also help the body repair damaged joints, is generating much controversy, although many clinical studies in both Europe and the United States appear to support the supplement's benefits. As good as this news may be, it is largely irrelevant for vegetarians, because glucosamine sulfate is derived from animal products. Cartilage extracts, especially chondroitin sulfate, also are popular, but their effectiveness isn't as well-documented as that of glucosamine sulfate, and product purity, absorption and utilization in the body have been questioned by scientists. Cartilage substances also are not vegetarian.

But that's not the end of the supplement story. Practitioners cite other natural products for relieving arthritis pain. In a University of Massachusetts Medical Center study, gamma-linolenic acid (GLA) relieved pain of arthritis. In the study, the GLA came from borage seeds, but evening primrose, black current and borage oil also contain GLA, an omega-6 fatty acid.

According to Robert C. Atkins, M.D., author of Dr. Atkins' New Diet Revolution (Evans, 1992), the mainstay of any arthritis treatment program should be supplements of omega-3 fatty acids, another type of essential fatty acid (EFA) found in flaxseed and purslane. While omega-3 capsules won't relieve symptoms nearly as quickly as the NSAIDS, Atkins warns that such drugs are responsible for some 10,000 deaths every year from ulcers. Balancing the ratio of omega-3 to omega-6 fatty acids, have shown therapeutic benefits for a wide variety of diseases, including arthritis, asthma, psoriasis and ulcerative colitis.

Many natural-health practitioners urge arthritis patients to follow a regimen of antioxidant vitamins and minerals to neutralize the toxic buildup of free radicals--highly reactive particles that careen around the cells causing damage and disease, including, some experts feel, arthritis. Leading most lists are vitamins C and E, beta-carotene, selenium, zinc, calcium and magnesium, B-complex and pantothenic acid.

HERBS AND HOMEOPATHY: FAITHFUL HEALERS

For some treatments, you don't have to go very far. Ginger and turmeric, found in many kitchens, are widely used in Asia as anti-inflammatory agents. Other herbs also can offer short-term pain relief. Rosemary Gladstar, author of Herbal Healing for Women (Fireside Books, 1993), recommends taking valerian, which she says soothes joints and muscles; placing warm packs of comfrey and castor oil on affected joints; applying capsaicin, a derivative of cayenne pepper found in many anti-inflammatory creams; and taking tinctures or teas of fever few and dandelion. An herbalist can work with arthritis sufferers to come up with the right regimen.

As for homeopathy, Dana Ullman, M.P.H., author of The Consumer's Guide to Homeopathy (Putnam, 1995), cites a study published in the British Journal of Clinical Pharmacology saying 82 percent of the patients with rheumatoid arthritis "experienced some degree of relief" after taking a homeopathic prescription. Remedies commonly prescribed for arthritis include Rhus tox, Bryonia and Ledum. For best results, advises Ullman, see a homeopath.

EXERCISE TO EASE PAIN

Every arthritis specialist that Suzanne Farrell consulted gave her the same advice--stop dancing. That was the one thing Farrell would not do. "It was only when the curtain rose that the pain abated," she writes.

In her determination to keep performing, Farrell hit on a treatment that is now bolstered by study after study: exercise. Moderate workouts not only reduce joint stiffness but also relieve pain and inflammation. Weight lifting, walking, tai chi, yoga, biking, swimming and aqua aerobics can all be beneficial.

You can choose any combination of the proven alternative approaches to treating arthritis--the important thing, as Farrell's example suggests, is to keep right on dancing.

Jeanne McCarten is a journalist living and working in Portsmouth, N.H.

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