Overview 

Arthritis (Rheumatoid Arthritis, Osteoarthritis) is a progressive, chronic condition classified as an inflammatory disease and autoimmune disorder that affects about 1.3 million Americans. For some of these people, arthritis may emerge after a specific injury or repetitive use of one or more joints. For others, arthritis results from the immune system incorrectly attacking the synovium, or the thin layer of tissue that lines the joints. In any case, arthritis is never simply a part of normal aging. 

In Rheumatoid Arthritis (RA), the joints of the hands, wrists, elbows, knees and ankles are commonly affected by inflammation. RA also tends to occur symmetrically, meaning that if one hand has damage to the joints, then the opposite hand will also be affected. However, RA is also a systemic condition and can affect other organs, including the heart, lungs and even the skin. Conversely, osteoarthritis (OA), also known as ‘degenerative arthritis,’ is localized to the affected joint and the impact on the synovium remains targeted to the site.  

Researchers believe that the mechanism of both RA and OA is basically the same and involves impaired collagen synthesis and dysfunctional proteoglycans, the specialized proteins that make up cartilage that surrounds each joint. In the absence of arthritis, the cartilage absorbs shock from the joint by releasing water to create a protective barrier. Meanwhile, the synovial tissue secretes a special fluid to lubricate the cartilage and keep it smooth. However, when this normal process is interrupted in the early stages of OA, the cartilage retains water, becomes inflamed and slowly deteriorates. Eventually, the very bone the cartilage was designed to protect will form cavities and calcium overgrowths known as osteophytes, resulting in pain with movement. In the later stages, OA may progress to the point that pain is experienced even when at rest. 

Currently, there is no cure for arthritis. However, it is imperative that aggressive treatments begin at the first sign of symptoms to help avoid serious complications later, including disability or deformity. In addition, simple blood tests will determine if you are at specific risk for becoming susceptible to an advanced form of the disease by checking for the presence of antibodies to rheumatoid factor (RF) or cyclic citrullinated proteins (anti-CCP). Patients diagnosed with RA, whether they test positive for antibodies or not, are generally at increased risk for developing other autoimmune disorders, as well as cardiovascular and kidney disease. 

Symptoms and Diagnosis of Arthritis 

The symptoms may be different from one person to another and depends on whether the inflammatory condition is due to OA or RA, but the typical signs of arthritis include:

- Swelling, redness or tenderness of the joints 

- Decreased range of motion 

- General stiffness 

- Fatigue 

- Muscle aches 

- Fever 

While blood tests may reveal the presence of RA antibodies, not everyone that tests positive develops RA. Furthermore, there are no standard lab tests that can rule out arthritis over other joint diseases. Therefore, diagnosis is made based on a physical examination, a review of medical history, and an account of the symptoms experienced. However, there are certain blood tests that can help confirm the physician’s findings in addition to testing for antibodies, such as: 

- A blood test for c-reactive protein, which measures the degree of inflammation present. 

- An ESR test (also known as the Biernacki Reaction), which determines erythrocyte sedimentation rate, or the rate at which red blood cells precipitate and form sediment in the bottom of a test tube in the span of one hour. An elevated rate indicates a high level of fibrogen, a protein that causes blood cells to stick together to form clots. content and a greater degree of inflammation. 

In addition, X-rays or magnetic resonance imaging (MRI) may be used to help determine the degree of damage to the synovium and inflammation in the joints. 

Conventional Therapies 

Conventional treatment for arthritis usually involves the use of medications that can be broken down into three main types: 

NSAIDS: Nonsteroidal anti-inflammatory drugs to reduce inflammation. This includes over-the-counter medications, such as aspirin or ibuprofen. Some prescription medications in this class, however, have recently been found to increase the risk of heart attack or stroke and have been removed from the market. 

Corticosteroids: Corticosteroid medications (i.e., prednisone) may be prescribed in order to quickly reduce inflammation. However, many of the drugs in this class can produce serious side effects and, for this reason, are usually given for a short duration. 

DMARDs: Disease-modifying antirheumatic drugs attempt to slow the progression of the disease by suppressing the immune system. 

Complimentary Therapies 

Massage: Many Western physicians are beginning to suggest massage therapy for their arthritis patients. Studies have shown that massage therapy can relieve muscle ache and joint pain, while reducing stress hormones. Massage also promotes an increased production of endorphins, the body’s natural painkillers. 

Acupuncture: This therapy is based on belief in Traditional Chinese Medicine (TCM) that disease is the result of an imbalance of energy in the body. In acupuncture, needles are used to stimulate the 14 meridian points, which are seen as the channels in which energy travels in the body. As with massage, research has shown that this form of therapy also increases endorphin release, as well as other pain-relieving neurotransmitters. 

Acupressure: Also known as Shiatsu, this form of therapy is also based on the TCM system of meridian points referenced in acupuncture. However, rather than using needles to stimulate these points, the practitioner using pressure techniques with the thumb, forefinger and palm of the hands.  

Recommended Supplements in the Treatment of Arthritis 

Even Western allopathic physicians recognize the importance of diet and nutrition to combat the oxidative damage and progressive degeneration associated with arthritis. In addition, unlike NSAID therapy, nutritional therapy strives to address the underlying cause of this disease by providing natural antioxidants and anti-inflammatory agents that minimize the action of inflammatory cytokines and promote collagen synthesis. 

Omega-3 

The result of more than 20 years of research has established that omega-3 fatty acids are of excellent benefit for arthritis sufferers. Of particular benefit are the fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which improve overall metabolic functioning while decreasing levels of inflammation-producing cytokines. 

S-adenosylmethionine (SAM-e) 

SAM-e is the active form of the amino acid methionine, which is manufactured by the body from adenosine triphosphate and methionine before being converted into cysteine. Studies have shown that SAM-e protects the synovium by blocking certain enzymes responsible for cartilage breakdown. In addition, research indicates that SAM-e may help to restore joint cartilage and lining since it stimulates cell growth and the production of specialized proteins known as proteoglycans. SAM-e also seems to be better tolerated than either naproxen or piroxicam. However, since SAM-e is not generally well absorbed, the enteric-coated tablets are recommended.

Helpful Herbs in the Treatment of Arthritis 

Borage 

Borage seed oil is a rich source of gamma-linoleic acid (GLA), which possess anti-inflammatory qualities. Specifically, GLA goes to work by blocking the action of arachidonic acid, which is found in animal proteins. Otherwise, this acid would be converted in the body into leukotrienes and other prostaglandins, which mediate inflammation. GLA also blocks the action of another inflammatory mediator known as tumor necrosis factor-alpha by synthesizing into the prostaglandin precursor dihomo-gama-linolenic acid (DGLA). 

Evening Primrose Oil 

Evening primrose oil is also high in GLA content. In fact, this botanical offers one of the best modes of bioavailability of GLA. As such, it delivers similar benefits to that which borage seed oil provides. 

Ashwagandha 

Ashwagandha is well known in Ayurvedic medicine as a potent treatment for rheumatoid arthritis because the extract obtained from the root and berry of the plant possess anti-inflammatory, antioxidant and immunomodulatory properties. Studies have shown that the active constituents of this herb seem to target and inhibit cyclooxygenase, as well as being compared to hydrocortisone sodium succinate in efficacy. 

Curcumin 

The active component of turmeric, curcumin has demonstrated an ability to inhibit several inflammatory mediators, including cytokines, lipoxygenase enzyme, and COX-2. Curcumin also blocks the action of collagenase, hyaluronidase, and elastase, which play a role in cartilage deterioration. 

Capsaicin 

Commonly known as cayenne or chili pepper, capsaicin is formulated into a topical application to be absorbed via the skin. This substance is valued for its pain-reducing effect by inhibiting the action of an agent called substance P, a neurotransmitter that signals pain to the brain. 

Nettle 

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