Natural Treatments for Osteoarthritis

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org<

FROM:   Alternative Medicine Review 1999 (Oct); 4 (5): 330–341 ~ FULL TEXT

Osteoarthritis (OA) is the most common form of joint disease. Although OA was previously thought to be a progressive, degenerative disorder, it is now known that spontaneous arrest or reversal of the disease can occur. Conventional medications are often effective for symptom relief, but they can also cause significant side effects and do not slow the progression of the disease. Several natural substances have been shown to be at least as effective as nonsteroidal anti-inflammatory drugs at relieving the symptoms of OA, and preliminary evidence suggests some of these compounds may exert a favorable influence on the course of the disease.

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Introduction

Osteoarthritis (OA), the most common form of joint disease, is characterized by erosion of articular cartilage. The joints most often affected by OA are the knees, hips, spine, and hands, although other joints may be involved. OA is usually classified either as primary (idiopathic) or secondary. In the former, no obvious predisposing factor can be identified; in the latter, the arthritis appears be the result of trauma, repetitive joint use, congenital or developmental defects, metabolic or endocrine disorders, or other factors. Clinical manifestations of OA include pain, stiffness, and decreased range of motion of affected joints. In more-advanced cases, significant disability may occur. It is estimated that 100,000 people in the United States are unable to walk because of severe OA of the hip or knee.

In the past, OA was considered a degenerative disorder, in which the joint gradually “wears out.” However, more-recent evidence has resulted in a change of thinking concerning the pathogenesis and natural history of OA. It is now known that the joint cartilage of individuals with OA is highly metabolically active, engaging (at least early in the course of the disease) in a process of remodeling and repair of damaged tissue. Arrest or reversal of the disease, once thought to be impossible, has now been shown to occur spontaneously in some individuals with OA. [1]

Conventional pharmacological treatment of OA consists primarily of nonsteroidal antiinflammatory drugs (NSAIDs) and analgesics. While these medications often relieve symptoms, they are far from ideal therapeutic agents. NSAIDs, in particular, can cause serious side effects, including peptic ulcer and (less commonly) hepatic or renal failure. And neither of these classes of medications prevents or delays the progression of OA. In fact, there is evidence, both in animals with experimental OA [2] and in humans, [3] that administration of NSAIDs may actually accelerate joint destruction. New approaches are therefore needed, both to increase the safety and efficacy of symptomatic treatment and to exert a favorable influence on the course of the disease.

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