Arthritis - Naturopathic Approaches, Treatments & Success Stories (Mega Report from 33 Sources)

Arthritis - Naturopathic Approaches, Treatments & Success Stories (Mega Report from 33 Sources)

Arthritis is a well-known condition that causes extreme, debilitating, life-altering pain. According to the Arthritis Foundation, arthritis affects over 50 million Americans, making it the leading cause of disability in the country ((link removed)). This means that one in five adults, 300,000 children and countless families deal with the consequences of this painful condition every day. The Centers for Disease Control reports that more than 43% of adults with arthritis have limitations in work or play due to pain ((link removed)). Arthritis is actually an umbrella term for more than 100 different diseases (link removed). While all types share the same general symptoms of pain and joint inflammation, each has a unique etiology, some of which are better understood than others. The most common forms of arthritic diseases include osteoarthritis (OA) and inflammatory arthritis, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and gout.

Osteoarthritis

The concept of the pathophysiology of OA is still evolving from a cartilage limitation to a multifactorial disease affecting the entire joint (source). Traditionally viewed as “wear and tear” of articular cartilage, OA is a degenerative joint disease caused by disruption of the physiological pathways that affect cartilage and other joint structures. The physiological events that occur in OA result in progressive degeneration of the joints, including destruction of cartilage, narrowing of the joint space, cysts, disc and facet joint changes, and changes in the synovium, joint capsules, ligaments, muscles, meniscus, fat pads, and the layer of bone beneath the cartilage (source). Symptoms of osteoarthritis can include joint pain, loss of mobility and deformation (source). Currently, only symptom-modifying medications are approved for use by the FDA. These are primarily pain-relieving therapies that have limited effectiveness and can have life-threatening side effects and significant toxicity (link removed).

Kimberly M. Sanders, ND(University of Bridgeport):
"Our goal is to prevent disease before it even begins. Osteoarthritis can be prevented for many by maintaining a healthy body weight and reducing the risk of injury in young adulthood. By teaching young athletes safety measures and proper body mechanics, we can reduce the risk of injury as well as the risk of developing osteoarthritis later in life. Preventing overuse of joints can also reduce the risk of arthritis. Therefore, teaching patients about correct ergonomics and posture is an important preventative measure. Finally, evaluating and treating vitamin D deficiency is another possible preventive measure. The treatment goals for a patient with osteoarthritis include controlling pain and improving joint function. To achieve these goals, naturopathic treatments include anti-inflammatory and analgesic Interventions to reduce pain, ideally to reduce dependence on NSAID painkillers. NDs may also include other therapies such as hydrotherapy, acupuncture, manipulation, and other physical therapies. In order to improve joint function, the naturopathic doctor wants to slow down the loss of cartilage and ideally restore the amount of cartilage in the joint space.”

Inflammatory arthritis

Inflammatory arthritis is a category of arthritis that includes diseases characterized by inflammation of the joints and other tissues (link removed). Most conditions classified as inflammatory arthritis are also autoimmune diseases. In autoimmune diseases, the immune system, which is supposed to protect the body, attacks the body instead. Symptoms of inflammatory arthritis can include pain, swelling, warmth, and tenderness in the affected joints, as well as morning stiffness lasting more than an hour (link removed). Inflammatory forms of arthritis are systemic and affect the entire body. Because of this, inflammation-related symptoms may occur, including skin rashes, development of lumps or nodules under the skin, eye inflammation, hair loss, dry mouth, and fever (link removed). Current theory posits that a genetically susceptible individual is exposed to an environmental trigger, which is the most likely mechanism for triggering inflammatory arthritis (link removed).

Jennifer Bennett, ND, LAc (Bastyr University):
"Laying the foundation for health, such as getting enough sleep, drinking enough water, and trying to reduce stress, is always a good starting point to reduce inflammatory burden. Identifying and removing triggers that stimulate the immune system, such as food allergies, improper balance of the gut microbiome, hormonal imbalance, and other environmental toxins, are the next best approach to preventing inflammatory arthritis and improving symptoms. Symptoms such as gas, bloating, frequent or urgent bowel movements, constipation, fatigue, irregular menstrual cycles, early menopause, chronic headaches, chronic congestion, or allergies may be factors for underlying triggers. Correcting these other symptoms is part of the approach to reduce inflammation and prevent arthritis. It should be noted, however, that if the joint is already damaged, the inflammation will only partially relieve the pain and prevent further damage. Depending on how much damage has been done to the joint, further treatment should be undertaken (if possible) to minimize pain.”

Rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis (source). It affects more than 1.3 million Americans, about 75% of whom are women (source). RA is characterized by persistent synovitis (inflammation of the synovial lining), systemic inflammation, and autoantibodies (particularly to rheumatoid factor and citrullinated peptide) (link removed). The small joints in the hands and feet are most commonly affected, and sometimes RA can even affect organs such as the eyes, skin, or lungs. Over time, persistent inflammation can destroy the joint and lead to permanent joint deformity and damage.

Psoriatic arthritis

Psoriatic arthritis is a type of autoimmune inflammatory arthritis that occurs in some patients with skin psoriasis. However, it can occur in people without skin psoriasis, especially those with relatives with psoriasis (source). Psoriatic arthritis occurs most often in the larger joints. It is particularly pronounced in the joints of the lower extremities and in the distal joints of the fingers and toes, and can also affect the dorsal and sacroiliac joints of the pelvis.

gout

Gout is a form of non-autoimmune inflammatory arthritis that affects over 8 million American adults and is the most common inflammatory joint disease in men (link removed). The incidence of gout has more than doubled in the last 20 years, likely due to dietary changes and the increased prevalence of obesity (link removed). Fortunately, this does not lead to system-wide inflammation in RA or psoriatic arthritis (link removed). In gout, joint inflammation is the result of increased levels of uric acid in the bloodstream (hyperuricemia), which leads to the deposition of uric acid crystals in the joints. The likelihood of developing gout increases with a rich diet (red meat and wine are common culprits that cause increases in uric acid). The result is extremely painful joint inflammation. The most common site for gout is the large joint at the base of the big toe, but it can also affect other joints.

Naturopathic treatments

Although different forms of arthritis cause pain in different ways, the basics of naturopathic management and treatment options are fairly similar across all types.

Tyna Moore, ND, DC(National University of Natural Medicine):
"Arthritis is a metabolic and systemic disease, so lifestyle changes such as diet, exercise and targeted supplements are crucial. Lowering sugar, increasing healthy proteins and fats, balancing hormones and maintaining adequate daily exercise and joint strengthening are my job. In addition, I use regenerative injection therapies such as Prolotherapy and platelet-rich plasma as my preferred treatments. But these injections simply don’t work or last unless the other factors are addressed.”

diet

Of the non-pharmacological treatment approaches, dietary interventions are among the most common. In recent years, the role of dietary antioxidants in the treatment of arthritis has been increasingly addressed by researchers in reported studies. Although the underlying cause of arthritis is largely unknown, a number of nutrient and non-nutrient components of foods have been shown to influence the inflammatory process and, in particular, influence the progression of clinical disease (link removed). New research shows that fruits and their polyphenols play a protective role in preclinical, clinical and epidemiological studies of various forms of arthritis (link removed). Berries and berry extracts have shown protective properties regarding joint structures and overall inflammation levels (link removed), (link removed). There is also some evidence on the role of specific fruit - polyphenols, such as quercetin and citrus flavonoids, in relieving arthritis symptoms (link removed).

Joanne Gordon, ND, MSPT(Southwest College of Naturopathic Medicine):
"Proper nutrition is necessary for joint health. Switching patients to a whole food diet, primarily plants, helps reduce pain and inflammation in as little as two weeks. These benefits are increased when you eliminate processed foods like bread, sugar and dairy. Foods like salmon contain essential fatty acids and vitamin D, berries are rich in antioxidants and are one of my favorite supplements for people with joint and joint problems Muscle pain is vitamin D. So many people are low in vitamin D and it can often produce a big difference.”

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Movement as medicine

Exercise is recommended as a conservative first-line intervention approach for arthritis, particularly osteoarthritis. There is strong evidence that aerobic and strengthening exercise programs help improve pain and physical function in adults with mild to moderate OA (link removed). Arthritis can be a barrier to physical activity. Studies have found that 43.5% of adults with arthritis report arthritis-related activity limitations (link removed). However, exercise can also be preventative in the development of arthritis. Research has found that, when adjusted for age, the prevalence of arthritis among adults who report no leisure-time physical activity, at 23.6%, is significantly higher than the prevalence of arthritis among adults who report meeting basic physical activity recommendations, at 18.1% (link removed).

Kimberly M. Sanders, ND(University of Bridgeport):
"As in all cases, naturopathic doctors try to find the underlying cause of osteoarthritis. If the patient is carrying excess weight, weight loss can slow the progression of the disease by reducing stress on the joints. Proper strengthening of the muscles around the affected joint is also encouraged to support the joint and improve function. Low-impact exercise, especially swimming, is also useful for the treatment of Great benefit for osteoarthritis symptoms.”

Physical medicine

Physical medicine is an approach to patient care that includes a variety of physical modalities such as physical therapy, chiropractic, other types of bodywork, and hydrotherapy. These approaches can help relieve symptoms of arthritis. For example, physical therapy sessions along with disease education improved mobility and joint stiffness in RA patients during a six-week trial, and hamstring strengthening under the care of rehabilitation specialists improves outcomes in knee OA and joint replacement (Source1, (link removed).

There is also evidence for the use of hydrotherapy and spa medicine to treat arthritis. In one study, patients with RA underwent 28 days of therapies that included mud packs, mineral baths, and shower massages. Participants showed significant improvement in symptoms and functioning, including a better sense of overall well-being, by the end of the study (link removed). Another study, also involving RA patients, showed that a two-week treatment involving mud packs and mineral baths improved pain and tenderness for an average of six months after treatment (link removed).

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Supplements and herbs

There is a wide range of nutritional supplements and herbal products that have been studied for their therapeutic benefits in treating arthritis. Among the most commonly used are glucosamine and chondroitin, and these products have been extensively studied both alone and in combination. Glucosamine may work better than ibuprofen at relieving joint pain, and chondroitin may work better than placebo at improving pain and mobility (link removed).

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Omega-3 fatty acids from fish oil have extremely well-established anti-inflammatory effects and have been used for years to treat painful joint diseases. Omega-3 supplementation has been shown to reduce the pain of RA and OA and may reduce dependence on over-the-counter painkillers (link removed). Another fatty acid called gamma-linolenic acid (GLA), derived from black stream seeds, borage and evening primrose oil, also has powerful anti-inflammatory effects. A meta-analysis of studies examining the effect of GLA on rheumatoid arthritis found a 33% reduction in pain and a 15% improvement in mobility (link removed).

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Herbal supplements have also shown benefits for those suffering from arthritis. A meta-analysis of 49 studies using the herb  Boswellia serrata (Frankincense) found that 90 days of treatment significantly improved symptoms such as pain and physical function compared to placebo (link removed).(link removed) Curcumin extract, derived from turmeric longa root, is popular among naturopaths for its incredible anti-inflammatory properties. Studies have shown that curcumin can both prevent and treat OA and RA symptoms by reducing systemic inflammation and protecting the joint's synovium from inflammatory damage (link removed) , (link removed).  Green tea and green tea polyphenols have also been studied as a possible treatment for arthritis. Green tea modulates inflammation through multiple biochemical pathways and regular consumption of green tea can prevent both the onset and progression of arthritic conditions (link removed).

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Our recommendation: (link removed)

Our recommendation: (link removed)

Success stories from naturopathic doctors

Joanne Gordon, ND, MSPT(Southwest College of Naturopathic Medicine):
"Connie, a retired doctor, had painful arthritis in her left thumb and knee that prevented her from knitting, spinning yarn, or taking care of her new 8-week-old puppy due to pain. Connie eliminated some of the most common inflammatory foods like sugar and dairy, checked her vitamins and hormones, and then received some prolotherapy sessions. Connie noticed a significant difference in hers Pain levels and can now knit, care for two Cairn terriers and look after her other farm animals.”

Jennifer Bennett, ND, LAc (Bastyr University):
"Many patients show improvement in their arthritis symptoms, and some may even discontinue their medications over time. One notable patient was a woman diagnosed with rheumatoid arthritis at age 32. She had been receiving a combination of leflunomide and methylprednisolone for many years with limited success. Her other symptoms included an irregular Menstrual cycle (cycles of 65 to 33 days), chronic migraines and chronic stress. After a year, we were able to regulate her menstrual cycles to every 31 days with herbs such as flax and vitex, which reduced her chronic migraines and joint pain. We also worked on an anti-inflammatory diet and her gut microbiome with berberine and high doses Probiotics corrected. We were eventually able to taper her off her steroid with minimal joint pain or flares. and we are currently working to get her off her leflunomide dosage. To date it is relatively pain-free and recent imaging shows no progression of joint damage after a year and a half.”

Kimberly M. Sanders, ND(University of Bridgeport):
"Steven is a 56-year-old man who first presented in June 2018 for treatment of left knee osteoarthritis, which he rated as 5/10 in severity. He was morbidly obese with a BMI of 47.8. On physical examination, I noted a mild effusion in the left knee, but no erythema or pain on palpation. Limited flexion of the left knee was also noted. Examination of the right knee was normal. On his first visit, I ordered basic labs to check his blood sugar and cholesterol levels along with vitamin D and thyroid panels. His fasting glucose returned slightly elevated at 101 mg/dL, A1C at 5.8%, and his insulin was high at 21.8 uIU/mL. His vitamin D was also at 25 ng/ml low. His cholesterol levels were within normal limits. Based on these findings, I determined that insulin resistance was contributing to his obesity. This was a likely cause of his left knee osteoarthritis. Additionally, his vitamin D insufficiency could also pose a barrier to healing, as lower vitamin D levels are linked to worsening osteoarthritis progression can. My focus for the patient was short-term symptomatic control with the long-term goal of improving insulin sensitivity and promoting weight loss to reduce tension on the joint.
He received an exercise and nutrition plan to improve insulin sensitivity, as well as vitamin D replacement therapy, a bioflavonoid complex, an omega-3 supplement high in EPA, and a curcumin supplement for symptom control and anti-inflammation. My focus for the patient was short-term symptomatic control with the long-term goal of improving insulin sensitivity and promoting weight loss to relieve joint tension. He received an exercise and nutrition plan to improve insulin sensitivity, as well as vitamin D replacement therapy, a bioflavonoid complex, an omega-3 supplement high in EPA, and a curcumin supplement for symptom control and anti-inflammation. My focus for the patient was short-term symptomatic control with the long-term goal of improving insulin sensitivity and promoting weight loss to reduce tension on the joint. He received an exercise and nutrition plan to improve insulin sensitivity, as well as vitamin D replacement therapy, a bioflavonoid complex, an omega-3 supplement high in EPA, and a curcumin supplement for symptom control and anti-inflammation.
Steven returned in August 2018 with updated labs. His fasting glucose remained elevated at 103 mg/dL, but his insulin was now 11.6 uIU/mL. His A1c% was not repeated as only two months had passed. He had not yet noticed any weight loss or pain reduction, but also admitted that the diet was followed irregularly. He regularly followed the exercise program, which is likely responsible for the observed drop in insulin. After another two months, his fasting glucose remains elevated at 106 mg/dL, but his A1c% is now 5.5%. His insulin is still 11.1 Uiu/mL and his vitamin D is now 31 ng/mL. Most notable, however, is a 30% improvement in his knee pain and function at this visit. He noted that after consistent use, the combination of curcumin and high-EPA fish oil supplement appeared to provide great relief, although no weight had yet been lost. As of our last visit with Steven in February 2019, his insulin remains at 11.2 Uiu/mL and his A1c% is now 5.3%. Now that the holiday season is over, he finds that his eating plan has been more adherent since the new year and has already noticed a 16-pound weight loss. His knee pain remains 2/10 and he has reduced his reliance on ibuprofen by using curcumin and a high EPA supplement instead.”

Tyna Moore, ND, DC(National University of Natural Medicine):
"It is my passion to help my patients relieve their pain. My favorite case was a patient with a frozen and painful shoulder. She could barely use her arm or raise it more than a foot from the side of her body. She wanted platelet-rich plasma, but I knew better. Too much, too fast, too strong can make this type of condition even worse. We started slowly and quietly with gentler regenerative injection types, incorporated hormone balancing and general care, worked our way up from there with the strength of the injections, incorporated rehab and strengthening and within a few treatments she was 100% pain free and able to enjoy full range of motion. She threw her arms full over her head and shouted, “Look at me!” Seeing her relief from pain brought a lot of joy to my heart.”

Naturopathy has a large and comprehensive toolbox to help people with arthritis.