Osteoarthritis is a degenerative condition of the joints, caused by cartilage breakdown.
Image Credit: Crevis/Shutterstock.com
The synovial joints are responsible for most of the free joint motion in the body where two or more bones come into contact.
To minimize friction and maximize gliding movement, the ends of the bones in each joint are covered with a smooth slippery gleaming coat of cartilage. Overuse, and age-related deterioration, takes its toll on this, however, leaving it worn and pitted.
The symptoms include joint pain, damage to the underlying bone with continued heavy use of the joint, and eventually restriction of movement at the affected joint. This can lead to a significant limitation of independence and lower quality of life.
The joints most frequently affected are the hands and the knees which take the brunt of hard work and weight-bearing. It is more common in females, increases with age, and is more likely in overweight individuals.
Natural remedies – an overview
There are a host of natural remedies for osteoarthritis, chiefly because many medications used for this condition are either associated with significant side effects or ineffective. The most commonly encountered natural methods include:
- Hot and cold packs
- Communication and support
- Massage therapy
- Tai Chi and Qi Gong
- Supplements and nutraceuticals
- Omega-3 fatty acids
Hot and cold packs
Cold compresses with acutely inflamed joints, followed by warm compresses afterward, can provide significant pain relief without using medication.
The cold reduces the inflammation while the warm pack soothes the muscle spasm. Splinting the joint also helps during acute pain by preventing joint movement and resulting stresses.
Exercise is key, all experts agree, to keep the damaged joints as flexible as possible, and relieving pain. The exercise should be guided by a physical or occupational therapist to avoid putting stress on the affected joint. Occupational therapists can also help to learn new methods of doing daily tasks to avoid hurting oneself more.
Communication and friendship
Free and open communication with the doctor about the pain is important, and patients should also look at their pain habits to see if their use of pain medication, alcohol, or any other substance is increasing or is excessive.
Talk about how pain is affecting your quality of life and your habits. Seek support and change to get back in control of your life.
Mental relaxation and being aware of one’s surroundings help bring peace of mind, which is profoundly healing by itself, at least in terms of restoring control.
There are many different natural methods, some of which are as simple as a prayer, or meditating on a simple essentially noble thought. Sleep is an essential part of gaining energy to deal productively with the pain, and a regular sleep schedule is helpful with this.
Massage and reflexology
Massage is an age-old health condition that involves kneading and pressing the soft tissues skillfully. It provides pain relief and better function at least over the short term when done gently.
Tai Chi and Qi Gong
These practices involve careful postures, gentle movements, mental focus, breathing patterns and relaxation, all of which will benefit people in pain by numerous mechanisms.
For one, they improve balance and coordination, improve the mood and the quality of life, reduce anxiety and may promote better sleep. The risk of falls is lower and back pain is likely to be improved. It is thus not surprising that Tai Chi produces pain relief and better function in knee osteoarthritis.
Acupuncture refers to the practice of painlessly inserting very fine needles into the skin at specific points to relieve pain and inflammation as well as other diseases.
A large Phase III clinical trial showed that it was effective in reducing pain, and improving knee function in knee osteoarthritis, and could be a good complement to conventional therapy. However, the benefit is modest and may vary from patient to patient. The placebo effect cannot be discounted as there is a very small difference between the benefit derived from acupuncture and sham acupuncture.
Supplements and nutraceuticals
Glucosamine and chondroitin sulfate are natural substances that makeup part of the joint cartilage. These nutrients are often added to the patient’s diet, supposedly to help rebuild lost joint cartilage. However, several studies have shown that these supplements likely provide little to no benefit to persons with osteoarthritis.
The GAIT trial was the first large multicenter clinical study to test this hypothesis concerning knee osteoarthritis. The two supplements were tested alone and in combination, against a nonsteroidal anti-inflammatory drug (NSAID) and a placebo.
After 24 weeks of treatment, the researchers found that up to 60% of patients on placebo had a pain reduction of 20% or more, compared to 70% with the NSAID. There was no significant difference in pain scores between the placebo group and the glucosamine/chondroitin group overall.
However, when they looked at patients with the most pain, 79% had 20% or more pain reduction with these supplements and only 54% with placebo. However, less than 350 of the approximately 1500 participants were in this category, making the results liable to error.
Moreover, cartilage loss may slow over time, as seen with the placebo group on follow-up at 2 years. Overall, no benefit has been observed in many other studies. One animal study found kidney damage, but this is yet to be confirmed in humans.
Some herbs, like a cat’s claw (a woody Amazon vine used in traditional medicine for contraception and immune-boosting), evening primrose oil, feverfew, ginger have not been studied or are be ineffective for osteoarthritis.
A Chinese plant called thunder god vine is useful in rheumatoid arthritis but there is no data on its role in osteoarthritis. It can be poisonous and may have side effects involving the reproductive system, bones, and hair growth.
It should be taken only under medical supervision, as a result. Willow bark is a source of salicylic acid, which is a pain-reliever and anti-inflammatory chemical, and may be used with care in osteoarthritis.
Curcuminoids in turmeric may have positive effects on osteoarthritis, from preliminary studies, comparable to ibuprofen, an NSAID, based on early studies, but these have not been followed by strong studies.
It is safe unless taken in great excess when it may cause gastric irritation. Local application of capsaicin (derived from hot peppers) in the form of cream may help soothe pain in osteoarthritis of the hand.
Permanent magnets, as well as electromagnets, are marketed for osteoarthritis. A 2013 study shows that there is some improvement with the use of small machines or mats to apply electromagnetic fields to the joint or to the whole body.
The same year, a transcranial magnetic stimulation device was approved by the US Food and Drug Administration (FDA) for migraine treatment. However, this may interfere with pacemakers, insulin pumps and other metallic devices. Other than this, no side effects are known, though this should not be used for the primary treatment of osteoarthritis.
Omega-3 fatty acids
Omega-3 fatty acids are used as supplements, are found in the body and are rich in seafood and fish oil capsules. There is not much evidence that they are useful in osteoarthritis, but no serious side-effects have been established, and these compounds can be obtained by eating a healthy diet.
There is a vast amount of information and claims floating around on the Internet about a wide variety of therapies and supplements, and this article is not exhaustive by any means. Niacinamide, vitamin C, vitamin E, boron, manganese, and S-adenosyl methionine have all had their lease of popularity, which rapidly waned.
It is important to sift through efficacy and safety claims before using any of these, to keep your doctor informed before starting any new treatment and choosing a qualified practitioner who is aware of other medications that the patient is on.
Natural remedies should not be the first line of treatment with chronically painful conditions. However, they may in some cases be complementary to other therapies with significant success.
Reviewed by Jennifer Logan, MD, MPH