Arthritis (Osteoarthritis)  

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

What do you think about arthritis?

If you believe that arthritis is incurable and can only get worse then you probably shouldn’t start trying any of the following approaches unless you can re-open your mind and re-examine your convictions!

I have been in full time practice as a medical herbalist since 1989 in Christchurch, New Zealand and have treated hundreds of people with arthritis in those years. Living in a culture where Western medicine is dominant most of those people come to see me already having taken copious amounts of drugs and repeatedly hearing how they have to learn to live with their problem and not expect it to improve.

We have done things that have made a positive and noticeable difference but in all too many cases those people that have been improving have then not stuck around long enough to get the long term gains and changes that are necessary for lasting healing to happen. Why is that?

Some loss of flexibility is perhaps inevitable as we age but no-one should resign themselves to a lifetime of suffering. Our bodies have remarkable self-healing abilities and inflamed joints can heal far more than most people could imagine but I have found that the single biggest obstacle to working with arthritis has been the beliefs that people hold about it.

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Drugs; pain relief at a heavy cost

The long-term conventional treatment of osteoarthritis involves substances called non-steroidal anti-inflammatory drugs (NSAIDS). Steroidal injections or pills may also be temporarily used in advanced conditions. The use of these drugs may be necessary in the short term. Bringing down unacceptable levels of pain or immobility is when conventional medicines make the most difference. However, real problems arise when drugs are relied on for therapy in the long-term.

Some of the side effects of aspirin and other NSAIDS (such as voltaren, indomethacin, naproxen and ibuprofen) are well known: ulcer formation, gut upsets, headaches, dizziness etc. What is less well known is that experimental studies have shown that NSAIDS inhibit cartilage synthesis and actually accelerate cartilage destruction. In other words the drugs actually increase the rate of degeneration within the joints.

Several studies have attempted to determine the ‘natural course’ of arthritis. In other words, researchers have sought to determine what happens when people with osteoarthritis are given no treatment at all. One group of researchers studied the natural course of osteoarthritis of the hip over a ten-year period. At the beginning of the study, all subjects had x-ray changes suggestive of advanced osteoarthritis, yet the researchers reported significant improvements over the 10 year time with many of them. X-rays confirmed these improvements, including complete recovery in 14 of 31 hips. These results and others raise the serious concern that medical intervention may actually promote the progression of osteoarthritis.

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Can you really help arthritis?

The short answer to can you really help arthritis is 'yes', but only slowly and carefully. The advice I would give anyone with arthritis is to do whatever it takes to find out which safe, natural and affordable treatment helps them the most and then just stick with it, however long it takes.

What follows are the things that I have found to consistently help people, but nothing works for everyone. You don’t just have to be prepared to be patient; you also have to be prepared to experiment. Try things out properly, not just for a day or two. Discard the things that don’t seem to work and keep a hold of the things that obviously do (on average you probably need at least a week to be sure, sometimes even two!).

One or more of the suggestions below might just be what you need to turn things around. However if you are still getting harm from a different direction at the same time then the going may be just too slow to keep going so the first question to ask is 'are you doing anything that is making the arthritis worse?' If you are then seriously, just stop it! Don't take drugs to mask the pain and keep doing something that is stressing your body. If you could travel forward in time to your future self you can be in no doubt that he or she would be telling you in no uncertain terms to not do anything to harm your precious body. It's the only place you have to live!

Arthritis is always blamed on 'wear and tear through aging'. This is not untrue but neither does it accurately reflect reality because many people age without arthritis. For most people the main reason arthritis is developing is because of problems such as

~ unhealed injuries
~ poor circulation to the joints
~ something missing in the diet or something causing harm from the diet,
~ some repetitive strain to the inflamed joint or joints,
~ an accumulation of toxicity in the joints.

One or more of these ongoing causes of harm are much more likely than simple aging by itself to be what is making the joint wear out faster than it can self-repair.

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Cleansing

Eating a cleansing diet and taking potent cleansing herbs can be pivotal in starting a healing process in a damaged joint but if you don't need to do this then it could actually make things worse so
how do you know if you need to put a lot of focus on cleansing?

I believe that if people learn how to look at it then their own tongue will be a reliable guide to them in this vital matter. Get into the habit of looking at it each day. If it is relatively cleaner and pinker on the days that you feel better but then if it tends to a thicker coating and particularly if that coating tends towards being a creamy or even yellow colour when the joints are especially sore then yes, cleansing is likely to be a key strategy towards your healing.

A consistent practice throughout all the old systems of medicine has been to remove toxic accumulations from affected joints. This has been done through direct measures typically involving heat (more about that later) but also through using following a cleansing diet and taking herbal medicines that purify the blood through the liver and, especially, the kidneys.

Detoxification is a big subject with many myths and misconceptions. If it is something that you need to direct your attention to then I recommend start with my article here. Again I do recommend you to work with a good herbalist if at all possible but if this is not an option then the economic and very effective Juniper & Celandine cleanse will reliably help - detailed info on what this involves here. It is also very important to keep the diet clean and light when doing this sort of work - more detail on that side of things here.


Juniperus communis (Juniper berry)

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Herbs for arthritis

There are a number of other herbs with deep traditions of use for arthritis and many of them also clearly work by stimulating cleansing in different ways. In my own practice I will commonly give a tonic that contains a number of these herbs at the same time and you will find that this is a common practice amongst other herbalists as well.

Dandelion

Dandelion can be enormously helpful if given over at least a few weeks. Dandelion squeezes the hepatic sponge (the liver) and rinses the renal filter (the kidneys). A detailed write up on Dandelion including how to use it can be found here.

Celery

The medicinal use of celery seed can be pivotal at flushing out acidic wastes and thus alleviating much pain and stiffness in sore joints. Celery is written up in detail here.

Devil's claw

This South African herb with the outrageous name is a potent and proven arthritis remedy but it must be taken in sufficient doses and over a reasonable time frame (at least a week) to really assess its ability to help (more about it
here)

Turmeric

This common kitchen spice has an array of ingredients with remarkable, and now very well proven, benefits against inflammation and damage (more here)


Curcuma longa (Turmeric root)

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Acid vs. Alkaline diet

Many old traditions of health and medicine have reached the same conclusion even though they have developed in very different parts of the world and that is that for people with arthritis an acidic diet is bad for you and an alkaline diet is good.

The body has to eliminate acid metabolites and joint problems are a classic outcome of a failure to do this. If you have arthritis you should definitely reduce your intake of acidic foods and eat more alkaline foods. For those who are interested there is a chart with more detail below but all this can be very simply summarised into one, well-worn phrase... ‘Eat lots of fruit and vegetables!'

To see how you could eat in this way the cleansing diet mentioned earlier under cleansing gives a practical summary - it is again linked here.

One point needs clarification here that causes much confusion. Acidic foods are not those which taste acidic but rather are those which leave an acidic residue after digestion. A number of foods that taste acidic (e.g. citrus fruits and tomatoes) are in fact highly alkaline. For example, however they may taste, lemons actually alkalise the body!

In general it can be fairly stated that anyone who has a condition, or tendency to joint inflammations should aim to emphasise alkaline foods and spare or reduce acidic foods in their diet. What follows is a table of the food groups with their average levels of acidity. This is based on recent German studies that have determined the potential renal acid level (PRAL) in well-designed experiments.

Food Group
PRAL
Fats & Oils
0
Fish    
7.9
Fruit & Fruit juices
-3.1
Grain Products
.. Bread
3.5
.. Flour
7.0
.. Noodles
6.7
Meat & meat products
9.5
Dairy products
.. Milk & non-cheese products
1.0
.. Low protein cheese (less than 15g per 100g)
8.0
.. High protein cheese (more than 15g per 100g)
23.6
Vegetables     
-2.8
Lentils/Peas
0.2
A negative value means the food is alkaline.

The most acidic food of all is Parmesan cheese (PRAL 34.2!) and easily the most alkaline food is raisins (PRAL –21.0). (As an interesting side-note a popular old remedy for arthritis was to soak some raisins in Gin overnight and then eat the raisins in the morning!) Tea, coffee and wine are generally alkaline. Beer and soft drinks are acidic. Mineral water can be quite alkaline (up to PRAL –1.8) Bananas are very alkaline (PRAL –5.5), followed by apricots (PRAL –4.8). Spinach is also extremely alkaline (PRAL –14.0) Processed meats are easily the most acidic of any form of meat or fish consumption. Egg yolks are very acidic (PRAL 23.4). Chocolate, peanuts and walnuts are mildly acidic and almonds and hazelnuts are alkaline.

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Check for food allergies

A key driver for arthritis in some people is a low-grade, chronic and usually undetected food allergy (perhaps better described as an intolerance). For some individuals with arthritis, allergies to members of the nightshade family (tomatoes, potatoes and peppers) have been a major contributor and as some people get much better when they avoid those foods it has somewhat entered the mythology that these herbs cause arthritis - they don't! However if you are allergic to these or some other foods then it may well be that you are eating something that certainly will be pro-inflammatory.

As with detoxification, the whole area of food allergy/intolerance is rife with misunderstandings. If you have any childhood history of eczema or asthma or if you have developed migraines or hay fever in later life, or if you have a tendency to allergic 'shiners' (dark rings under the eyes) or cracks in the corners of your mouth then this may well be an area that you really do need to explore. In this case I direct you to the detailed article on this important subject here.

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Check your oil and water

Many people I meet who have arthritis are chronically dehydrated. You can see it in their skin, on their tongues and in the way their blood cells clump and show brittle edges under the microscope.

Seeing how dry your skin is can be a rough guide but you should be able to tell for yourself whether dehydration is an important part of your arthritis picture by whether your joints ache more or less according to how well you have been keeping up your good dietary fats and your fluids. The stickier your blood the more everything may hurt and vice versa, the better lubricated you are the better your joints may feel. To cure dehydration you need both oil and water.

Oils

A deficiency of oils in the body will likely show up in a dry skin or scalp, or even just a lot of creaking and cracking in the joints on movement. The best way to get extra oils into the body is via the diet: especially with eggs, nuts, seeds, avocados, oily fish and olive oil.

If the need to build up the healthy oils is especially high then use a supplement as well as having lots of good fats in the diet. But be careful to get a good fish oil (it should smell okay when you pierce a capsule; if you wouldn't eat it if it were fresh fish then don't swallow it as a pill!)

Water

The gradual loss of mobility and flexibility in osteoarthritis can be connected to deterioration in the free circulation of fluids in and around the joint.  One of the most effective strategies to improve circulation is to make the blood less ‘sticky’ so it can flow more freely. Blood stickiness can virtually always be improved by simply drinking optimal amounts of water every day. For most people this requires around 6-8 good-sized glasses and most people fall well short of this or only take their fluids in the form of tea and coffee, which actually do very little to hydrate the body because they are both mildly diuretic.

I have found one of the best strategies for success to in breaking the dehydration habit is to put a large glass jug full of water somewhere visible inside your home or office and make sure you have drunk it all before dinnertime. Adding some lemon or herbs such as lemon balm or mint to the water keeps it fresh and extra pleasant to drink.  

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Get the joint moving

~ Do you know why arthritis usually feels worse in the cold?
~ Or why an arthritic joint usually feels worse when it hasn’t been moving for a while?

Arthritis is an inflammation of the joint. Inflammation means, as the word suggests, that there is a flame inside i.e. there is too much heat within. That heat creates swelling, pain and damage. Anti-inflammatory drugs are extremely ‘cooling’ they take away the inflammation and the pain, swelling etc. goes down.

Given all that, wouldn’t you think that an arthritic joint would feel better in the cold and be better off without any extra heat or movement that creates more warmth?

This is one of the many paradoxes of medicine that makes you look deeper if you want to understand what is going on. When a person’s circulation is poor they are much more prone to getting what is known in oriental medicine as ‘stuck heat’. The joint may be too hot and  inflamed but the person in general is too cool and depleted to remove the problem by themselves. Arthritis is worse in the cold or when the joint has been still because it is those times that it is that much harder for the blood to circulate around the joint, carrying away the chemistry of inflammation.

People have instinctively understood this for millennia. Every great tradition of medicine views arthritis as a problem where too much debris is combined with not enough circulation. As well as eating a clean diet, including good oil and drinking lots of water it is essential that the blood is flowing through and around every affected joint in the body.

There are some specific and whole body strategies that improve circulation that I will talk about in a moment in the herbal section but for the fastest and more direct treatment possible you cannot go past your own or someone else’s hands.

Whatever else I may do with my patients with arthritis, one thing that is pretty much universal is to get them doing self-massage or, even better, if they are lucky enough to have someone close to them that can commit to doing it regularly, to get massage from them.

The technique and the exact cream or liniment to use are of much less importance than the simple, regular mobilising of the joint by getting hands on into it and moving everything around. In any case the secret to good massage is simply feedback. You (the person who is receiving it) has to say 'harder, softer, faster, slower, a bit to the right, a bit deeper... there, that's it!' ...and so forth until they get it and both you and they know they've got it. If you do this you will get great massage, it never fails. If you are doing it for yourself (and most people will need to be the one who does it at least some of the time if not all of the time) then remember it is the quality and not quantity that counts. You aren't trying to make anything hurt more in order to feel better; you are mobilising, stretching and moving the stuck joints, it can only help and you just need to be patient and persistent with it for as long as it takes.

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Get heat (fighting fire with fire)

As I was saying in the last section, many people instinctively use heat to ease joint pain and around the world, throughout history, heating measures have been used to relieve pain in the joints.

A slightly more detailed explanation of why this works requires us to briefly visit one of the key principles behind many natural systems of medicine. Instead of viewing symptoms of diseases as catastrophic events to be subdued at any cost the stance taken in the old ways of medicine is to view these symptoms as necessary side effects of the body’s attempt to free itself from disease.

So, for instance, in a situation of fever, instead of suppressing or fighting down the temperature the traditional therapist will typically use measures that actually support the fever process until it naturally breaks and resolves itself. In the case of joint inflammations this means seeing the swelling, inflammation and subsequent pain as the body’s attempt to resolve an unhealthy state of affairs within the joint.

Heating treatments at first seem a weird thing to do when there is inflammation, theoretically it should make things worse rather than better. The proof, as always, is in the pudding.

The increased blood flow from massage, movement or heating herbs causes a therapeutic inflammation, achieving painlessly what the body has been struggling to create with pain, swelling and disability.

In effect we are reading what the body is trying to do and saying ‘let's help speed the way for this process to get to where it is trying to go’ 

Almost all the people with chronic osteoarthritis I have worked with clearly respond positively to heating measures. You can pretty much tell straight away if it is helping because pain will be lessened and mobility increased. There are however instances when it won’t help. Sometimes a body part is already at a maximum level of inflammation and any further ‘stoking up’ would be counterproductive. Nor would you typically reach for a heating treatment for joints affected by gout or rheumatoid arthritis in their acute stages.

Heating plus Cooling

In some cases it will be best to use a combination of heating and then cooling strategies. This is where you follow up a hot wheat bag, or a hot compress, or simply bathing the body or an affected limb in hot water, with a cold ice-pack or a cold compress; made simply by placing a hand towel or other cloth into water from the fridge or to which ice-cubes have been added and then the wet fabric placed against the skin until the heat comes out of the body and the compress has warmed.

How you might know when to simply focus on heating therapy or when to also employ ice-packs etc. will be strongly influenced by whether a person is a hotter or cooler constitution. Hot constitutions will often be helped by some cooling therapy whereas cool constitutions are likely to only really need heating up to help them get better. The subject of 'constitutions' is an old, fascinating and highly useful are to explore and it is introduced in more depth here. If you read further into it you will see a link that shows you how to work out what constitution you are.

A further general rule of thumb for knowing when to focus on heating treatments is that the longer the problem has been around the more likely it is to help. The key thing to understand is that you are working with the principle of helping the body to resolve something it has been trying, unsuccessfully, to do for ages. Fighting fire with fire, getting heat into the joint can be done both externally and internally and I talk more about some practical ways to achieve this next...

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External Heat

These are the most commonly used methods of getting external heat

  1. Wheat or rice bags
  2. Tiger Balm
  3. Liniments with menthol, eucalyptus or wintergreen
  4. Russian Ointment (with cayenne)
  5. Heat Lamps      
  6. Hot water bottles
  7. Saunas, spas, hot baths

Hot baths are not for everyone but if you know you are a 'bath person' then I would encourage you to think of this as a regular part of your 'therapy'. If you can obtain some Epsom salts (magnesium sulphate) and throw a good handful of these into the bath as it is being run you will get an even deeper level of relaxation of movement of blood through your joints.

I personally think that wheat bags are one of the very best ways to get heat from the outside in. The gentle penetrating nature of the heated wheat bag is particularly suited to the deep aches of arthritis.

No one thing is for everyone and you should use what suits you best but if you are wondering where to start; start with a wheat bag. They are the only thing that really belongs in a microwave. Several minutes (with an egg-cup of water nearby is best) and it is ready to go. So long as you don't over-heat your wheat bag (you will smell cooking wheat if you do) then you will be able to use it for years.

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Internal Heat

The following are the most effective ways I know of turning up the internal heat and so helping the body to clear stuck heat in a joint or joints. I would hardly imagine successfully treating someone with chronic arthritis without at least one of them but you really have to try things out to know what they can or can’t do for you.

Ginger & Cinnamon

Ginger has a well-deserved reputation for helping with circulatory problems. It is a fascinating herb with a rich history and many therapeutic benefits - you can read a lot more about it here. Ginger was recently been picked up by the pharmaceutical industry as an arthritis treatment but we can harness the benefits of ginger with higher dosages and much lower costs by simply using the fresh root and making a tea. Cinnamon has unique warming properties of its own and is well known for its blood purifying properties and in fact I think it can be a very good arthritis herb in its own right - more about it here. The lemon and honey make the drink more palatable but also have their own health benefits and remember from the section earlier about acidity that lemons are actually very alkaline once they are absorbed!

Ginger & Cinnamon Decoction  
    Chopped Fresh Ginger root
1 large dsp
    Small piece of Cinnamon stick
(approx ¼ or less)
    Squeezed fresh lemon
½
    Honey
1 tsp (or more to taste)
    Water
1 ½ cups

~ Instructions:

Add the chopped ginger with a slightly broken up piece of cinnamon stick to 1½ cups of water. Bring to the boil then gently simmer for about 5-10 minutes. Take off the heat, squeeze in ½ the lemon and then strain through a fine sieve into a cup. You should have reduced the water to less than a full cup. Add the honey and drink whilst it is still hot, you should notice a powerful feeling of warmth spreading through your body.

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Cayenne

Cayenne is the king of heating medicines. I use it a lot in my practice but, like everything, it is not for everyone. This is one of the few times I happily use herbs in a capsule form (generally they are more effective in liquid forms).  I often get people to start with taking 2 Cayenne capsules twice a day and then gradually build up to 4 or even 5 capsules two or even three times a day.  People will often reach their limit before they get to those levels, most commonly they say they just feel too hot in their stomachs, in any case the body reliably gives feedback in one way or another. I tell people that if by misfortune one of the capsules breaks and they get a throat or stomach burn to drink milk or yoghurt but above all to not panic. As painful and burning as it feels, it is not actually ever going to harm your tissues (this is why police can spray Cayenne pepper into people’s eyes with impunity!)

The reason we go up to such high doses is to get the condition to shift. Once the core body temperature has come up and the circulation has been freed there is usually a significant improvement in the arthritic condition. At that time I would suggest going down to a lower daily dose (such as 2 or 3 capsules a day) but watching for things getting worse again as a cue to pick the dose back up.

Whatever you do to heat up has to be kept up. If you stop too soon then you have to expect your body and its joints to get stuck heat again sooner or later. You can read about Cayenne in more detail here.


Capsicum minimum (Cayenne)

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A summary and final thought

Of course there are many other arthritis treatments in the world of natural medicine but what I have described above covers my favourite treatments, the things I have seen help the most.

In summary they are:
~ make sure your mind is truly open to getting better or read as widely as required to get there!
~ carefully consider whether drugs are helping in the long run
~ stop doing anything that might be making you worse
~ consider the need to cleanse your body to some degree
~ consider using some of the great herbal allies for arthritis
~ eat a more alkaline than acidic diet
~ keep up good levels of oil and water
~ keeping the bones warm and the joints moving
~ be prepared to add heat to the fire to help it to work itself out.

I can only imagine that this must all look rather daunting to anyone who is at all new to this kind of medicine. Couldn't this all be a lot easier? Well yes, but that doesn't mean you will get anywhere via trying to take a short cut. Even in the natural health world I have seen a great decline in the holistic approach in favour of simply giving people pills that are presumed to make it all go away without the person having to actually do any work for their health!

I'm afraid that this is simple exploitation on the part of the companies that market a pill for every ill. I think you might temporarily alleviate but you will never cure arthritis without a comprehensive approach that includes diet, movement, warmth, addressing the worsening causes etc.

I want to re-emphasise one absolutely crucial point here at the end of this article. You must patiently treat your arthritis over a long period of time to have any reasonable chance of affecting a lasting cure.

The medical line that arthritis can only be managed and never cured is because all they have to offer is pain-killers and surgery. The idea of helping the fire rather than putting it out is completely foreign to a Western doctor. Likewise there is simply no comprehension of the significance of diet, toxicity, nutrient deficiencies, food intolerances etc...

I very well know that this path is not for everyone but if you who are reading this are prepared to do whatever it takes to get better then you did come to the right place to learn about some legitimate natural treatment options for arthritis and I wish you every strength and patience for what may be a long but also can be a great journey of healing ahead.


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Constitutional Health Note

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as what might potentially help your joints to heal. The great majority of the patients I have personally worked with who have true osteoarthritis have been from the cooler constitutions but, in any case, there is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd